Treating rosacea with botulism toxin: Protocol for a systematic review and meta‐analysis

Abstract Background Rosacea is a chronic inflammatory disease usually associated with persistent erythema and periodic flushing. This disease is difficult to treat, and the outcomes are often unsatisfactory and prone to recurrence. In recent years, botulinum toxin has been used as a new treatment for rosacea; however, its efficacy and safety remain under discussion. Although a systematic review of the effectiveness and safety of botulinum toxin has been previously conducted by other researchers, our systematic review and meta‐analysis evaluate the efficacy of botulinum toxin from a more comprehensive and detailed perspective to provide evidence for clinicians. Methods Any study using botulinum toxin for the treatment of rosacea was considered for the analysis. Results A total of 22 studies were included, 9 of which were randomized controlled trials involving 720 subjects. After treatment, all studies showed varying degrees of improvement in patient signs and symptoms along with reduced Clinician's Erythema Assessment (CEA) scores. The improvement was maintained for several months, and the adverse effects were mild and self‐limiting. Conclusion Botulinum toxin may be an effective treatment for patients with rosacea; however, further clinical evidence is needed to confirm its long‐term efficacy and side effects. The study was preregistered with Prospero (CRD42022358911).