Oral medication or light-based therapies for persistent erythema and flushing in rosacea may be ineffective in some cases.

Studies with large samples and long-term observations have not been conducted to determine the effectiveness and safety of intradermal botulinum toxin-A injection for intractable erythema and flushing.

This study aims to investigate the effective duration and safety of intradermal BTX-A injection for intractable erythema and flushing.

The improvement after intradermal BTX-A injection for intractable erythema and flushing usually lasts for 3–6 months, but the effect decreases significantly at 6 months.

BTX-A significantly improves the symptoms and quality of life of patients with refractory rosacea with few adverse effects.