TOPLINE:

In a randomized, double-blind trial of patients with erythematotelangiectatic rosacea (ETR), transcutaneous auricular vagus nerve stimulation (taVNS) for 3 weeks significantly reduced facial erythema, flushing, anxiety, depression, and fatigue compared with sham stimulation, with effects lasting 24 weeks after treatment.

METHODOLOGY:

• Researchers conducted a single-center, randomized, double-blind, sham-controlled clinical trial of 72 adults (mean age, 29.5 years; 93.1% women) with ETR and Clinician Erythema Assessment (CEA) scores ≥ 2 from February 2024 to August 2024 in China.
• Participants were randomly assigned in a 1:1 ratio to receive either taVNS (30 Hz frequency and 200 μs pulse width for 30 minutes daily) or sham stimulation for 3 weeks, followed by 24 weeks of follow-up.
• The primary outcome measure was the CEA score after 3 weeks of treatment; secondary outcomes were patient-reported improvements in erythema, facial flushing, sleep disorders, migraine, anxiety, fatigue, and depression.

TAKEAWAY:

• After 3 weeks of treatment, the taVNS group showed significantly lower mean CEA scores than the sham stimulation group (mean difference [MD], -0.92; P < .001).
• taVNS therapy also demonstrated significant reductions in patient-reported flushing (MD, -2.36; P < .001), erythema (MD, -0.97; P < .001), anxiety (MD, -5.42; P < .001), depression (MD, -6.22; P < .001), insomnia (MD, -7.93; P < .001), fatigue (MD, -17.77; P = .002), and facial migraine scores (MD, -2.42; P < .001).
• The benefits persisted throughout the 24-week follow-up period, with consistent improvements across all outcomes.
• Treatment-emergent adverse events were reported in 5.6% of participants in the taVNS group and 8.3% in the sham stimulation group; most were mild and spontaneously resolved within 1-5 days.

IN PRACTICE:

“Our findings demonstrated that taVNS rapidly improves cutaneous symptoms and systemic comorbidities, with sustained remission being observed during a 24-week follow-up period, and that adverse events were uncommon,” the study authors wrote. These results, they added, “position taVNS as a novel and cost-effective therapeutic option for ETR management.”

SOURCE:

The study was led by Jian Li, PhD, Department of Dermatology at The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China, and was published online on October 8 in JAMA Dermatology.

LIMITATIONS:

This was a single-center study with a modest sample size. The sham group could not replicate sustained cutaneous sensations. Patient-reported outcomes could have introduced expectation bias.

DISCLOSURES:

This study received funding from the Chongqing Health Commission, Southwest Hospital, and Army Medical University. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.