Rosacea is a chronic skin condition that affects millions of people around the world. Sufferers often find it hard to manage the redness, irritation and bumps which often come with Rosacea. Despite how widespread it is and the impact it can have on people’s lives, the exact causes of and definitive treatments for Rosacea remain elusive. However, one surprising skin treatment that has been extremely promising in treating rosacea is ivermectin cream. In this article, we’ll explore what ivermectin is, how it works for rosacea treatment and the best way to add it to your skincare routine.
What Is Ivermectin?
Ivermectin is an antimicrobial drug that has had wide uses for decades and is most famous of its use in treating parasitic infections. Initially developed in the 1960s for veterinary purposes, ivermectin quickly found its way in to human medicine initially due to its effectiveness against various parasitic diseases including worms. More recently, its it is enjoying increasing use in dermatology due to its multifunctional effects. The main actions on the skin that make ivermectin attractive include:
- Antiparasitic: Ivermectin effectively targets and eliminates parasitic organisms such as Demodex mites. These are common in conditions like rosacea and demodicosis. It is also highly effective against scabies mites. Ivermectin works by binding to the parasites’ nerve and muscle cells which leads to their paralysis and eventual death.
- Anti-Inflammatory: Through its strong anti-inflammatory effects, ivermectin helps reduce redness, swelling, and irritation in the skin. This makes it particularly useful for managing inflammatory conditions like rosacea and seborrheic dermatitis.
- Antibacterial: Ivermectin also has mild antibacterial properties which can reduce bacterial overgrowth often linked to skin irritation or secondary infections. However, as these antibiotic properties are mild, ivermectin is most useful in conditions where bacteria and inflammation coexist.
- Antioxidant Effects: Emerging research indicates that ivermectin may have antioxidant properties helping to neutralise free radicals and reduce oxidative stress. If additional research supports this, it means that ivermectin could potentially support overall skin health and prevent premature skin ageing.
How Does Ivermectin Work for Rosacea?
Rosacea is a complex skin condition, but two key factors are very likely to contribute to its symptoms. These are inflammation and the overgrowth of Demodex mites on the skin. These microscopic organisms live in hair follicles and sebaceous glands. Whilst harmless in most individuals, an overabundance of Demodex mites can irritate the skin, triggering redness, swelling and acne-like bumps characteristic of rosacea.
In 2014, the FDA approved ivermectin 1% cream (sold under the brand name Soolantra) for the treatment of papulopustular rosacea. This specific subtype of rosacea manifests as persistent redness, swelling and acne-like bumps. It can be both physically uncomfortable and emotionally distressing making effective treatment essential. The two ivermectin properties that make it effective for this type of rosacea are:
- Antiparasitic: Ivermectin targets and eliminates Demodex mites, significantly reducing their population. By addressing this root cause, it helps to minimise the irritation and inflammation linked to their overgrowth.
- Anti-Inflammatory: Beyond its antiparasitic action, ivermectin also has potent anti-inflammatory properties. These help to calm redness and swelling, promoting healthier and more resilient skin.
Benefits of Ivermectin for Rosacea
Ivermectin has quickly become one of the most popular treatments for rosacea and with good reason. By targeting both the underlying triggers and the resulting inflammation, ivermectin can help provide visible improvements over time. For many patients, this translates to fewer flare-ups, reduced redness and smoother more even-toned skin. As such the key benefits of ivermectin for rosacea treatment include:
- Targeted Action: Unlike general anti-inflammatory treatments, ivermectin tackles one of the root causes of rosacea; the Demodex mites.
- Ease of Use: As a topical cream, ivermectin is easy to apply and integrates seamlessly into most skincare routines.
- Fewer Side Effects: Compared to oral treatments, ivermectin cream is less likely to cause systemic side effects.
- Long-Term Results: Many patients see sustained improvements with consistent use and it is safe for prolonged use.
How long it takes to see results from ivermectin for rosacea varies from patient to patient. As such, patience is key when using ivermectin. Although some people may notice improvements within a few weeks, most only see significant results after 8-12 weeks of consistent use. Also improvements tend to be gradual and build up. Over time, you may find that your skin becomes less reactive and that flare-ups occur less frequently.
Where to Get it?
First of all this is a a prescription-only medication. To get ivermectin cream you’ll need to consult with a dermatologist or other healthcare provider who can assess your skin and determine whether it’s the right treatment for your rosacea or other skin concerns. They may then prescribe Soolantra (which is the licensed treatment) or some doctors may recommend a compounded formulation of ivermectin cream. Compounded cream are typically prepared by specialised pharmacies and may be tailored to suit your specific skin needs or combined with other ingredients like azelaic acid or metronidazole. They should then provide regular follow-ups to monitor your progress and make adjustments to your treatment plan as necessary.
