Clonidine is a potent oral medication occasionally utilized off-label by dermatologists to help manage facial flushing and burning seen in rosacea.
Originally developed decades ago to treat high blood pressure, clonidine acts in the central nervous system (the brain). It reduces the brain signals that cause the delicate blood vessels in the face to suddenly enlarge, causing flushing.
For rosacea, clonidine is prescribed in extremely small doses. While it can be highly effective for halting unprovoked flushing, due to potential side effects, it is typically reserved as a last resort treatment where Beta Blockers or Vascular Lasers have proven ineffective.
Side effects include dry mouth, drowsiness, sedation, and lightheadedness upon standing due to a lowering of baseline blood pressure. Importantly, a patient taking clonidine must never suddenly stop taking the medication, as doing so can trigger a sudden, dangerous rebound spike in blood pressure. The drug must always be tapered off slowly under medical supervision.