# A-10 — Oxymetazoline

One of only two drugs approved for the redness of rosacea, and the weakest primary endpoint in this register — honestly measured and honestly published.

- **Canonical:** https://www.30plusskin.care/actives/oxymetazoline
- **Site:** 30+/SKIN — Skincare, published as a spec sheet.
- **Issue:** ISSUE NO. 13 / REV. 2026.10
- **Standing terms:** INDEPENDENT · AFFILIATE-FUNDED · NOT MEDICAL ADVICE

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## Datasheet

- **INN / INCI:** Oxymetazoline hydrochloride
- **Family:** Alpha-1A adrenergic agonist
- **Molecular weight:** 296.84 g/mol
- **Layer reached:** STRATUM CORNEUM
- **Prescription only:** yes
- **Evidence grade:** A
- **Controlled trials on file:** 1
- **Strength range recorded:** 1%–1%
- **Representative reference concentration:** 1%
- **Irritation (0–10):** 3
- **Onset:** 3 H
- **Stability:** STABLE

## Mechanism

The concentration marker is not a recommended dose or a claim that other strengths are untested. Compare the vehicle, indication and trial population.

Constricts the superficial cutaneous vessels for a number of hours. It changes how the skin looks while it is working and does nothing to the underlying vascular hyperreactivity.

## Measured endpoints

| Endpoint | Effect vs comparator | Window | Record |
| --- | --- | --- | --- |
| Two-grade improvement on both erythema scales | +12% | 4 WK | REF-11 — Rhofade — trial 1, hour 9 on day 29 (Randomised, vehicle-controlled, parallel-group; composite of clinician and subject scales at four timepoints, n=440, grade A) |

## Layering

- **Do not layer with:** Uncontrolled cardiovascular disease, Raynaud's, scleroderma, Sjögren's, Narrow-angle glaucoma
- **Pairs with:** Ivermectin, Azelaic acid, Daily sunscreen

## Notes

- The endpoint was deliberately hard: two grades, on both the clinician's and the subject's scale, at four timepoints across twelve hours. At its best timepoint it reached 18%.
- 1% of subjects reported worsening inflammatory lesions of rosacea — small, specific, and the failure mode people fear with vasoconstrictors.
- Three warning categories narrow the eligible population sharply, and they land on exactly the group most likely to want it.
- The label offers no guidance at all on stopping.

## Products in the register containing it

| No. | Product | Stance | Score | Document |
| --- | --- | --- | --- | --- |
| R-41 | Mayne Pharma Rhofade | CAUTION | 62/100 | /reviews/rhofade-oxymetazoline-cream-review |

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## Elsewhere in the register

- [Review register](/reviews)
- [Active monographs](/actives)
- [Brand register](/brands)
- [Evidence register](/evidence)
- [The ledger](/ledger)
- [How we test](/how-we-test)
- [Agent guide](/llms.txt)
- [Sitemap](/sitemap.xml)

_SOURCE-BASED ASSESSMENTS. PUBLISHER PREFERENCES ARE IDENTIFIED SEPARATELY._