Sphenopalatine Ganglion Radiofrequency Ablation for Severe Facial Rosacea Manifestations

BACKGROUND: Rosacea is an inflammatory, persistent erythema that can present under several clinical subtypes. Recently, a neurogenic type of rosacea has been suggested that can be associated with chronic pain and headaches. AIMS: Here we describe a successful interventional treatment for severe, likely neurogenic rosacea associated with severe migraines previously treated using various conservative approaches. MATERIALS AND METHODS: Radiofrequency ablation of the sphenopalatine ganglion (SPG) was completed for the patient's primary chronic pain problem, severe migraine headaches. RESULTS: Completion of the left-sided ganglion denervation resulted in resolution of left facial rosacea symptoms/signs. After the right radiofrequency denervation (about 2 weeks later), rosacea signs/symptoms disappeared from the right side of the patient's face as well. Twelve months following the sphenopalatine radiofrequency ablation, the patient is still rosacea-free. CONCLUSION: A larger case series is needed to assess the efficacy of sphenopalatine radiofrequency ablation in long-term management of the facial subtype of rosacea.