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Can Rhofade Make Rosacea Worse?

Key Takeaways

  • Rhofade is FDA-approved to reduce persistent facial redness associated with rosacea.
  • In some people, Rhofade can temporarily worsen redness or trigger rosacea flare-ups.
  • Rebound redness has been reported, though it is uncommon.
  • Rhofade does not treat pimples or pustules associated with rosacea.
  • If symptoms worsen, consult a dermatologist or healthcare professional.

What Is Rhofade and How Does It Work?

Rhofade is a prescription topical medication used to treat persistent facial erythema (redness) associated with rosacea. Its active ingredient, oxymetazoline hydrochloride, is an alpha-adrenergic agonist that works by narrowing superficial blood vessels in the skin.

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By constricting dilated blood vessels, Rhofade helps reduce visible facial redness. It is not designed to treat inflammatory symptoms of rosacea, such as pimples or pustules.

Rhofade is approved by the FDA for once-daily topical use in adults. However, if you have mild rosacea you doctor may recommend lifestyle changes rather than medication.

Can Rhofade Make Rosacea Worse?

For most people, Rhofade improves facial redness. However, in some cases, it may temporarily worsen symptoms of rosacea.

Possible ways Rhofade may appear to make rosacea worse include:

  • Increased facial redness after the medication wears off
  • Irritated skin at the application site
  • Flushing
  • Rosacea flare-ups

These reactions are considered possible side effects of Rhofade, although they are not experienced by most users.

What Is Rebound Redness?

Rebound redness refers to redness that returns and appears more intense after the medication effect fades. This phenomenon has been more commonly associated with Mirvaso, another topical alpha agonist used for rosacea.

Although rebound erythema has been reported with oxymetazoline, clinical trials for Rhofade showed it is not a common side effect.

If redness becomes noticeably worse after stopping or using Rhofade, it is important to seek medical advice. A dermatologist can help determine whether the medication should be adjusted or discontinued.

What Do Clinical Trials Show?

In clinical trials reviewed by the FDA, most patients experienced improvement in facial redness with Rhofade. However, some participants reported:

  • Application site irritation or redness
  • Worsening inflammatory lesions
  • Allergic reactions

Serious side effects are rare but may include allergic reactions or cardiovascular concerns due to the medication’s effects on blood vessels.

Who May Be at Higher Risk of Worsening Symptoms?

Certain individuals should use caution when considering Rhofade.

Because oxymetazoline affects blood vessels, people with the following conditions should consult a healthcare professional before use:

  • Raynaud’s phenomenon
  • Scleroderma
  • Thromboangiitis obliterans
  • Narrow-angle glaucoma
  • Uncontrolled blood pressure

These conditions involve vascular sensitivity, which may increase the risk of adverse effects.

If you are breastfeeding or have other medical concerns, discuss risks and benefits with a healthcare professional.

Does Rhofade Treat All Types of Rosacea?

No. Rhofade is specifically indicated for persistent facial redness (erythema). It does not treat:

  • Pimples
  • Pustules
  • Thickened skin
  • Eye symptoms

If your rosacea includes inflammatory bumps, other rosacea treatment options such as Soolantra (ivermectin) or Finacea (azelaic acid) may be recommended.

A comprehensive skin care routine, including gentle cleansers and sunscreen, is also important to help prevent rosacea flare-ups.

What Should You Do If Your Rosacea Gets Worse?

If you notice worsening redness, increased irritation, or new symptoms after you use Rhofade:

  • Stop applying the medication.
  • Contact your dermatologist or healthcare professional.
  • Avoid other potential skin irritants.
  • Do not reapply until you receive medical advice.

You may also report serious side effects to the FDA through MedWatch at fda.gov.

Your provider may adjust your rosacea treatment plan or recommend alternative prescription drugs.

How to Reduce the Risk of Irritation

To minimize possible side effects:

  • Apply only a pea-sized amount to the entire face.
  • Use a thin layer.
  • Avoid applying to irritated skin or open wounds.
  • Wait for skin care products to absorb before layering products. The American Academy of Dermatology offers tips on selecting over-the-counter skin care products that reduce the risk of worsening rosacea flare-ups.
  • Use sunscreen daily to protect sensitive skin.

Using more than directed will not improve results and may increase irritation.

The Bottom Line

Rhofade is effective for many people with persistent facial redness due to rosacea. However, in some cases, it can cause temporary worsening redness, irritation, or rosacea flare-ups.

If you experience worsening symptoms, speak with your healthcare provider. They can help determine whether Rhofade is the right rosacea treatment for you.

Frequently Asked Questions

Can Rhofade cause rebound redness?
Yes, rebound redness has been reported, although it appears to be less common than with some similar medications. If redness worsens after using the medication, consult a healthcare professional.

Does Rhofade make rosacea pimples worse?
Rhofade does not treat pimples or pustules. In some cases, inflammatory symptoms may persist or worsen, and additional rosacea treatment may be needed.

Are allergic reactions to Rhofade common?
Allergic reactions are considered rare but possible. Seek medical attention if you experience swelling, severe itching, or difficulty breathing.

Should I stop using Rhofade if my skin becomes irritated?
If irritation is mild, your healthcare professional may recommend monitoring symptoms. If irritation is significant or worsening, stop use and seek medical advice promptly.

Is Rhofade safe for people with vascular conditions?
People with vascular disorders such as Raynaud’s phenomenon or scleroderma should consult a healthcare professional before using Rhofade due to its effects on blood vessels.

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