Yet another use for Botox:
Rosacea is an extremely common and frequently frustrating skin condition. For all those that suffer from the redness and flushing that accompanies rosacea, also called erythematotelangiectatic rosacea, a novel and impressively effective therapy is again in the news, Botox.
In a recent study published in Dermatologic Surgery. Intradermal injections of Botox were found to be safe and effective in treating the facial redness of rosacea.
In the study multiple injections were performed “intradermally” and the amount used ranged from 15-45 total units. Unquestionably, patients noticed decreased flushing, erythema (redness), and inflammation within one week. The results persisted 3-6 months.
Even though the injections of Botox were placed into the cheeks, none of the study patients experienced any weakness or relaxing of the smile or cheek muscles. This may be secondary to the amount and, more likely, the location in which the product was placed. Botox when used to treat wrinkles is not injected intra-dermally, but deeper, either sub-dermally or intramuscularly.
Botox blocks the release of the neurotransmitter acetylcholine, which plays a role in local vascular control. It should be noted however that neurovascular regulation is much more complex than simple acetylcholine release. Thus, there have also been case reports of this treatment approach being ineffective in some patients. This illustrates the complexity of the condition.
For those of you that suffer from rosacea, you know that there are very few treatment options to truly target the redness that accompanies rosacea. A newer topical medication called Mirvaso, targets the redness by constricting the superficial blood vessel in the skin and can do a great job in a temporary fashion, but I have seen mixed results in practice and have my own concerns about the product. And then of course there are lasers.
Laser therapy remains the gold standard for the treatment of erythematotelangiectatic rosacea. They just work. Unfortunately since they are not covered by insurance in the vast majority of cases, these options may not be talked about enough with patients suffering from the disease.
Botox for rosacea represents a new and interesting application of a surprisingly complex medication. And it is always nice to have options in medicine. If you suffer from rosacea, consider laser or Botox. You will be pleased.