Botulinum toxin for the treatment of erythema and flushing of rosacea with two different techniques: intradermal injections and facial electroporation

INTRODUCTION: Facial erythema is a frequent and often distressing complaint in patients with rosacea. Botulinum toxin has been proposed as a treatment of facial erythema with relatively good results.
OBJECTIVE: This study aims to assess botulinum toxin’s safety and efficacy in a split-face trial in two different administration modalities: intradermal injections on one side of the face and facial electroporation on the other side.
MATERIALS AND METHODS: The trial enrolled 20 subjects aged between 25 and 75 years with erythematotelangiectatic rosacea. Subjects received five units of Botulinum toxin through intradermal injections on the right side of the face. The same amount was introduced through electroporation technique on the left side. We conducted the evaluation using a standardized erythema grading system (System Vectra) and digital photographs at baseline, 2, 6, and 12 weeks.
RESULTS: The effectiveness in reducing the erythema of botulinum toxin with both the injection and electroporation was evident from the second week and persisted until week 12. Both techniques were effective.
CONCLUSIONS: Intradermal injection of botulinum toxin and electroporation seems both effective and safe for treating erythema related to rosacea. The mechanism of action is still controversial.

Keywords: Erythema; Mesotherapy; Botulinum Toxins, Type A