Ivermectin for Rosacea

September 16, 2021

Treatment of rosacea with permethrin or ivermectin is not new. Soolantra was the first cream specifically approved with this ingredient for rosacea. However it has been well known for years that one of the potential triggers for rosacea in a subset of patients can be a mite known as Demodex that lives on our skin. Demodex may reside in our hair and oil glands and trigger inflammation associated with rosacea. Ivermectin is thought to work both by killing this mite as in addition to its work as an anti inflammatory agent to reduce the inflammation associated with rosacea. 
Rosacea is a chronic and multifaceted condition that can have a number of triggers. However in a subset of patients ivermectin can be highly effective oral or topically. In some cases, rosacea resistant to other therapies in a biopsy will actually reveal the mites on the skin and help guide therapy. 
I have definitely used and recommended this treatment in specific circumstances such as sudden onset of rosacea not otherwise explained or in those resistant to other treatments. It’s safe, effective and well tolerated. Even if it doesn’t work, it helps to address this as  potential cause directly.

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