Important Safety Information

The Advanced Redness SolutionRx

Please read this information carefully before using your prescription. Keep it for reference, and message your DermClick care team if you have any questions.

01

What it is

The Advanced Redness SolutionRx is a compounded prescription topical medication, formulated by a licensed compounding pharmacy for individual patients under the direction of a licensed dermatology provider, working from protocols built by DermClick's founding board-certified dermatologists.

Active ingredients

Azelaic acid - an anti-inflammatory and antimicrobial active used in moderate-to-severe rosacea treatmentIvermectin - an antiparasitic and anti-inflammatory active that addresses Demodex mite activityMetronidazole - an antibiotic and anti-inflammatory agent used in rosacea treatment

Inactive ingredients

Centella asiatica - a soothing botanical ingredientCeramides - barrier-reinforcing lipids

02

What it treats

The Advanced Redness SolutionRx is prescribed for the treatment of moderate to severe rosacea, including:

  • Papulopustular rosacea with persistent or severe inflammation
  • Erythematotelangiectatic rosacea with persistent facial redness
  • Rosacea with suspected or confirmed Demodex mite involvement
  • Rosacea that has not responded to single-active treatments
  • Inflammatory papules and pustules associated with rosacea

Your dermatology provider has determined this formulation is appropriate for your specific skin based on the assessment you completed.

03

Who should not use it

Do not use The Advanced Redness SolutionRx if any of the following apply to you. If your situation changes after your assessment, contact your DermClick care team before continuing use.

  • You are pregnant, planning to become pregnant, or nursing, as metronidazole and ivermectin are not recommended during pregnancy or breastfeeding
  • You have a known allergy or sensitivity to azelaic acid, ivermectin, metronidazole, Centella asiatica, or any other listed ingredient
  • You have a history of disulfiram (Antabuse) use within the past 2 weeks, as metronidazole can cause severe reactions
  • You have a history of severe liver disease
  • You have an active skin infection or open wounds in the application area
  • You have used oral isotretinoin, commonly known as Accutane, within the past 6 months
  • You are under 12 years of age

04

Warnings and precautions

Pregnancy and nursing

Do not use during pregnancy, while planning a pregnancy, or while nursing. Both metronidazole and ivermectin carry pregnancy and nursing precautions. If your pregnancy status changes during treatment, contact your DermClick care team immediately so your prescription can be adjusted. The Redness & Acne FormulaRx is the pregnancy-safe rosacea option in the DermClick lineup.

Alcohol interaction

Topical metronidazole can rarely cause a disulfiram-like reaction, including nausea, flushing, or rapid heartbeat, when combined with alcohol consumption. Risk is higher with oral metronidazole, but discuss alcohol use with your dermatology provider during your assessment.

Sun sensitivity

Sun exposure is a primary rosacea trigger. Apply broad-spectrum SPF 30 or higher every morning, and avoid prolonged sun exposure, tanning beds, and sun lamps. Daily SPF is non-negotiable for rosacea management.

Skin barrier sensitivity

This is a multi-active formula and may cause initial dryness, tingling, or sensitivity for the first 2 to 4 weeks. If sensitivity persists beyond 4 weeks or worsens significantly, contact your DermClick care team, as your application frequency or formula can be adjusted.

Eye, lip, and nostril contact

Avoid contact with eyes, lips, the corners of the nose, and any mucous membranes. If contact occurs, rinse thoroughly with cool water.

Waxing and laser treatments

Do not wax, undergo laser treatments, or use chemical peels on areas where you apply this medication. Pause use for at least one week before and after any such procedure, and consult your DermClick care team.

Hypopigmentation in deeper skin tones

Azelaic acid can rarely cause lightening of the skin in patients with deeper skin tones. If you notice any changes in pigmentation during treatment, contact your DermClick care team.

Demodex die-off response

Some patients experience a temporary worsening of symptoms during the first 1 to 2 weeks of ivermectin treatment as Demodex populations decline. This is typically self-limiting. If it is severe or persists, contact your DermClick care team.

