Mesotherapy with botulinum toxin for the treatment of refractory vascular and papulopustular rosacea

Although treatment with topical and systemic antibiotics, azelaic acid, isotretinoin, tranexamic acid, chemical peels, and intense pulsed light therapy may significantly improve the papulopustular component of rosacea, in some patients the vascular symptoms of persistent erythema, mild edema, flushing, and telangiectasias tend to persist (Fig 1, A).