Soolantra cleared my spots but not the redness - what next?
This is very common and does not mean the treatment has failed. Soolantra (ivermectin) treats the inflammatory spots of rosacea - the red bumps and pustules - and in my experience it is the most effective cream for these. Often inflammation will lead to persistent redness due to an increased number of blood vessels at the skin surface, and a cream cannot help with this, so once the spots have cleared the redness is often what remains.
Why the redness stays
Rosacea has two separate components. Inflammation produces the papules and pustules, and this responds to creams and tablets. Over time rosacea also leads to an increased number of dilated blood vessels near the skin surface, which produce constant background redness and visible thread veins. No cream or tablet removes these vessels.
Before concluding that the redness will not improve, it is worth allowing time. Spots usually improve within two to four weeks, but the full benefit of ivermectin can take eight to twelve weeks, and background redness often takes longer still.
What helps the redness
- Vascular laser: targets the tiny blood vessels in the skin surface without injuring the skin, so that they are eliminated by the body's immune system and fade. For rosacea redness, most people need 3 to 6 sessions, 6 weeks apart.
- Redness creams: brimonidine (Mirvaso) or oxymetazoline (Rhofade) temporarily reduce redness for some hours and suit special occasions. They do not treat the vessels, and brimonidine can cause rebound redness.
- Continuing Soolantra: keep using it, or step down to a few nights a week, to stop the spots returning.
Spots gone but still red?
If your spots have settled but the redness has not, I can confirm what is causing it and whether vascular laser is likely to help. Consultations can be in person or remote.
Related Articles
- Ivermectin (Soolantra) for rosacea
- IPL vs VBeam (PDL) for redness and veins
- Brimonidine vs oxymetazoline for redness
- How many laser sessions do I need?
