Does brimonidine gel, 0.33%, decrease alcohol-induced facial erythema in patients with alcohol flushing syndrome?
In this randomized, placebo-controlled, double-blind split-face clinical trial of 20 individuals of East Asian descent, brimonidine gel was effective in reducing facial erythema in patients with alcohol flushing syndrome. Brimonidine decreased observed erythema by an average of 2.1 and 1.7 points as evaluated by the clinician and the patient, respectively, on an erythema grading scale of 0 to 4 points.
This study demonstrates that brimonidine gel is effective in reducing the alcohol-induced facial erythema of alcohol flushing syndrome.
Alcohol flushing syndrome (AFS, also known as Asian glow and Asian flush) affects 20% to 47% of East Asians and causes significant psychosocial distress. There are no approved treatments for this condition.
To determine whether brimonidine gel, 0.33%, decreases facial erythema in patients with AFS after consumption of alcohol.
Design, Setting, and Participants
In this randomized clinical trial, 20 healthy volunteers of East Asian descent with a self-reported history of AFS were recruited between April 2018 and March 2019.
Participants were randomized to application of brimonidine gel to either the left or right half of their face. Placebo control was applied to the opposite side. After 30 minutes, participants ingested alcohol.
Main Outcomes and Measures
Outcomes were specified before data collection. The difference in erythema between the treated and placebo side of each participant’s face was measured 60 minutes after drug application (primary outcome) and at 90 and 120 minutes after drug application (secondary outcomes). Participants were asked to rate their likelihood of using the medication again and their likelihood of recommending the medication to a friend on a scale of 0 to 10.
The mean (SD) age of the 20 individuals enrolled in the study was 30.5 (8.4) years, and there were 10 women (50%). There was a significant difference in erythema at 60 minutes after drug application as measured by the difference in Clinician Erythema Assessment score (2.1; 95% CI, 1.5-2.71; P < .001) and by the difference in Subject Self-Assessment score (1.7; 95% CI, 1.1- 2.3; P < .001). This effect persisted at 90 and 120 minutes. Individuals were likely to use the medication again (7.2; 95% CI, 6.0-8.3) and would also recommend it to a friend (7.6; 95% CI, 6.5-8.6).
Conclusions and Relevance
This study demonstrates that brimonidine gel is effective in reducing the facial erythema of AFS. Patients with psychosocial distress due to AFS may benefit from treatment with brimonidine.
ClinicalTrials.gov identifier: NCT03497442
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Yu WY, Lu B, Tan D, et al. Effect of Topical Brimonidine on Alcohol-Induced Flushing in Asian Individuals: A Randomized Clinical Trial. JAMA Dermatol. 2020;156(2):182–185. doi:10.1001/jamadermatol.2019.3508
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: