The paper published online on September 5, 2014 in the British Journal of Dermatology (BJD) systematically reveals the possible mechanisms of propranolol treatment in infants and children. At the same time, the authors use examples (pictures) and pathway diagrams to exhaustively illustrate the opportunities and challenges facing propranolol treatment of hemangiomas. Before and after treatment (upper picture: 1 month of propranolol treatment; lower picture, 6 months of propranolol treatment) As the most widely used drug for hemangioma treatment in the world: propranolol hydrochloride, 90% of children with hemangiomas responded well to it, but the mechanism of its action is still unclear: the authors believe that propranolol may antagonize the action of adrenergic analogs in the body, which can cause the periampullary cells of hemangiomas (Hem- peritye) contraction, leading to hemangioma endothelial cell loss (apoptosis + proliferation inhibition); other potential effects include inhibition of hemangioma stem cell differentiation, angiotensin system, etc. However, propranolol use is not without side effects; blood glucose testing is required during use; and drug resistance, relapse, or ineffectiveness occurs in approximately 10% of children. Therefore, exploring the pharmacological mechanisms of propranolol in the treatment of hemangiomas can not only improve the efficiency of treating hemangiomas, but also take means to reduce its potential side effects. Currently, for refractory hemangiomas, drug therapy other than propranolol, such as timolol and atenolol, has been carried out in our outpatient clinic, and from the information of the current follow-up, the efficacy of most of the children is satisfactory. In cases where the above drugs are resistant or ineffective, we use hormonal drugs, which have also achieved good results.