Question 1

What is Mirvaso?

Accepted Answer

Mirvaso is a prescription-strength topical treatment that's approved by the Food & Drug Administration (FDA) to treat rosacea. Its active ingredient, brimonidine tartrate, works by temporarily narrowing the blood vessels in the face, which slows blood flow and minimizes skin redness.

While it works best to treat permanent (nontransient) rosacea, Mirvaso isn’t a permanent solution: facial redness returns once the cream or gel has worn off.

An open-label clinical study (funded by its manufacturer, Galderma Laboratories) of patients with facial erythema of rosacea, or skin redness, found that it worked within 30 minutes of application, and its effects lasted up to 12 hours.

You must be at least 18 years of age to use Mirvaso.

Question 2

What are the pros and cons of Mirvaso?

Accepted Answer

Pros

It’s fast-acting. Mirvaso begins constricting blood vessels and dialing down facial redness within minutes of application.
It’s affordable, compared to other rosacea treatments. Lasers or IPL treatments provide longer-term solutions, but Mirvaso is available at a considerably lower price point of $100, on average—versus the hundreds or thousands you might pay for a series of laser or IPL treatments. Mirvaso may also be covered, at least partially, by insurance.

Cons

It’s temporary. Think of Mirvaso like a girdle for your blood vessels: it constricts only while you’re wearing it. The second it wears off, your blood vessels return to their normal size and redness levels.
There’s a risk of rebound redness. When it wears off, it’s like opening a dam to blood flow.
You'll need to visit a dermatologist or other health care professional for an erythema assessment to ensure it's the right rosacea treatment for you.
Using Mirvaso topical gel requires a period of acclimation, and it shouldn't be applied to irritated skin or open wounds.
In a clinical trial, the most common possible side effect was flushing, although there are risks of contact dermatitis, a slight skin burning sensation, and allergic reaction (in the form of hives, severe swelling, and trouble breathing), and other adverse events. If you think you're experiencing serious adverse reactions, seek medical help right away.
As with other prescription drugs, you might not be a candidate for Mirvaso if you have certain medical conditions, such as high or low blood pressure, blood vessel diseases (obliterans), coronary insufficiency, orthostatic hypotension, uncontrolled cardiovascular disease, scleroderma, bradycardia, Raynaud's phenomenon, or Sjögren's Syndrome.
It isn't recommended if you're taking beta-blockers, cardiac glycosides, monoamine oxidase inhibitors, and anti-hypertensive agents, since it can have drug interactions.
You'll need to avoid it if you're breastfeeding, since it can pass into breast milk. It also needs to be stored out of reach of children.

Question 3

How do you use Mirvaso?

Accepted Answer

Use Mirvaso as you would any moisturizer. Start with clean, dry skin and dab a pea-sized dose onto affected areas of the face, like your forehead, chin, nose, and each cheek. Then gently massage a thin layer evenly over your face, avoiding the eyes and lips.

Some RealSelf members say they found Mirvaso easier to apply and longer-lasting when combined with a gentle daily moisturizer.

Question 4

How long does it take Mirvaso to work?

Accepted Answer

Mirvaso works immediately and remains effective for an average of six to eight hours.

Some patients apply it twice daily, to prolong its effect or to avoid having “rebound redness” in the middle of the day.

Dr. Steven Greene, a dermatologic surgeon in Seattle, says he often tells his patients to try repeat applications. “Mirvaso is very helpful for many who suffer from redness associated with rosacea. For those who experience rebound redness, simply apply it two times a day, to see if this will normalize the result.”

Question 5

Can Mirvaso make rosacea worse?

Accepted Answer

RealSelf members say it’s not a miracle fix for redness, and of those who thought it was “Not Worth It,” most complained about rebound redness.

One member shared in her review, “Mirvaso works... at first. I had extremely mild redness in my T-zone, and I thought I'd try something to get rid of it. Although it made my skin look like Snow White’s during the day, as soon as it wore off (after five to eight hours), I got horrendous rebound redness. There were days that it looked like I had a chemical burn on my face. The only discomfort I experienced was the intense heat from my skin during times of flare-ups… which was practically daily.” Rebound redness went away after she stopped using Mirvaso.

Some say adapting to Mirvaso just takes time. One RealSelf member says, “I have had chronic redness due to rosacea for years. I started using Mirvaso over a month ago, and it has really helped. It was a little irritating at first, but now I apply it with sunscreen or hypoallergenic moisturizer, per my dermatologist's recommendation, and it's fabulous. I usually apply it midmorning, and it lasts into the evening. I highly recommend giving it a try.”

If Mirvaso doesn’t work for you, there are other rosacea treatment options, several of which may offer a long-term solution.

Dr. Amy Paul, a dermatologic surgeon in Grand Junction, Colorado, says she has “not prescribed a lot of Mirvaso, due to the risk of rebound redness. "If redness and broken capillaries are your main issue with rosacea, you might want to look into laser treatment," she suggests. "Vascular lasers and IPL can be helpful in reducing the redness once and for all, and [you] only need occasional maintenance and excellent sun protection to continue the results.”

MIRVASO

Genevieve Monsma

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Genevieve Monsma

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