Intralesional corticosteroids are one preferred method for treating small localized infantile hemangiomas because of efficacy in halting proliferation and minimal systemic side effects. Although often efficacious, this procedure is uncomfortable for infants. We describe the successful use of an oral 24% sucrose solution given via needleless syringe to the anterior tip of the tongue or in combination with a pacifier as an analgesic during intralesional injection of infantile hemangioma. Options for anesthesia in this young age group include topical prilocaine/lidocaine, injectable lidocaine, and parent soothing. Most often, topical or intralesional anesthesia is deferred when treating hemangiomas of infancy with intralesional corticosteroids. We use oral sucrose as a compassionate option.
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