Abstract： Rosacea is a chronic inflammatory disease that occurs in the midface,the pathogenesis of which remains unknown.Persistent facial erythema and episodic facial flushes are challenging problem to treat.Botulinum toxin A applied extensively clinically in cosmetic dermatology.Recent studies have confirmed that it could be applied to the rosacea,which provide a new option for clinicians.However,there is no consensus on the mechanisms,indications,specific treatment options,efficacy,safety and the combination therapy regimens of botulinum toxin A treatment in rosacea.In this review,we update the recent progress on botulinum toxin A in the treatment of rosacea and explore the existing problems and challenges.The search for a more ideal and high-quality regimen yet continued.