Topical Treatments

  • What is it and how does it work?
  • Who is it for?
  • Who is it not for?
  • How well does it work?
  • What are the possible side effects?
  • Will it inconvenience me?
  • How much does it cost?

Topical Treatments

What is it and how does it work?

Alpha adrenergics (Brimonidine and Oxymetazoline)

These narrow blood vessels (vasoconstriction) to temporarily reduce blood flow to the skin surface, leading to less facial redness.

Who is it for?

Mild to severe facial redness.

Who is it not for?

Some people are sensitive to brimonidine. Caution for those with heart conditions, depression, certain eye conditions (glaucoma), and conditions with dry eye and mouth (Sjögren syndrome). Check with your health care professional to make sure this treatment is right for you.

How well does it work?

There is good evidence that these medications have a 2 times greater chance of reducing redness compared to no active treatment. However, only about 40% of patients respond to brimonidine and about 22% respond to Oxymetazoline. (High certainty evidence for brimonidine, moderate certainty evidence for oxymetazoline.)

What are the possible side effects?

Serious: None

Other:

  • Brimonidine: Flushing, erythema, acne vulgaris, skin allergic reaction, pain, blurred vision, nasal congestion.
  • Oxymetazoline: Irritation, redness or pain at applied sites and worsening of rosacea.

Pregnancy:

  • Brimonidine: Category B
  • Oxymetazoline: No risk category assigned as no data on use of this drug in pregnant women. However, eye drop solution was pregnancy category.

Will it inconvenience me?

Topical inconvenience (Reminders for application are required. Time is required for proper application of topical treatments.)

How much does it cost?

$$$$. Cost is based on price without insurance and may vary.