More big news on the skin treatment front came with the recent FDA approval of Mirvaso Gel (brimonidine), a new and highly effective topical medication for treating the erythema (i.e. redness) caused by acne rosacea. While it isn’t a cure per se, it does represent a progressive leap forward in managing this frustrating – and for some people debilitating – skin disorder.
Like with so many other chronic conditions, if you don’t have rosacea, you’ve probably haven given it that much thought. You think a little redness, maybe a breakout or two, no big deal. But if you’re one of the 16 million Americans who do suffer from this stubborn inflammatory ailment, rosacea literally turns you red in the face and is notoriously stubborn to treat.
Blush, flush and burn
Technically known as acne rosacea, its name alone causes confusion because it’s not actually related to acne except for lesions that can look like pimples. The confusion is doubly unfortunate because some medications for acne (technically acne vulgaris) can make rosacea symptoms worse. Mechanically, rosacea is too-porous capillaries that leak blood into the surrounding tissues, hence the redness.
We know what it looks like and feels like:
-Redness, blushing or flushing across the midface, forehead and nose that can become semi-permanent with age
-Stinging and burning
-Possible telangiectasia (thread-like capillaries)
-Possible papules or pustules
-Rare but serious rhynophyma (the distorted nobby nose of W.C. Fields, more common in men)
We know who gets it:
-Fair-skinned descendants of Northwest European origin (so much for the luck of the Irish)
-Three times as many women as men
-Those over 30 and progressively worsening with age
We know there are a huge number of triggers:
-Stress and anxiety
-Spicy foods
-Certain skin care products
-Exercise
-Extreme weather conditions
But, we don’t know the exact cause and we don’t know the cure. Read on though, the picture gets better.
Testing what’s what
As a dermatologist, in addition to treating patients, I particularly love doing clinical research. It is so exciting to be on the forefront of raking medical knowledge and to contribute to the advancement of medicine. For Mirvaso, our practice participated in two-month long clinical trial in testing the drug. (At this point, let me emphasize that I personally have no financial involvement with neither Mirvaso nor Galderma Laboratories, its manufacturer.) The study sample tested a total of 550 patients. The results were spectacular and Mirvaso became an innovative option on the market.
That was then
By far the most effective overall rosacea solution to date has been series of the Vbeam laser treatments or intense pulsed light sessions that clear the redness by actually destroying the little rogue capillaries themselves. While the cosmetic effects are excellent, they require multiple sessions and regular follow-ups . . . prohibitively expensive since most insurance companies are unwilling to pick up the tab.
Prescriptions of low-dose antibiotics can fade rosacea’s redness too. But some patients get yeast infections from these and others, quite rightly, worry that years of daily antibiotic dosing could have health consequences down the road.
This is now
Enter Mirvaso Gel, the first and only FDA-approved topical treatment specifically developed for the facial redness from rosacea. Unlike other anti-inflammatories, Mirvaso directly works at the receptors on the tiny blood vessels in your face to shrink them as a primary action, which is why the formula itself is so unique. And since the medication stays efficacious for 12 hours at a stretch after application, it means the user gets to control the redness instead of the other way around.
Rosacea redness happens but it doesn’t have to show on your skin.
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