Mirvaso Rebound Flushing

Brimonidine (Mirvaso) can be effective for temporarily reducing the redness seen with rosacea, however for a significant proporiton of patients it can cause rebound flushing which results in greater redness than previously as it wears off.

Why it happens

Brimonidine works by constricting the small blood vessels in the face. When it wears off after several hours, these vessels don't just return to their normal dilated state; they can overcompensate and dilate even more widely than before. This results in a sudden, intense, and often burning flush that can be significantly worse than the original baseline redness.

How to taper or switch safely

If you are experiencing rebound flushing from Mirvaso, do not stop it abruptly, as this can worsen the rebound. The best approach is a very slow taper. Reduce the amount you use and apply it less frequently over several weeks. This allows your blood vessels to gradually readjust. During this time use gentle skincare. This can be combined with medical treatments for rosacea. Switching to oxymetazoline (Rhofade) may also be an option for some patients.

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Dr. Magnus Lynch, Consultant Dermatologist

About Dr Magnus Lynch

I am a London-based Consultant Dermatologist and Dermatological Surgeon. I am highly experienced in skin cancer diagnosis, Mohs micrographic surgery, acne, rosacea, acne scarring and laser treatments. I studied at the Universities of Cambridge and Oxford, and completed my dermatology training and Mohs fellowship at the prestigious St John’s Institute of Dermatology. I graduated from medical school in 2003 and have worked exclusively in Dermatology since 2012.

I lead a research team at King’s College London investigating the molecular biology of skin cancer. In recent years I have been involved in Media Appearances, including the Channel 5 series 'Skin A&E', where I perform skin surgeries and treat various skin conditions. Filming for the next series has recently completed and the series will be released later in 2025.

My NHS practice is at Guy's Hospital. I consult with private patients at the London Bridge Hospital, OneWelbeck (near to Bond Street station) and on Harley Street. A new consultation is £250. Book A Consultation.

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