Assessment of Efficacy of Intradermal Injections with Botulinum Toxin in Treatment of Facial Erythema in Rosacea Patients.

Introduction: Rosacea is a chronic inflammatory skin disease with symptoms like flushing, telangiectasia, papules, pustules, and persistent erythema. Treatment options include self-care, skin care, and endorsed medicines or light and laser therapy. This study investigates the efficacy of intradermal injection of botulinum toxin in treating facial erythema in rosacea patients. Methods: This randomized single-blinded controlled trial investigated the effectiveness of intradermal botulinum toxin injections in treating facial erythema in 23 rosacea patients aged 18-55 from Damascus Hospital of Dermatology. The right cheek received 10 Units of Botulinum toxin (BTX), while the left cheek received normal saline (NS). Patients were evaluated using the Clinician Erythema Assessment (CEA), Global Aesthetic Improvement Scale (GIAS) and Patient Satisfaction Scale (PSS) for 12 weeks. Statistical analysis was performed using different suitable statistical methods. Results: The study involved 23 patients with type 1 rosacea, mostly females and married, with a median age of 40.43. Improvement in CEA and GAIS was observed in both cheeks during subsequent visits, with no significant difference between the two cheeks. Patients reported positive effects throughout the study, which increased from 59.26% in the first visit to 70.37% in the last visit. Patient satisfaction increased from 56.5% to 73.9% between the first and last visits. Side effects were observed in some patients during the study, but there were no serious adverse events. Conclusion: Rosacea is a challenging condition to treat, and current options can be limited and costly. This study found that BTX and normal saline had a similar effect on facial erythema, and aesthetic benefits suggesting micro-needling may have greater impact on rosacea patients. Furthermore, micro-needling treatment, which has been effective in treating various dermatological conditions, can also be utilized as a treatment option for rosacea patients. Micro-needling may be a low-cost alternative to BTX.