Botulinum toxin for the treatment of refractory erythema and flushing of rosacea.

BACKGROUND Persistent erythema and severe rosacea flushing can cause significant physical discomfort and emotional stress to patients. Currently, no satisfactory treatments are available. METHODS We report two cases of refractory flushing and erythema of rosacea that were successfully treated with intradermal botulinum toxin injections. RESULTS Good cosmetic results were achieved for both patients. The side effects during and after treatment were mild pain and localized bruising; these symptoms resolved within several days without further treatment. CONCLUSION Intradermal botulinum toxin injection may be an effective treatment for refractory erythema and rosacea flushing that deserves further study in a larger patient population.