Used Mirvaso for 3 days and had rebound flushing: Would doing an excel or fraxel be a good idea to treat or risky?

I am now back to baseline but my nose is still quite red don't want to trigger anything--my skin seemed very inflamed after mirvaso and has finally calmed down--but I'd also like to treat the redness of my noise.

Doctor Answers 3

Mirvaso and facial redness

Mirvaso can offer dramatic though temporary improvement in facial redness. I have found that rebound flushing as you experienced is quite common. The Mirvaso has probably not changed your baseline condition and it should still respond well to treatment of the vessels.
Excel V is a good choice to treat facial vessels. However, I prefer the V beam because it seems to be more comfortable and provide more reliable results. Each specifically targets the redness and can dramatically improve your redness.


Boulder Dermatologist
4.4 out of 5 stars 7 reviews

Rebound flushing more common than reported.

Mirvaso is trick to use. Take on average 10 applications for a patient to figure it out and get the even spread to stop skipped and streaky areas. Some patients will find it can give rebound, if this happens-

You can 1. Take an anti inflammatory with this 2. Take a tablet short term to reduce rebound or 3. Use a laser such VBeam to treat the rebound. Of all these methods, I prefer laser, as the rebound gives me the 'window' to target the blood vessels with laser. 

Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)

To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. 

A detailed history, together with a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -

1. Lasers ( to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness. 

2. Creams - anti inflammatory

3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. 

4. For females- Mineral make up is recommend, over make up that contains parabens. 

For the best results, consult a dermatologist for both medical and laser treatment options. 

Kind regards.

Dr Davin S. Lim.

Laser Dermatologist.

Brisbane, Australia. 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Treatment for Redness

If you are interested in treating redness then the Excel would be the choice over Fraxel, though Fraxel is a good treatment it does not treat redness. In my office I use the Vbeam for Rosacea treatments, best improvement is seen after a series of 3-5 treatments done one month apart. Consult with a Board Certified Dermatologist to see what the best option for you is.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.