Drug interactions

Tell your dermatology provider about any prescription or over-the-counter medications you use, especially:

  • Disulfiram (Antabuse), which carries a risk of severe reaction with metronidazole; do not use within 2 weeks of disulfiram
  • Oral warfarin or other anticoagulants, as topical metronidazole has been reported to potentiate the effect of warfarin
  • Lithium, as metronidazole may increase lithium levels
  • Other topical rosacea or acne treatments, including additional metronidazole, ivermectin, or azelaic acid
  • Topical retinoids, including tretinoin, adapalene, tazarotene, or retinol
  • Other alpha-hydroxy or beta-hydroxy acids at high concentrations
  • Benzoyl peroxide products
  • Oral antibiotics commonly prescribed for rosacea, including doxycycline or minocycline
  • Topical or oral corticosteroids in the application area

05

Possible side effects

Common side effects

These may happen especially in the first 2 to 4 weeks of treatment.

  • Mild tingling or stinging when first applied
  • Temporary dryness, peeling, or flaking
  • Mild redness or warmth at the application site
  • Temporary worsening of symptoms in the first 1 to 2 weeks, known as the Demodex die-off response
  • Increased sensitivity to sun and rosacea triggers

Less common side effects

  • Persistent redness, swelling, or itching beyond the adjustment period
  • Contact dermatitis or allergic reaction at the application site
  • Lightening of the skin, known as hypopigmentation, particularly in deeper skin tones
  • Disulfiram-like reaction when combined with alcohol, including nausea, flushing, or rapid heartbeat
  • Mild headache, nausea, or metallic taste, which is rare with topical metronidazole

These are typical of multi-active rosacea treatment and usually settle within the first 2 to 4 weeks as your skin adjusts. Your DermClick care team can adjust your application frequency or your formula if these symptoms become uncomfortable.

Rare but serious

Contact your DermClick care team or seek emergency care if you experience:

  • Severe rash, hives, or swelling of the face, lips, tongue, or throat
  • Difficulty breathing
  • Signs of severe allergic reaction
  • Severe blistering or skin sloughing at the application site
  • Neurological symptoms, including numbness, tingling, or confusion, which are extremely rare with topical metronidazole

06

How to use it

Application

Apply a thin layer to clean, dry skin on the affected area once daily in the evening, after washing your face and patting it dry. Wait at least 20 minutes after washing before application.

Frequency

Start with every other night for the first 1 to 2 weeks. Increase to nightly use as your skin tolerates it. Your DermClick care team will adjust your ramp-up plan based on how your skin responds.

Amount

A pea-sized amount is enough for the entire face. More is not better and can cause stinging without improving results.

Storage

Store at room temperature, away from direct sunlight and heat. Keep the cap closed when not in use. Do not freeze.

Shelf life

Use within the period indicated on your prescription label. Do not use after the expiration date.

Morning

Gentle, fragrance-free cleanser, moisturizer, broad-spectrum SPF 30+ (mineral sunscreen is often best tolerated by rosacea-prone skin)

Evening

Gentle cleanser, then The Advanced Redness SolutionRx, then a barrier-supporting, fragrance-free moisturizer.

07

If you have a reaction

For mild irritation

Reduce application frequency to every other night or every third night, apply a fragrance-free, barrier-supporting moisturizer 10 to 15 minutes after the medication, and message your DermClick care team. We can adjust your formula or your ramp-up plan.

For moderate to severe reactions

Stop using the medication. Message your DermClick care team. Send photos if you can so your dermatology provider can review and respond.

For medical emergencies

For severe rash, swelling of the face or throat, difficulty breathing, signs of severe allergic reaction, or neurological symptoms such as confusion, severe numbness, or tingling, call 911 or go to your nearest emergency room immediately.

Contact your DermClick care team

  • Phone: 1-833-496-4045
  • Email: support@dermclick.com
  • Account dashboard: message your care team directly at app.dermclick.com
Message your care team

08

About compounded medications

Compounded medications are prepared by a licensed compounding pharmacy for individual patients, based on a prescription written by a licensed dermatology provider. They are not individually evaluated or approved by the FDA.

The active ingredients in The Advanced Redness SolutionRx- azelaic acid, ivermectin, metronidazole, Centella asiatica, and ceramides - are well-established ingredients used in clinical dermatology, individually and in combination. Compounding allows your dermatology provider to combine them into a single nightly formulation tailored to your skin, rather than asking you to layer three separate prescriptions on top of already-reactive skin. The supporting ingredient isn't an optional extra - it is what makes the multi-active protocol livable for sensitive, rosacea-prone skin.

Your prescription is compounded by a 503A licensed compounding pharmacy and shipped directly to you.