FCP 13 : Efficacy and safety of botulinum toxin a injection in recalcitrant erythematotelangiectatic rosacea: a pilot study

Background: There are few pharmacologic options to reduce erythema and flushing in patients with recalcitrant erythematotelangiectatic rosacea (ETR). Development of a novel therapeutic approach to ETR is required. Objectives: This study aimed to investigate the efficacy and safety of intradermal botulinum toxin injection as an aid in persistent erythema of rosacea patients. Methods: A total of 20 Korean patients with recalcitrant ETR were enrolled to receive treatment by injection of botulinum toxin. Patients received one treatment of intradermal botulinum toxin injection and were assessed 1, 2, 4 and 8 weeks after treatment. The severity of erythema and telangiectasia was investigated by a non-treating physician, and the erythema index (EI) was assessed by mexameter at each visit. Patient's satisfaction and any adverse events were also assessed at each visit. Results: Intradermal injection of botulinum toxin significantly reduced erythema severity and EI in ETR patients. Patients reported a satisfaction score of 2.94 in mean 5-point scale at 8 weeks after treatment. Patients participating in the final analysis did not report side effects except injection pain and temporary facial muscle paralysis. Conclusion: Intradermal injection of botulinum toxin can be used as an effective and relatively safe adjuvant agent for recalcitrant and persistent erythema of ETR patients.