Rosacea Erythema — SCE Dermatology MCQ

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EasyInflammatory DermatosesRosacea ErythemaSCE Dermatology

A 35-year-old woman has rosacea with persistent background erythema of her central face. She asks about a topical treatment specifically targeting the facial redness. What topical agent addresses rosacea-associated erythema?

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Correct answer: E — Topical Brimonidine 0.33% gel (an alpha-2 adrenergic agonist causing vasoconstriction)

Topical Brimonidine 0.33% gel (Mirvaso) is specifically designed to address persistent background facial erythema (redness) in rosacea through alpha-2 adrenergic agonist-mediated cutaneous vasoconstriction. It provides visible reduction in erythema within 30 minutes, lasting approximately 12 hours. However, rebound erythema (paradoxical worsening after wearing off) has been reported in some patients and should be discussed during counselling. Topical Oxymetazoline is an alternative vasoconstrictive agent. These treatments address erythema specifically — they do not treat papulopustular disease (which requires topical Ivermectin, Azelaic acid, or Metronidazole). Vascular laser/IPL is the definitive treatment for persistent telangiectasia.

Reference: BAD 2021 Rosacea Guidelines; NICE