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Nearly all of it comes from that one group, which is the real reason for caution

Oxymetazoline has a more gradual onset, one review in the Journal for Drugs in Dermatology reported that the return of erythema is less common in patients using oxymetazoline as compared to brimonidine.5 Overtime, 10 to 20% of patients treated with commercially available brimonidine gel noted paradoxical erythema, this adverse effect was noted to be significantly less likely with the oxymetazoline topical treatment group, of which 1% of patients noted application site erythema as compared to 0.4% in the placebo group.7 Combination Therapy for the Management of Rosacea Oxymetazoline and brimonidine have demonstrated efficacy for the management of erythema associated with rosacea

It is being studied in models of colitis, dermatitis, and inflammatory wound healing

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