1 Crawford G.H.

Pelle M.T.

James W.D. Rosacea, I: etiology, pathogenesis, and subtype classification.

2 Wilkin J.

Dahl M.

Detmar M.

Drake L.

Liang MH.

Odom R.

Powell F. Standard grading system for rosacea: report of the National Rosacea Society expert committee on the classification and staging of rosacea.

3 Craige H.

Cohen J.B. Symptomatic treatment of idiopathic and rosacea associated cutaneous flushing with propranolol.

3 Craige H.

Cohen J.B. Symptomatic treatment of idiopathic and rosacea associated cutaneous flushing with propranolol.

4 Hsu C.C.

Lee J.Y. Carvedilol for the treatment of refractory facial flushing and persistent erythema of rosacea.

To the Editor: Rosacea is a common facial disorder characterized by centrofacial erythema, flushing, telangiectasia, edema, papules, and pustules.Treatment of erythematotelangiectatic rosacea (ETR) with severe facial flushing and persistent erythema remains challenging despite some successes with β-adrenergic blockers,clonidine (α-adrenergic agonist), naloxone (opiate antagonist), ondansetron (serotonin antagonist), and endoscopic thoracic sympathectomy. Traditional β-blockers nadolol and propranolol (20-40 mg, 2-3 times a day)can suppress flushing reactions, but the side effects of hypotension and bradycardia may pose problems because most patients are normotensive. Carvedilol, a nonselective β-adrenergic blocker with α1 blocking activity and potent antioxidant activity, is indicated in treating mild to moderate congestive heart failure. We have recently reported a case of refractory ETR successfully treated with carvedilol.In this report, we present the results of carvedilol therapy in a case series.