Ivermectin (Soolantra) for rosacea
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.
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 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.
How can I help
I see patients in person in central London. An in person consultation allows me to examine the skin directly including features that are difficult to capture in a photograph such as 3-dimensional changes and textural change. This is the better option where the diagnosis is uncertain, where previous treatment has not been effective, or where a procedure is being considered. For more straightforward conditions such as acne and rosacea a remote consultation with clear photographs can be a good option.
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