Ivermectin (Soolantra) for rosacea - common questions

By Dr Magnus Lynch MA(Cantab) DPhil(Oxon) MRCS FRCP
Consultant Dermatologist & Dermatological Surgeon

Topical ivermectin (brand name Soolantra) is a widely used topical treatment for inflammatory rosacea. It works by reducing inflammation and also targeting Demodex mites, which may contribute to flare-ups. In my experience it is the most effective topical treatment for inflammatory rosacea. These are some of the most common questions that patients ask me:

How long until I see results?

Most people begin to notice improvement within two to four weeks of daily use, with fewer bumps and less irritation. The full benefit can take eight to twelve weeks, when many patients see a substantial reduction in papules and pustules. Background redness often takes longer to improve and may require additional treatments alongside ivermectin. It can be continued long term if it is effective.

Should I push through the initial “die-off” flare?

Some patients experience mild irritation such as dryness, tightness, or a slight sting in the first week or two, which often settles with moisturiser. However, if you develop marked burning, redness, or worsening inflammation, I would advise pausing treatment to allow things to settle then trying again with either a smaller quantity and applying every other day rather than every day.

If I stop ivermectin, will my symptoms come back?

Rosacea is a chronic condition, and ivermectin helps to control symptoms rather than curing the underlying tendency. If you stop treatment completely, the spots and bumps often return gradually, typically within a few weeks to a few months. Some patients find that stepping down to applying it only three to five nights per week after initial clearance is enough to maintain control.

About Dr Magnus Lynch

I am a London-based Consultant Dermatologist and Dermatological Surgeon. My NHS practice is at Guy's Hospital and is focused on Mohs micrographic surgery and the treatment of complex skin cancers. My private practice additionally focuses on laser treatments, regenerative dermatology, rosacea, acne, pigmentation and scarring. I have particular expertise in the diagnosis and treatment of skin cancer, including minimally-invasive techniques, Mohs micrographic surgery, and facial reconstructive surgery. I studied at the Universities of Cambridge and Oxford, and completed my dermatology training and Mohs fellowship at the prestigious St John’s Institute of Dermatology. I graduated from medical school in 2003 and have worked exclusively in Dermatology since 2012.

I lead a research team at King’s College London investigating the molecular biology of skin cancer and skin cancer diagnostics, and I constantly aim to translate the latest findings into better patient care. You can learn more about my Research.

In recent years I have been involved in Media Appearances, including the Channel 5 series 'Skin A&E', where I perform skin surgeries and treat various skin conditions. Filming for the next series has recently completed and the series will be released later in 2025.

How I can help

If you’re struggling with rosacea or skin sensitivity I can tailor a treatment plan with clear timelines and a maintenance strategy.

I consult with private patients at several well-appointed and conveniently located sites across central London:

• London Bridge Hospital: Conveniently situated within The Shard, next to London Bridge station.
• Skin55 Ltd: Located at 55 Harley Street, this beautiful Edwardian building houses one of the largest private dermatology facilities in the UK with a comprehensive laser suite.
• OneWelbeck: Located close to Bond Street underground station. Mohs surgery, lasers, and other skin surgeries are performed in the state-of-the-art surgical suite here.

A new consultation is £250, a follow up consultation is £220. For more information on fees, please visit Prices.