Oxymetazoline (topical)

Also known as: Rhofade (brand), alpha-1A adrenergic agonist

Dermatology

In plain English

Oxymetazoline cream reduces the persistent facial redness (flushing) of rosacea by temporarily tightening small blood vessels in the skin. It treats the redness itself, not the bumps, and its effect lasts through the day with once-daily use. Some people notice redness returning or slightly worsening as it wears off.

The science

Oxymetazoline is a selective alpha-1A adrenergic receptor agonist that causes cutaneous vasoconstriction, reducing the background erythema of rosacea; it is FDA-approved as a 1% cream for persistent facial erythema. The Cochrane and JAMA rosacea reviews support topical alpha-agonists (oxymetazoline, brimonidine) as effective for the erythema component, distinct from treatments for inflammatory lesions.

References

• van Zuuren EJ et al., Cochrane Database Syst Rev 2015 (interventions for rosacea, incl. alpha-agonists)
• van Zuuren EJ et al., Interventions for rosacea (summary), JAMA 2015