Intradermal Microdroplet Injection of Standard-Diluted Incobotulinumtoxin A for the Treatment of Erythematotelangiectatic Rosacea: A Study From a Dermatology Center in Medellín, Colombia.

[BACKGROUND] Most previous studies of botulinum toxin A (BoNT/A) use for rosacea have reported using hyperdiluted BoNT/A. Different dilutions than the standard practiced dilution for wrinkle treatment result in confusion, especially if there is more than one injector in an office because daily logistics become complicated.

[OBJECTIVE] To evaluate the safety and efficacy of the use of intradermal injections of incobotulinumtoxin A (INCO) in the standard dilution used for wrinkle treatment (100U vial in 2cc) for the treatment of erythematotelangiectatic rosacea (ETR).

[METHODS] Data from 13 patients with ETR treated with INCO were prospectively collected in this single-center, open-label preliminary study. Patients answered the Rosacea-specific Quality-of-Life instrument (RosaQol) questionnaire, and a non-treating blinded dermatologist evaluated the Clinician Erythema Assessment (CEA) score using a five-point grading scale at baseline and 15-day and three-month follow-ups.

[RESULTS] A significant decrease occurred in the total RosaQoL score at 15-day and three-month (p<0.001) follow-ups compared to baseline. Baseline CEA score was considered moderate (84.6%) or severe (15.4%). Most patients were assessed as almost clear or mild at the 15-day and three-month follow-ups (99.3% and 88.9%, respectively).

[CONCLUSION] Standard 2mL dilution INCO, used for aesthetic indications, may be a safe and effective option for treating ETR-related erythema and flushing.