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  • Hi Carol,

    I understand you're worried that Brimonidine might have bad, unforeseen, long term side effects on the skin.

    For me, just the opposite seems to be true. For me, the Brimonidine seems to be actually allowing my skin to rest and heal.

    For me, the long term bad effects of flushing outweigh almost everything else.

    My rosacea has progressed so catastrophically and become so debilitating; my flushing so appallingly painful and overwhelming, that THAT is the source of the damage to my skin, not Brimonidine.

    Repeated flushing, especially on the intensity I experience it, is terrible for my skin.

    It makes my rosacea progress; it tends to leave my blood vessels permanently dilated and more likely to flush again; and flushing is clearly far worse for my skin than almost anything else. It leaves it inflamed and fragile and angry and broken out.

    Brimonidine calms it down and lets it heal.

    Just my two cents.
    • 58 yr old woman
    • Rosacea at 48, debilitating at 52
    • Clonidine 100mgc ev. 8 hrs;
    • Remeron 15mg nightly;
    • Zebeta=Bisoprolol=Beta blocker 5mg nightly;
    • Brimonidine worked well initially, then MASSIVE rebound flushing and damage;
    • Countless IPL with Lumenis One;
    • Now purpuric V Beam with Candela Perfecta; more clearance, less downtime than IPL;
    • Botox (with mesotherapy needles), good not great results;
    • Monthly Kenalog injection to blunt debilitating flushing.


    • Great news Natalja! I had some weird stinging and flushing last night. Although I think it is hormonal. When I woke my face felt flushed but didn't look bad. I think I might buy the pure form too because I have a feeling the preservatives might be irritating my skin.

      I got a reply from the compounding pharmacist and he asked me to remind him in a month about the brominidine (because he is sourcing some new suppliers). He also said the topical clonidine was used for patients to reduce pain. He doesn't think that topically it will reduce flushing but I am still keen to try it.


      • Hi,

        this morning still pale on the treated area´s, the rest moderately flushed.
        So far no other side effects. I called the pharmacist to ask how I can store the solution. I first desinfected the weighting scale and measuring cup in boiling water and used bottled water from a sealed bottle by the way, just to be on the safe side.
        He said that it can be stored in the fridge, to preserve it longer. The molecules of brimonidine are small he said and it´s very solutable to water, so he doesn´t expect christals to be formed in the fridge. I put the solution straight on my face. I put some of the liquid in a little cup and put it on my skin with my finger, as much as needed and I also ´paint´ more on the patches that are blotchy. Not sure if this is too much though, as it´s the strength of the normal eye drop solution, but it´s been working..

        I have ordered the 5 g sample here:
        Miss Fairy Yang

        The corporation is Sinochem Nanjing,
        Last edited by nat007; 3 September 2010, 08:16 AM.
        My rosacea related blog:


        • On a note, I would wait with ordering anything untill I have tried this for a week or so, without side/effects or problems or rebound flushing. So far I have only used it one day...
          And although most skin is palish, I have a stubborn flushed area in the inner cheek today. It´s expensive if it turns out to have rebound problems etc.
          My rosacea related blog:


          • See pictures at:

            My rosacea related blog:


            • Very bad rebound in right cheek. Left one is fine for some reason. The right cheek has already a red patch this morning but now it´s full blown all over the cheek, haven´t had it this bad in a long time. Not sure if it is brimonidine related, did have some irritation from indirect sunlight earlier this week, but this is really full force flushing.

              Will give my skin some days to calm down again and see again.
              My rosacea related blog:


              • Big flare on the left cheek as well this morning. Am having two red flushed cheeks again. Am sure now that it has to do with the after effect of the brimonidine, as the left cheek was not too bad before I put brim. on it. Have to sit it out now and see how long it takes for the skin to settle again. Big bummer, as I was over the moon with my pale complexion. But if this is the standard, then the flare ups might not be worth the positive effects perhaps. Although it might also be an option to keep using the brimonidine solution every other 8-10 hours and be a step ahead of rebound flushing. The thing is though, that I am not yet certain if this stuff can cause long term damage or alterations to the facial blood vessels and I don't want to risk anything here. But the test is completed for now, it works and it has after effects. I am sad that I have to go through the busy weekend looking like this and feeling burned up, and more sad that I can;'t put the brimonidine on my face at the moment, but well.

