This Surprising New Treatment for Rosacea May Offer Major Relief

Rosacea is one of the most stubborn skin conditions because there's no cure and it involves a lot of trial and error to find the right products and treatments to manage it. But because it affects nearly 14 million people in the U.S. alone, dermatologists are always looking for possible cures and answers to get rid of rosacea once and for all.

Typical in-office treatments for rosacea include lasers and light-based procedures, but as Refinery29 reports, neuromodulators (think Botox Cosmetic, Dysport and Xeomin) are now being added to the list of options for reducing frustrating flare-ups (off-label). Tiny amounts of the neuromodulators can be injected into superficial layers of skin, which may help hinder the blood vessels' ability to dilate (a cause of redness and inflammation). 

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"There is some evidence collected over the years that neuromodulators injected into the skin more superficially, can have a dramatic effect on the redness associated with rosacea," explains Nashville, TN, dermatologist Michael Gold, MD. "It is not a permanent effect, but many have seen and shown effects that can last several weeks or even a month or two." 

"I do think this treatment works for rosacea, but only the burning, stinging types," says Montclair, NJ, dermatologist Jeanine Downie, MD. "This is because the burning is histamine-induced (histamine is what surges when an insect bites you). When blood vessels dilate (like in rosacea), that is histamine as well, and the neuromodulators mitigate the effects."

If you do consider opting for this treatment, Dr. Gold says it's important to seek a skilled injector who is board-certified. "Care must be given when doing these injections. If the neuromodulator is injected deeper than what is needed to address the redness, the patient may experience a droop or loss of use of that treated area. It's not permanent, but it's not something you don't want to happen."

Dr. Gold says that although this treatment isn't really common right now, hopefully we will see some good clinical trials that can support the claim moving forward. "There are numerous uses for neuromodulators that we still have yet to explore. These are some of the most exciting molecules that have crossed into our specialty, and with care and proper guidance, they can have profound effects on our patients—all for the positive."

1 Comment
  • Posted on

    This is a very interesting article as it addresses yet another little understood role for neuromodulators. I must say, however, for me this particular use of toxins falls into the category of "last resort" options. While it is true that rosacea can never be "cured" in the traditional sense of the word, it certainly can be controlled with the correct regimen. In fact, I would venture to say that is the same idea and approach that would be used when considering neuromodulators for the treatement of rosacea - this is a control tactic and something that must be repeated indefinitely or the effect may be lost. Therein lies the issue; we must use our best judgment when recommending strategies and tactics for the chronic management of intractable conditions to our patients. In my own experience, very few cases of rosacea are so unmanageable that control can't be achieved with proper restoration of the skin's barrier function, control of sebum, stimulation of proper dermal repair and skin cell turnover, and avoidance of irritants and exposures that contribute to flare-ups. This can primarily be achieved with the right topical agents, and it is incumbent upon each practitioner to find that combination of products to recommend. It is much more economical, less risky, and I think overall effective to regularly apply topical agents to control rosacea long term than to drive people into a unending regimen of injections every few months to control their skin condition. For those cases that are refractory to a more conservative approach, we may be forced to consider that use of toxins as a last resort when all else fails, and if anything. This is the value that this article and this idea bring to me. Neuromodulators are great for weakening muscles as a first line approach - we all use them for this because there are no better options to achieve the same results. I doubt we'll see a huge increase in the volume of toxin use because of its effect on rosacea; or at least I personally don't think we should.