Long-term management of distinct facial flushing and persistent erythema of rosacea by treatment with carvedilol

Background: The treatment of persistent erythema and flushing episodes in patients with rosacea remains a clinical challenge. A possible therapeutic option could be the use of antihypertensive drugs. Objectives: We therefore evaluated the effect of the non-selective beta-blocker carvedilol in five Caucasian patients. Methods: In a monocentric retrospective case study, the patients were treated with carvedilol titrated up to 12.5mg twice a day over at least six months. Patients self assessment (PSA), clinicians erythema assessment (CEA), and the patients levels of embarrassment and satisfaction were performed by questionaires. Results: The CEA grade description as well as the PSA grade description decreased remarkably in all five patients. Furthermore, all patients reported to have a major improvement of their level of satisfaction and no feelings of embarrassment anymore. Conclusions: These findings demonstrate that facial flushing and persistent erythema can be effectively treated by carvedilol long-term with a fast onset of improvement in a dose well tolerated.