                Is there anyone with suggestions perhaps? It works, but why do I (others) get rebound flushing?
                It can't be the inactive ingredients, as there are none in my case. I would love to use this daily but am not convinced I am not making matters worse in the long run with it.
                My rosacea related blog:


                • Hi Natalja,
                  I'm so sorry it caused rebound flushing for you. It did the same for me when I tried alphagan drops on my face in January 2009. When I tried this med though I used the .1 and then the .15% concentration so it was weaker than what you and WC and the others are using I believe.

                  I don't know why for some people it causes this reaction and for some it does not.
                  The real question is why it isn't causing the rebound for the others.
                  Hopefully that is something the scientists are working on regarding this and perhaps that is why it is taking so long to come to market.

                  Hope you recover quickly



                  • Hey Natalja,

                    I looked at the pictures and I'm amzazed at the difference in just a few hours. I'm sorry to hear about the rebound flushing. It definitley has promise though. Have you thought about diluting the solution more and applying it only a couple of times a week?

                    I'd expect your skin to return to normal soon enough without any long term damage. If it is drying up your skin make sure you apply a good moisturiser. I don't generally use any topicals but when I have in the passed and my skin has dried out, I've found that moisturising daily helps return my skin to a more balanced state.

                    Try not to worry because your skin will recover, and if you decide to try it again you now have the benefit of experience to help you make a more successful attempt the next time.

                    All the Best Natalja.


                    • Thanks guys. I think the worst is already over, flushing wise. Still redness on mostly one cheek, but clear patches of skin are showing already in between and the full force flushing seems over. So I think the flushing reaction is about 8 hours or something. Perhaps about as long as the paleness reaction is, so that´s not a good thing. Don´t know either Melissa why some , like WC, are not having the rebound flushing. I do have to admit that I used the solution (similar to 0,2%) very generously on my face, and didn´t use the 2 drops, but more. So that might have added to the reaction afterwards. But only afterwards, not during the 8/10 hours of action, then I was very pale. Qustions indeed. Will wait till skin is back to its old self and try again in time, as I am very impressed with how it works. Just don´t know why this rebound flushing is happening.
                      Will try different amounts in the near future.
                      My rosacea related blog:


                      • Hi everybody I'm new in this forum but wanted to share my succes with pilocarpine. After I read the post by supramom and made some research on the internet I asked my derm to prescribe me pilocarpine off label. I have tried brimonidine before which was good but the skin became slightly more reactive to certain triggers. With Pilocarpine I have (most important) not experienced any rebound redness and it reduces redness just as good as brimonidine drops. Is there anybodyelse who has made the same experience?


                        • what is policarpine

                          How interesting...Could you tell us policarpine is it an eye drop?


                          • Yes, Pilocarpine is eye drops prescribed for Glaucoma same as Brimonidine. I experimented with it simply because I had it on hand and it is for the same disease as Brimonidine is.


                            • policarpine

                              Hi Supramom,
                              Thank you for your reply. Could you tell me how do you use it (dilute it with cream /water/use direct) and how long does the effect last? Do you use it daily or just when want to prevent a flush? Sorry so many questions. Do you also find that it doesn´t give you rebound effect?
                              Thank you


                              • I use it both ways - sometimes I rub it right onto my cheeks, sometimes I put it in my cream. I was worried that it would be diluted in the cream, but I don't think it's effect is any less when used in cream. I put in 2 drops.

                                I use about 3 times per day, but only because I wash my face 3 times a day as I have terrible ocular rosacea problems. I don't really flush, and never have. I just have those small areas of redness right on my cheekbones. The area is not very big. It seems to take a while for the Pilocarpine to kick in, but I think it is because I am putting it on after rubbing my face. I don't have any residual effects, but again, I don't flush.

                                Good luck!