Dr Deborah Lee, Dr Fox Online Pharmacy Tells Us All About Brimonidine Gel As An Effective Acne Rosacea Treatment
If you are suffering from acne rosacea, you will know all about the embarrassment of constant flushing and flushing of the face. So good news – there is an effective treatment known as Brimonidine Tartrate Gel – brand name – Mirvaso Gel.
- What is brimonidine gel?
- How it works?
- Is it effective?
- How should it be used?
Read on and find out.
What is brimonidine gel?
Brimonidine gel is an aqueous gel which contains 3.3 mg of brimonidine per 1 gram of gel. It is a product approved for the treatment of facial redness in adults with acne rosacea.
How it works?
Brimonidine tartrate is a type of medicine that works by blocking specific receptors found in the walls of blood vessels. Receptors are just shapes found in cell walls – much like the sites where the pieces of the puzzle fit together. At a receptor site, a molecule can click on it and do something.
After the gel is applied to the skin, the brimonidine diffuses through the skin and enters the cells. When brimonidine clicks on the alpha-2 adrenergic receptor, it inhibits negative feedback from the neurotransmitter, norepinephrine, causing local concentrations to increase. This causes the small blood vessels in the skin to narrow.
When blood vessels near the surface of the skin constrict, they become smaller in diameter, so blood flow through them is reduced. This means the skin looks paler – the skin is less red and less reddened.
Is it effective?
The National Institute of Health and Care Excellence (NICE) recommends the use of brimonidine gel for people with acne rosacea.
NICE cites two randomized controlled trials, in which the use of brimonidine gel was found to be superior to placebo. In one trial, the success rate with brimonidine gel was 31.5%, compared with 10.9% for placebo. In the second trial, the success rate would be 25.4% for the brimonidine gel, compared to 9.2% for the placebo. These results were statistically significant.
The benefits were seen within 30 minutes of gel application, with maximum effect after 3 hours. The effects lasted 6 hours or more. In fact, there was still a visible effect of using the gel after 12 hours. There was also no increase in the number of inflammatory lesions found on the face, and no worsening of telangiectasias (small dilated blood vessels).
In addition, patients were more likely to be satisfied with treatment after using brimonidine gel than after using placebo.
How should it be used?
Brimonidine gel should be applied to clean, dry skin before applying other rosacea treatments and before any makeup or sunscreen.
A small amount of the gel the size of a pea should be applied to each of the 5 facial regions – forehead, nose, both cheeks and chin. It should be spread over the skin in a thin layer, taking care to avoid the eyes and mucous membranes such as the inside of the nose and mouth. As an alpha-blocker, if absorbed in too high a dose into the bloodstream, it could cause low blood pressure, so apply the gel with care.
After application, you must wash your hands. The gel takes a few minutes to dry on the skin. Other rosacea treatments and sunscreen can be applied to the skin when it is dry.
Brimonidine is only applied to the skin once a day, usually in the early morning.
The most common side effects of applying brimonidine gel to the face are flushing, itching, and stinging or burning. These occur between 1.2% and 3.3% of users.
Other side effects may be present. Flushing is thought to occur in 9.1% of users and worsening rosacea in 3.6%. Contact dermatitis is observed in 2.2%.
Who does not fit?
Because it causes vasoconstriction and therefore reduces blood flow, brimonidine gel is not suitable for people with heart disease, orthostatic hypotension (low blood pressure when standing) or Raynaud’s disease.
There are no studies to show whether brimonidine gel is safe during pregnancy or breastfeeding, in children, or in the elderly.
There is currently no other topical treatment that can help redness on the face. As an alternative, occasionally beta blockers or clonidine may be taken orally.
Brimonidine can be used in addition to other common treatments for rosacea such as metronidazole gel or azelaic acid and oral antibiotics such as doxycycline.
How to get brimonidine gel
Brimonidine gel can be prescribed by your GP or consulting dermatologist. It can also be prescribed and purchased from online pharmacies.
The psychosocial effects of living with rosacea are immense. For people with rosacea, concern about their physical appearance has a major effect on their mental health, leading to loss of self-confidence, loss of self-esteem, anxiety, and depression.
The National Rosacea Society reported that 50% of people with rosacea feel that rosacea has robbed them of a happy life.
If brimonidine gel can help reduce the stigma of facial redness and facial redness, it must be a welcome option.
For more information
DermNet NZ – Brimonidine
The National Rosacea Society – Dealing with Rosacea