Targeting Neurovascular Inflammation in Rosacea: A Systematic Review of Botulinum Toxin Therapy

Rosacea is a chronic inflammatory dermatosis characterized by persistent erythema and episodic flushing, often associated with suboptimal treatment outcomes and frequent recurrence. Botulinum toxin has recently been proposed as a novel therapeutic modality in its management. This systematic review evaluates the current evidence regarding the efficacy and safety of botulinum toxin in patients with rosacea. A comprehensive search of major electronic databases was conducted to identify relevant studies assessing its clinical application. Overall, the available literature suggests that botulinum toxin is associated with improvements in clinical signs and symptoms, particularly erythema, with effects sustained for a variable duration. Reported adverse events were predominantly mild and self-limiting. However, interpretation of these findings is limited by small sample sizes, heterogeneity in study design, and relatively short follow-up periods. Further high-quality, standardized studies are required to better define its role in routine clinical practice.