Review

Why brimonidine and oxymetazoline behave differently (2017)

The two drugs act on different adrenergic receptors, which is the leading explanation for why worsening redness has been reported far more with brimonidine.

A dermatologist reviews the two approved creams for lasting facial redness in rosacea. He covers the reports of redness getting worse after brimonidine, summarises the early oxymetazoline data, and explains the likely mechanical reason the two differ: brimonidine acts mainly on alpha-2 receptors and oxymetazoline on alpha-1a. This is one expert's synthesis, not a trial.

Del Rosso JQ. Topical alpha-agonist therapy for persistent facial erythema of rosacea and the addition of oxymetazoline to the treatment armamentarium: where are we now? J Clin Aesthet Dermatol. 2017;10(7):28-32.