How to Use Ivermectin in Your Skincare Routine
Adding ivermectin into your skincare routine is fairly straightforward but it is vital to follow your provider’s instructions woth regards to frequency, amounts and duration. A typical protocol usually looks like the below:
- Cleanse Properly: Start by cleansing your face with a gentle, non-stripping cleanser. Look for one that is free from harsh fragrances, alcohol or exfoliating acids as these can irritate rosacea-prone skin. Its ideal to cleanse twice daily (once in the morning and once in the evening) to remove dirt, oil, skincare and makeup.
- Apply Ivermectin as Directed: After cleansing, pat your skin dry with a soft towel. Take the prescribed amount of ivermectin cream and apply it evenly to the affected areas. This is typically done once daily, usually in the evening though your doctor may advise otherwise. It is best to avoid applying the cream to broken or irritated skin. You should also keep it away from your eyes and mouth.
- Moisturise: This is crucial to maintain hydration and support your skin barrier, especially if your skin feels dry or tight. Choose a product formulated for sensitive skin to minimise irritation.
- Protect: In the morning, always finish your routine with a broad-spectrum sunscreen that offers at least SPF 30. Sunscreen is especially important for rosacea-prone skin. This is because as UV rays can trigger flare-ups and worsen redness.
- Don’t Go Rogue: Use ivermectin exactly as prescribed by your doctor. Overuse won’t speed up results and could lead to irritation which can actually slow you down.
Safety & Side Effects
Ivermectin is generally safe and effective for a wide range of people with papulopustular rosacea. However, like any medication, ivermectin may cause side effects. Common side effects include:
- Temporary skin dryness
- Mild redness or irritation
- A sensation of warmth or stinging after application
These symptoms are usually mild and subside as your skin adjusts to the treatment. Rarely, there may also be more serious problems such as allergic reaction which is why it is important to perform a patch test first. If you experience severe or persistent side effects, you should consult your treating doctor. Additionally, ivermectin may not be suitable for everyone including:
- Those with ocular rosacea (affecting the eyes) or erythematotelangiectatic rosacea (redness without bumps) may require alternative treatments.
- Individuals with sensitive need to exercise caution as irritation can occur initially.
- Ivermectin skincare is generally not recommended for use during pregnancy or breastfeeding unless specifically advised by a healthcare provider. This is because aits safety in these settings has not been fully established.
Alternatives to Ivermectin for Rosacea
Although ivermectin is a highly effective treatment for some types of rosacea, it’s not the only option available. Depending on your specific symptoms, skin type and severity of the condition, your dermatologist may recommend other treatments. These may be either as standalone skincare treatments or in combination with each other and/or ivermectin.
- Topical Metronidazole: This anti-inflammatory cream has been a mainstay in rosacea treatment for years. It’s particularly effective at reducing redness and inflammation and is often used for milder cases of rosacea or in conjunction with other therapies.
- Azelaic Acid: This versatile ingredient is known for its anti-inflammatory, antimicrobial and skin-brightening properties. It can help reduce redness and bumps while improving overall skin texture. As such azleaic acid is an excellent alternative or companion to ivermectin.
- Niacinamide: A soothing ingredient with anti-inflammatory properties, niacinamide helps to strengthen the skin barrier and reduce redness. It can be used alongside prescription treatments like ivermectin for enhanced results.
- Tretinoin: Low doses of tretinoin may be useful for rosacea as it helps to improve skin texture, promote cell turnover and reduce inflammation. However, tretinoin can be irritating, so it must be introduced carefully under a careful guidance.
- Oral Antibiotics: Medications like doxycycline are often prescribed for more severe or widespread rosacea in low doses. They work by reducing inflammation and calming flare-ups.
- Laser & Light Therapy: For persistent redness, visible blood vessels or flushing, treatments like pulsed dye laser (PDL) or intense pulsed light (IPL) can be highly effective. These therapies target the blood vessels beneath the skin helping to reduce redness and texture.
Ivermectin is used for a wide range of skin conditions including rosacea, scabies, demodicosis, lice infestations, acneiform eruptions and seborrheic dermatitis. This is due to its many benefits including its ability to target parasites and calm inflammation. Ivermectin is a valuable skincare treatment for pustular rosacea as it provides a targeted and easy to use treatment for this complex multifactorial skin condition. That being said, ivermectin is not a miracle cure nor is it a silver bullet. It is not suitable for everyone or all types of rosacea and may not be enough by itself. As such you should always seek help from a medical provider who can help you start the best treatment for you.
At City Skin Clinic, we are passionate about personalised skincare. We offer safe and effective compound skincare treatments with prescription-strength ingredients. These include Tretinoin and Hydroquinone where appropriate through online skin clinic. Our doctors treat a range of conditions such as acne and scars, hyperpigmentation, melasma, skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.
