Enhanced skin delivery of propranolol HCl using nonionic surfactant-based vesicles for topical treatment of infantile hemangioma

Infantile hemangiomas (IHs) are frequent neoplasms that consist of proliferating endothelial-like cells. Although oral administration of propranolol hydrochloride (PLH) was proposed for treating IHs, it was associated with several adverse effects. Hence the present study aimed at optimizing the efficacy as well as safety of propranolol niosomes which are topically prepared for treating IHs. Different types of Span and Brij were utilized for preparing niosomes via the use of a thin-film hydration technique. Among the tested types of Span, Span 60 produced the highest EE %, while Brij 52 produced niosomes of higher EE% than Brij 35. Increasing cholesterol levels from 30% to 50% in the prepared niosomes resulted in an insignificant decrease in EE %. Increasing the surfactant concentration from 90 to 180 mu M resulted in increasing in EE%. The measured Zeta potential for the selected formulations was found in the range of -16 to -35 mv, which ensured repulsion forces between the prepared vesicles that prevent their aggregations. The diameter of the vesicles is almost uniform and correlated to Z-size analysis. F14 (Brij 52-based niosomes) produced a more sustained release of PLH as compared to F13 (Span 60-based vesicles). Clinical studies concluded that topical application of the prepared niosomes of propranolol is an effective treatment for superficial and deep IH without the side effects seen with the systemic route. Moreover, dermoscopy is a good non-invasive tool that was very helpful in detecting the type of hemangioma as well as for following the patients under treatment.