Topical ivermectin 1% cream may help treat rosacea, particularly papulopustular rosacea. It’s available under the brand name Soolantra.

Rosacea is a skin condition typically characterized by inflammation, facial redness, small bumps, or thickened skin. It also sometimes affects the eyes.

Though there’s no known cause for rosacea, environmental and hereditary factors appear to play a role. A skin mite called Demodex and the bacterium it carries may also trigger the onset of some rosacea symptoms.

Ivermectin 1% cream (Soolantra) is an anti-parasitic prescription medication approved by the Food and Drug Administration (FDA) for treating rosacea.

Although its exact mechanism of action is unknown, its anti-inflammatory and anti-parasitic effects on the Demodex mite appear to play a role.

Here’s what else to know about using ivermectin for rosacea.

The FDA approved ivermectin 1% cream to treat rosacea lesions based on the results of two randomized, controlled, double-blind trials. In both studies, participants with moderate-to-severe papulopustular rosacea experienced significant reductions in lesions compared with the control cream.

While some rosacea creams may take up to a month to produce results, 1% ivermectin cream showed results after about two weeks of use.

According to a 2016 review by American Family Physician, ivermectin 1% cream was shown to clear or nearly clear papulopustular rosacea lesions in 40-80% of 1,371 patients after 3 months of use. Patients also reported a higher quality of life after treatment. Ivermectin more effective than topical metronidazole, another common rosacea treatment.

About half of patients’ rosacea symptoms returned about 4 months after discontinuing use.

In a 2019 review and meta-analysis, researchers concluded that ivermectin 1% cream worked better than metronidazole, azelaic acid, and a placebo for both short- and long-term treatment for papulopustular rosacea.

Keep in mind that ivermectin still hasn’t been studied in patients with milder rosacea or in other subtypes of rosacea, such as erythematotelangiectatic rosacea, which is characterized by facial redness and flushing.

There’s far less research into the use of oral ivermectin for rosacea. Though the research that does exist shows some promise, the FDA hasn’t approved its use for rosacea.

In recent years, some people have reported using oral ivermectin formulated for animals to treat rosacea and other conditions, including COVID-19.

However, this type of ivermectin is formulated for large animals, such as horses and cows, resulting in a highly concentrated product that can be toxic to humans, according to the FDA. This type of ivermectin also contains several inactive ingredients that haven’t been evaluated for human consumption.

While oral ivermectin may be a potential rosacea treatment in the future, topical 1% ivermectin is currently the safest, most effective option.

Topical ivermectin 1% cream isn’t linked to any serious adverse effects and is generally considered to be safe for most people.

That said, some mild side effects may include:

  • burning skin
  • skin irritation
  • skin dryness
  • itchiness

These effects are usually temporary and may decrease over time.

Though there aren’t any serious side effects associated with topical ivermectin 1% cream, it hasn’t been evaluated in human studies for use in children or those who are pregnant or nursing.

The FDA approved ivermectin 1% cream to treat rosacea in 2014. It’s known to treat papulopustular rosacea in particular, which is characterized by inflamed, acne-like bumps. It’s unclear whether it’s as effective for milder forms of rosacea.

If you’re interested in using topical ivermectin cream to treat your rosacea outbreaks, talk with your care team. If it seems like a good fit, they can provide a prescription.