Muscle Relaxant injections (BoNTA) as a possible treatment in the management of Rosacea

Rosacea is a common skin condition mainly affecting adults between the ages 30-50. It is more common in women. We know that the cause of Rosacea is due to multiple factors but most will have a strong inflammatory component.

The condition can be divided into several subgroups:

Those with redness, flushing and thread veins. (erythemato-telangiectatic)

Those with acne like spots (papulo-pustular)

Those with thickening of the skin, in particular affecting the nose (rhinophyma)

Those with eye symptoms such as dryness and soreness

Not all symptoms occur in all cases and most commonly the symptoms are on the face: on the cheeks, forehead, nose, around the mouth and chin. The main symptoms in the first group are burning, sensitivity, and flushing aggravated by a change in temperature, emotional factors , hot spicy food and alcohol.

The management of Rosacea may involve the use of antibiotics orally or topically e.g. oral Efracea, which is a low dose slow release formulation of Doxycyline; topical Metrogel and Rozex cream (both forms of Metronidazole) are popular prescription choices. Topical azelaic acid (such as Finacea gel, a 15% formulation) can also be of benefit. More recently, the introduction of Brimonidine 0.33% topical gel (Mirvaso) has helped in the temporary management of facial redness in some cases. Light-based therapies such as Laser and Intense Pulsed Light (IPL), have been effective options for managing the facial redness, telangiectasia and papules for quite a few years now and can provide effective long lasting symptomatic relief.

Botulinum Toxin (BoNTA) was suggested as a possible therapeutic option in the management of Rosacea after anecdotal reporting of improvement of flushing and redness. It has also been reported to reduce sebaceous gland hyperactivity and pore size.

In the small number of papers describing this treatment, it is suggested about 1/3 will find it very helpful, 1/3 will find it of some use and 1/3 will not benefit. It usually takes 2-4 weeks for it to take effect and the benefit can last 4-6 months, sometimes longer.

Therefore BoNTA is a useful consideration in the management of Rosacea, in particular for redness and for flushing symptoms. This is a prescription only medicine. Combination therapy using lasers/IPLs and prescribed medication can usually yield the best results.beforeafter_erythema

If you would like to find out whether BoNTA, lasers and IPLs could benefit your symptoms, call us on 01227 472288 to make an appointment. We are the Skin specialist clinic with doctors with many years experience in the use of lasers, IPLs and Botulinum toxin injections and hence are best placed to give you the most up to date advice and prescriptions appropriate to your needs.