Efficacy of Topical 2% Carteolol in the Treatment of Infantile Hemangiomas: A Dermoscopic and Clinical Evaluation

Background Infantile hemangiomas (IH) are the most common benign vascular tumors in infants, often requiring treatment in 10–15% of cases due to complications. While systemic propranolol is the first-line treatment, its potential for systemic side effects raises interest in topical therapies. This study investigates the efficacy of topical 2% carteolol in treating IH and its dermoscopic changes over time. Methods A total of 15 patients with IH were treated with topical 2% carteolol drops applied twice daily for 3 months. Clinical and dermoscopic images were captured at baseline, 1 month, and 3 months. Dermoscopic features such as erythema, clods, coiled vessels, dotted vessels, and others were evaluated. Visual Analog Scale (VAS) scores were used to assess treatment response. Results The most frequent dermoscopic findings at baseline were coiled vessels, followed by serpentine and dotted vessels. At 1 and 3 months, significant improvements were observed, with reductions in erythema and coiled vessel scores (p < 0.05) and at 3 months with reductions in clod score (p < 0.05). The skin-colored structureless area significantly increased, indicating lesion regression (p < 0.05). VAS scores showed a significant decrease over the 3-month period, with a positive correlation between baseline dotted vessel scores and treatment response (r:0.656, p:0.008). Conclusions Topical 2% carteolol is an effective and safe treatment for IH. Dermoscopic monitoring provides valuable insights into treatment progression, showing significant changes in erythema, clod, and vascular patterns. The presence of dotted vessels at baseline may serve as a predictor of a favorable treatment response. Further studies with longer follow-up are needed to validate these findings.