Document Type : Original Article


1 Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran

2 Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran

3 Skin & Cosmetic Research Department, Shanghai Skin Disease Hospital, Shanghai, China


Background: Brimonidine tartrate is an alpha-2 adrenergic receptor agonist approved for treating rosacea. This study aimed to assess the efficacy and safety of a brimonidine gel in rosacea patients with skin types III and IV.
Methods: This study was a phase II before-after clinical study in 20 patients with moderate to severe rosacea treated with brimonidine 0.33% gel. Clinician’s Erythema Assessment (CEA), Patients’ Self-Assessment (PSA), skin erythema (ΔE), lightness (ΔL), and biophysical parameters were measured before treatment and 4 and 8 weeks later. Ultrasound parameters were also measured at the same time points.
Results: Eighteen patients completed the study. CEA and PSA decreased significantly from 3.05 to 2.10 and 2.15 after 4 weeks and 2.20 and 2.15 after 8 weeks, respectively (P<0.01 for both). Furthermore, ΔE and ΔL, as well as the skin erythema index, improved after 4 weeks of treatment. The skin echo density of both the epidermis and dermis also increased after 8 weeks (P<0.05). During the study, no serious adverse events occurred other than some reports of temporary moderate redness.
Conclusion: Daily application of brimonidine 0.33% gel is safe and effective for the treatment of rosacea in darker skin types.