Would Botox Be Worth a Try to Stop Rosacea Flare Ups on my Cheeks/nose, Since Ive Tried Everything Else?

Acetylcholine is a major neurotransmitter that is released by certain types of nerves (sympathetic, parasympathetic, and sensory nerves). After being released from nerve endings, acetylcholine can bind to sweat glands (resulting in sweat formation), and blood vessels (resulting in dilation). Lately, there has been extensive research into the role of acetylcholine in nerve-mediated disorders, especially those that are accompanied by skin flushing and sweating.

 

Neuromodulators, like Botox, Dysport and Xeomin are extremely effective at blocking the release of acetylcholine from nerve endings in the facial skin 

There is recent clinical evidence indicating that skin flushing to internal body heating can be completely abolished by skin injections of Botox. One study showed that Botox injections into normal human skin completely blocked skin flushing caused by increases in internal body temperature. The same study also suggested that Botox may block other dilator neurotransmitter substances that may be co-released with acetylcholine. Neuromodulators will have little effect on pimple and pustule breakouts or in eliminating preexisting telangiectasias (broken blood vessels).

For this reason, it is certainly worth a try to inject tiny droplets in a gridlike pattern across the cheeks and other areas that are prone to flushing. This may be used alone or in combination with the topical use of oxymetazoline or brimonidine solutions, which also have been shown to diminish flushing in some patients. Neuromodulators should only be injected in this fashion by board certified dermatologists who are thoroughly experienced in their use for all other conventional purposes.

I am not aware of Botox being used to help with Rosacea.  Botox works by weakening muscles that can cause lines or furrows, and in some cases muscle spasm.  Rosacea is not related to muscle movement, so I don't think Botox would affect it.