A randomized, controlled, split-face study of topical timolol maleate 0.5% eye drops for the treatment of erythematotelangiectatic rosacea

Background: Centrofacial erythema associated with telangiectasis is the most common presentation of rosacea, known as erythematotelangiectatic rosacea (ETR). However, successful management of these symptoms remains challenging. Aim: The purpose of this study was to evaluate the efficacy and safety of topical timolol maleate eye drops 0.5% for ETR. Methods: In this randomized, single-center, single-blind, placebo-controlled split-face study, 16 patients with mild-to-moderate ETR who presented at West China Hospital between January 2019 to September 2020 were randomized to receive either topical timolol maleate eye drops 0.5% to one side of their face daily for 28 days and normal saline to the other side of the face. Patients were assessed with both the Clinician Erythema Assessment (CEA) and Patient Self-Assessment (PSA) at the 28-day follow-up appointment. Subjective assessment was performed by asking participants to grade their sensation of warmth and burning. Results: The sides treated with timolol demonstrated a significant improvement in both the CEA and PSA at the 28-day assessment. Patients reported a significant difference in warmth and burning sensations. The only adverse reaction was worsened redness on both sides of the face at Day 1 in one patient. Conclusions: In this small study, the application of topical timolol maleate was safe and effective for the treatment of ETR.