Objectives: 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.
Introduction: The therapeutic benefit of BTX in rosacea probably stems from acetylcholine blocking effects targeting arrector pili muscles (reducing pore size) and local muscarinic receptors in the sebaceous glands. Improvement in flushing, erythema and inflammation are attributable to potent blockade of acetylcholine release from autonomic peripheral nerves of the cutaneous vasodilatory system, and inhibition of the release of inflammatory mediators such as calcitonin gene-related peptide (CGRP) and substance P.
Materials / method: Botulinum toxin (BTX) diluted to 10 units/ml is administered intradermally in the hypervascular and telangiectatic centrofacial face as 0.05 ml microdroplet injections with 0.5 cm spacing under topical anaesthesia.. Significant reduction in erythema, edema, telangiectasias, and flushing is apparent within 1-2 weeks. Any remaining papulopustular lesions also show improvement;additiona Botulinum lly a reduction in pore-size is also noticeable within 2 weeks. The improvement lasts for 3-4 months but repeat sessions of BTX Mesotherapy are required once every 4-5 months to maintain the remission
Results: Clinical image after 3 weeks of treatment with intradermally injected diluted botulinum toxin displaying a significant reduction in the erythema, edema, inflammatory lesions as well as inconspicuousness of pores .Sustained clinical improvement appreciable after 3 month.
Conclusion: In conclusion, diluted BTX mesotherapy repeated every 4-5 months is an option to relieve the vascular signs and symptoms of rosacea, although the procedure is limited by the cost, and the need for repeated injections of BTX.
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