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

There are several types of rosacea, and there is no cure for any of them; however, there are treatments to maintain/lessen the severity of the condition 

1) "red" rosacea, characterized by easy flushing and discomfort - Small quantities of botox (or other neuromodulators) injected into the skin may help reduce flushing.  Also important, and more standard types of treatments, include: vigilant sun protection,  gentle skin care products, avoiding triggers for flushing (eg heat, spicy food, red wine), IPL.  In some patients, prescription medications can be of added benefit.

2) papular rosacea, characterized by redness and pimples - medications such as oral doxycycline and topical metronidazole or azeleic acid are usually very helpful.

3) ocular rosacea, characterized by dryness or foreign body sensation of the eye - doxycycline is of most use here, as is being evaluated by an opthalmologist

4) phymatous rosacea - this is a disfiguring form of rosacea, and unfortunately, this is quite difficult to treat

There was a study published in the JDD that showed that botulinum toxin A could help with Rosacea with no adverse events, but one should exercise caution on where it is placed to avoid problems with animation and facial function.  The best thing, and obviously the gold-standard is a treatment with either a pulsed dye laser or IPL in the hands of an experience board-certified Dermatologist and laser surgeon. Good luck.

I would discuss this with your dermatologist if you haven't already, for their expertise in this area. Without knowing your full health history and understanding what previous treatments were done, it's very difficult to answer this question.

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.