28 year old woman with redness and flushing of the face. Intermittent papules, but mostly redness. Gets worse with heat, coffee, red wine, spicey foods and emotional situations. The condition has been worsening over the past 3 years. Mother and older sister have a similar condition.
What’s your diagnosis?
Discussion: The patient was treated with a compounded formula of Oxymetazoline (0.05%) and Metronidazole (0.75%) in a moisturizing cream base. The patient applied the formulation twice daily with excellent results, controlling the redness and progression to her satisfaction.
The “after“ photograph was taken 1 hour after the initial application.
Oxymetazoline is a vasoconstrictor used in several over-the-counter decongestant nasal sprays.
In my experience it works very well to decrease erythema, immediately and short term, and the metronidazole works well to slow progression of the overall condition.
In the several patients that have used this compounded formulation, none have experienced any reliance or rebound issues noted with oxymetazoline containing nasal decongestants.