Is it safe to mix Mirvaso with an OTC hydrocortisone cream?

I'm not a big fan of Mirvaso.  In my hands, Mirvaso has caused more rebound redness than I care for.  I have had angry patients that did not care for the redness.  With that said, hydrocortisone should not cause any complication if you find benefit using it alongside mirvaso.  To my knowledge, there is no literature on a synergistic effect of the two being used together

Thanks for your question.  I have not prescribed a lot of Mirvaso due to the risk of rebound and reading reports of unhappy patients with the expensive medication not being worth it.  If redness and broken capillaries are your main issue with rosacea, you might want to look into laser treatment.  Vascular lasers and IPL can both be helpful in reducing the redness once and for all, and only need occasional maintenance and excellent sun protection to continue the results.  Avoiding triggers that make your skin flush and blush is also recommended, but be sure to ask your dermatologist directly if they recommend hydrocortisone.  That also can be a bit problematic on the face, as it can cause perioral or periorificial dermatitis and sometimes pigment change on the skin, so it depends on your skin type and how often you are using it.  Best of luck!

Mirvaso can be mixed with hydrocortisone cream, but you shouldn't really need to do that.  Mirvaso is a topical medication used to treat the redness of rosacea.  Mirvaso is generally well tolerated.  Some patients, especially in the first few weeks of treatment, report experiencing "rebound flushing", which means that, over the day, as the medication is wearing off, flushing can appear to return worse than it was to start with.  This is not entirely the case, since often the patient may have forgotten just how red they were!  However patients sometimes report that they have experienced something along those lines.  Hydrocortisone cream will not help with that issue.  For those able to continue treatment, despite initial flushing or irritation, they find that Mirvaso is well tolerated over time.  Be well!