Rosacea and Mirvaso Pros and Cons

Rosacea is a common condition characterized by transient or persistent central facial erythema, visible blood vessels, and often papules and pustules. Because the facial skin is the predominant site of involvement, many patients sense that rosacea alters their social and professional interactions, leading to problems on the job, in their marriage, or in meeting new people.

The expert committee stated that the diagnosis of rosacea requires the presence of one or more of the following primary features concentrated on the convex areas of the face: flushing (transient erythema), nontransient erythema, papules and pustules, and telangiectasia.


1. Erythematotelangiectatic type (ETR)
The flushing that rosacea patients experience is prolonged. Many people without rosacea experience evanescent flushing in response to embarrassment, exercise, or hot environments. The flushing of
rosacea, however, is not the evanescent several seconds to fewminutes of pinkness that is commonly experienced. Usually rosacea patients describe their flushing to last longer than 10 minutes. Such a prolonged vasomotor reaction may help in differentiating physiologic flushing from that seen in rosacea
patients. The central portion of the face is generally the site of the most intense color,9 but the redness
may also involve the peripheral portion of the face,

2. Papulopustular rosacea (PPR)
Patients with PPR (also known as classic rosacea, pink papular rosacea, and typologic center disease) present with a strikingly red central portion of the face but have persistent or episodic inflammation characterized by small papules that may be surmounted by pinpoint pustules. Edema may accompany such episodes but is frequently subtle in its expression. There is almost universal sparing of the periocular skin, which contrasts strikingly with the intense redness at adjacent sites. A history of flushing is often present; however, this symptom is usually milder than that experienced in patients with ETR. Irritation from external stimuli is also not as constant a feature; thus scaling and roughness are often absent. These patients are most often women in midlife.Telangiectases are often subtly present but may be obscured by the generally erythematous background.

3. Phymatous rosacea
The expert committee designated phymatous rosacea as one of the 4 rosacea subtypes.1 Phymata include marked skin thickening and irregular surface nodularities, and can occur on the nose (rhinophyma), chin (gnathophyma), forehead (metophyma), one or both ears (otophyma), and eyelids (blepharophyma). Four variants of rhinophyma (glandular, fibrous, fibroangiomatous,
actinic) can be recognized clinically and have distinct histopathologic features.

4. Ocular rosacea
Blepharitis and conjunctivitis are the most common findings in rosacea patients with ocular manifestations. Inflammation of the lids with recurrent chalazion and inflammation of the meibomian glands may be present. Interpalpebral conjunctival hyperemia, conjunctival telangiectases, and watery or dry, irritated eyes can occur. Burning or stinging, itching, light sensitivity, and a foreign body sensation are frequent symptoms in the patient with ocular rosacea. Keratitis, scleritis, iritis, and complications of such involvement are infrequent but can occur.

More about Rosacea in the files attached (including pictures for each Rosacea type):


Rosacea Grading System

Stories about what Rosacea can do to people’s life in the attached file called Rosacea in Real Life:


Books about Rosacea:

1.Rosacea Diagnosis and Management, Author: Frank C. Powell,
2.Acne and Rosacea: Epidemiology, Diagnosis and Treatment, Author: David J. Goldberg, Alexander Berlin,
3.Acne and Rosacea The Complete Guide, Author: Alison Bowser,
4.Pathogenesis and Treatment of Acne and Rosacea, Author: Christos C. Zouboulis , Andreas Katsambas
5.ACNE and ROSACEA, Author: G. Plewig , A.M. Kligman,
6.Rosacea, Your Self Help Guide, Author: Arlen Brownstein, Donna Shoemaker,
7.The Official Patients Sourcebook on Acne Rosacea, Author: James N. Parker M.D.
and Philip M. Parker M.D,
8.Rosacea Diet and Rosacea 101, Author: Brady Barrows,
9.The Rosacea Handbook, A Self Help Guide, Author: Ann-Marie Lindstrom,
10.Joy-Full, Holistic Remedies, Author: Georgie Holbrook,
11.The Rosacea – Acne Natural Remedy, Author: Georgie Holbrook,

Web-sites where you can find information about Rosacea including forums of Rosaceans:


What is Mivaso:

Mirvaso is a new treatment released by Galderma in August/September 2013.  It is a temporary fix for facial redness.


MIRVASO (brimonidine) topical gel, 0.33% is an alpha adrenergic agonist indicated for the topical treatment of persistent (nontransient) erythema of rosacea in adults 18 years of age or older.


Apply a pea-size amount once daily to each of the five areas of the face: central forehead, chin, nose, each cheek. MIRVASO topical gel should be applied smoothly and evenly as a thin layer across the entire face avoiding the eyes and lips.


Mirvaso gel Pros and Cons at the links below:


Positive and Negative Anecdotal Reports 

Please note about the following anecdotal reports in two spreadsheets (Positive and Negative):


66 reports

Negative (

242 reports