From the Guidelines
Ivermectin 1% cream is recommended for the treatment of inflammatory lesions of rosacea, as it has been shown to reduce Demodex folliculorum density and improve cutaneous inflammatory markers. The use of ivermectin for inflammation is supported by a 12-week pilot study of 20 subjects with IGA scores ≥ 3, which demonstrated clinical improvement with in vivo reduction of demodex mite density and improved cutaneous inflammatory markers with once-daily ivermectin cream 1% 1. Additionally, a pivotal phase 3 trial of 683 and 688 adults with moderate-to-severe rosacea showed that ivermectin 1% cream was more effective than vehicle in achieving treatment success, defined by IGA as “clear” (0) or “almost clear” (1) at 12 weeks 1.
Some key points to consider when using ivermectin 1% cream for inflammatory lesions of rosacea include:
- The treatment should be applied once daily to the affected area
- Clinical improvement can be expected after 6-12 weeks of treatment
- Ivermectin 1% cream has been shown to be safe and well-tolerated, with fewer adverse effects compared to vehicle 1
- The exact mechanism of action of ivermectin in reducing inflammation is not fully understood, but it is thought to be related to its ability to reduce Demodex folliculorum density and modulate the immune response 1
It is essential to note that ivermectin 1% cream is specifically approved for the treatment of inflammatory lesions of rosacea, and its use for other inflammatory conditions is not supported by clinical evidence. Established anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, should still be used for other types of inflammation.
From the Research
Ivermectin and Inflammation
- Ivermectin has been found to have anti-inflammatory properties, which may be beneficial in treating inflammatory conditions 2.
- The drug's ability to block the nuclear factor kappa-light-chain enhancer of the activated B (NF-κB) pathway, which modulates the expression and production of proinflammatory cytokines, is implicated in its role as an anti-inflammatory agent 2.
- Ivermectin has been evaluated for its potential to treat various inflammatory conditions, including rosacea, and has shown promise in reducing inflammation and improving symptoms 2.
Ivermectin and COVID-19
- Several studies have investigated the use of ivermectin in the prevention and treatment of COVID-19, with some showing potential benefits in reducing mortality, hospitalization, and viral clearance 3, 4, 5.
- A systematic review and meta-analysis found that ivermectin reduced the risk of death compared to no ivermectin, and also reduced the risk of COVID-19 infection by an average of 86% 5.
- However, other studies have found conflicting evidence, and the current evidence is not sufficient to support the use of ivermectin for COVID-19 treatment or prevention outside of clinical trials 3.
Ivermectin Dosage and Treatment Duration
- The optimal dosage and treatment duration of ivermectin for inflammatory conditions and COVID-19 are not well established, and more research is needed to determine the most effective regimen 6.
- A study found that a 5-day course of ivermectin was safe and effective in treating adult patients with mild COVID-19, and reduced the duration of illness 6.