From the Guidelines
Ivermectin for rosacea should be applied as a 1% topical cream once daily to affected areas of the face, with treatment continuing for up to 16 weeks, as it has been shown to reduce inflammation and kill Demodex mites that contribute to rosacea symptoms 1.
Key Considerations
- Apply a pea-sized amount as a thin layer to the entire face, avoiding the eyes, lips, and mucous membranes.
- Wash hands thoroughly after application.
- Improvements may be seen within 2-4 weeks, but treatment should continue as prescribed to maximize effectiveness.
- The medication works by reducing inflammation and killing Demodex mites, with a study showing that ivermectin 1% cream versus vehicle for moderate-to-severe rosacea resulted in treatment success, defined by IGA as “clear” (0) or “almost clear” (1) at 12 weeks, in 38.4% and 40.1% of subjects, compared to 11.6% and 18.8% in the vehicle groups 1.
Best Practices
- Apply after cleansing the face with a gentle, non-irritating cleanser.
- Allow the medication to fully absorb before applying other skincare products or makeup.
- Continue using the medication as prescribed even if symptoms improve quickly, as premature discontinuation may lead to relapse.
- If irritation occurs or symptoms worsen, consult your healthcare provider.
- Avoid alcohol, spicy foods, extreme temperatures, and other known triggers during treatment to maximize effectiveness.
Comparison to Other Treatments
- A head-to-head comparison study found that ivermectin 1% cream was superior to metronidazole 0.75% cream in reducing lesion counts and improving IGA ratings 1.
- A network meta-analysis concluded that ivermectin 1% cream is a more effective treatment for rosacea compared to other available treatments, including metronidazole 0.75% and azelaic acid 15% gel 1.
From the Research
Treatment with Ivermectin for Rosacea Directions
- Ivermectin 1% cream is a novel topical agent indicated for the once-daily treatment of inflammatory lesions of rosacea 2.
- The treatment has been shown to improve the symptoms of rosacea, including a reduction in inflammatory lesion count, and is well tolerated with low incidence of adverse events (<2%) 2.
- Topical ivermectin 1.0% cream has both anti-inflammatory and acaricidal activity against Demodex mites, which may contribute to its efficacy in treating rosacea 3.
- Ivermectin has been compared to other established treatment options, such as metronidazole, and has been found to be more effective in reducing the severity of papulopustular rosacea symptoms 3, 4.
Dosage and Administration
- Ivermectin 1% cream is applied once daily to the affected area 2.
- Combination therapy with 1% ivermectin solution and systemic treatment methods has been shown to be effective in reducing the severity of moderate to severe papulopustular rosacea symptoms 4.
Efficacy and Safety
- Ivermectin 1% cream has been found to be effective in improving the symptoms of rosacea, with a significant reduction in inflammatory lesion count and improvement in health-related quality of life 2, 3.
- The treatment has been shown to be well tolerated, with low incidence of adverse events (<2%) 2.
- Combination therapy with ivermectin has been found to be safe and effective, with no serious side effects reported 4.
Comparison to Other Treatments
- Ivermectin has been compared to other established treatment options, such as metronidazole, and has been found to be more effective in reducing the severity of papulopustular rosacea symptoms 3, 4.
- Topical ivermectin 1.0% cream has been found to be more effective than twice-daily metronidazole 0.75% cream in terms of reducing the severity of papulopustular rosacea symptoms 2.