This is a Prospective, Vehicle Controlled, Double Blind, Multicenter, Randomized Phase II trial, comparing the effect of twice daily B244 application for 8 weeks vs. vehicle application on treatment of mild to moderate rosacea.

This is a Prospective, Vehicle Controlled, Double Blind, Multicenter, Randomized Phase II trial, comparing the effect of twice daily B244 application for 8 weeks vs. vehicle application on treatment of mild to moderate rosacea.

At Screening and Baseline all subjects must have Type 1 erythematotelangiectatic rosacea (ETR).

The total duration of the study will be approximately 12 weeks. Participants will report for a Screening visit and if all inclusion criteria are met will undergo a washout period, between 2 days and 4 weeks, depending on current treatment. Subjects will then report for the Baseline visit.

Subjects will come in for visits at Day 7 (Week 1), Day 28 (Week 4), and Day 56 (Week 8). A final visit will be conducted at Day 84 (Week 12).

Efficacy will be assessed using Clinician Erythema Assessment (CEA), Investigator Global Assessment (IGA), Skindex16, and Patient Self-Assessment (PSA).

Blood and urine samples will be collected for standard safety laboratory tests. Participant's safety will be monitored throughout the study.

Investigators plan to enroll approximately 130 subjects.

Randomization will be 1:1 so that equal numbers of subjects will be treated in each arm of the study.

Inclusion Criteria:

1. Male and female subjects ≥18.
2. A clinical diagnosis of mild to moderate facial rosacea.
3. In good general health as determined by a thorough medical history, physical examination, clinical chemistry and hematology.
4. Presence of 3 to 20 inflammatory lesions on the face (i.e. papules/pustules).
5. A Clinician Erythema Assessment (CEA) score of 2-3 at Screening and at Baseline Visits (prior to the investigational product application).
6. Mild to Moderate IGA score of 2-3 at Screening and at Baseline Visits (prior to the investigational product application).
7. Willing to refrain from using any topical or systemic treatments for the treatment of rosacea, other than the investigational product.
8. Females of childbearing potential with a negative urine pregnancy test (UPT) at Screening and Baseline/Day 1 (prior to the investigational product application).
9. Ability to comprehend and comply with study procedures.
10. Agree to commit to participate in the current protocol.
11. Provide written informed consent prior to any study procedure being performed.

Exclusion Criteria:

1. Female subjects who are pregnant, lactating or who are trying to conceive will be excluded from participation in this study.
2. Any uncontrolled chronic or serious disease or medical condition that would normally prevent participation in a clinical trial, or, in the judgment of the Investigator, would put the subject at undue risk, or might confound the study assessments (e.g., other dermatological diseases), or might interfere with the subject's participation in the study, (e.g., planned hospitalization during the study).
3. Particular forms of rosacea (e.g., rosacea conglobata, rosacea fulminans, isolated rhinophyma, isolated pustulosis of the chin, Ocular rosacea Phymatous rosacea, Steroid-induced rosacea, severe rosacea including pyoderma faciale) or other concomitant facial dermatoses that are similar to rosacea such as peri-oral dermatitis, demodicidosis, facial keratosis pilaris, seborrheic dermatitis, acute lupus erythematosus, or actinic telangiectasia.
4. Presence of more than two (2) nodulocystic lesions on the face.
5. Presence of less than 3 and more than 20 inflammatory lesions on the face (i.e. papules/pustules).
6. Severe papulopustular rosacea requiring systemic treatment.
7. Participation at the time of eligibility assessment (Screening) in any other investigational drug or device study or may have participated within 30 days prior to Screening.
8. Commencement of new hormonal therapy or dose change to hormonal therapy within 30 days prior to baseline. Dose and frequency of use of any hormonal therapy started more than 30 days prior to baseline must remain unchanged throughout the study. Hormonal therapies include, but are not limited to, oral, injected or implanted hormonal methods of contraception or placement of an intrauterine device (IUD) or intrauterine system (IUS) or other forms of hormonal contraception that have comparable efficacy (e.g. vaginal ring or transdermal hormone contraception)
9. Presence of beard or excessive facial hair at Screening which would interfere with the study treatments or study assessments and refusal to remove for duration of study.
10. Carcinoid, Pheochromocytoma or other systemic causes of flushing.
11. Known sensitivity to B244 or its components.
12. Refusal to submit to blood and urine sampling for laboratory analysis.
13. Treatment with prohibited medications.

Modified Intent to Treat (mITT) Population: all subjects who all subjects who met all inclusion/exclusion criteria, were randomized, dispensed treatment, and had at least one post-treatment efficacy evaluation.

Baseline to Week 12.

Beginning with the Screening visit and through the end of study or early termination (ET) visit, the PI and study personnel reviewed each subject's clinical evaluation findings and queried the subject directly regarding AEs. Subjects were to be followed for AEs until 30 days post study conclusion or until the PI determined the AEs were stable, whichever was later. PIs monitored each subject for clinical evidence of adverse events on a routine basis throughout the study.

This is a double blind study. Participants will be assigned to study treatment in accordance with the randomization schedule generated for the allocation of vehicle or B244 prior to the initiation of the trial. Randomization will be centrally-based and performed using an appropriate IWRS (an automated randomization system).

Each participant scheduled to receive investigational product (IP) will receive a randomization number at the time of randomization. The randomization number will be used to identify the study medication kit assigned to the participant and indicate the treatment to be administered to that participant.