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27 year old woman with a 5 year history of rosacea and emotional facial flushing. Topical metronidazole products initially were marginally effective, but over the past year have lost their effect.
What is your diagnosis?
Diagnosis: Rosacea
In this case we recommended that she use brimonidine gel, 0.33% (Mirvaso). Brimonidine gel, 0.33% did well to control the redness and flushing. It took
approximately 1.5 hours to take full effect. Unfortunately for her it only lasted for about 6 hours. We had her mix Mirvaso 1:1 with a compounded formula of: metronidazole 0.75%, Oxymetazoline0.05% in a vehicle/base of Cerave lotion.
This mixture, described above, provided 12-14 hour results. See pictures for details.
Image 1
Before any treatment
Image 2
2 hours after treating; right face 1:1 mixture Brimonidine gel, 0.33% 1:1 with a compounded formula of: metronidazole 0.75%, Oxymetazoline0.05% in a vehicle/base of Cerave lotion on the right side of face, Brimonidine gel, 0.33% to the left side of face
Image 3
6 hours after treatment, Brimonidine gel, 0.33% alone on left face starting to wear off, compounded mixture still working on right side of face.
Image 4
10 hours after application of compounded mixture (metronidazole 0.75%, Oxymetazoline0.05% in a vehicle/base of Cerave lotion
)to full face
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