Is topical ivermectin effective for treating skin cancer?

Topical Ivermectin for Skin Cancer: Efficacy Assessment

Topical ivermectin is not recommended for the treatment of skin cancer due to lack of evidence supporting its efficacy for this indication, according to the American Academy of Dermatology guidelines. 1

Current Evidence on Topical Ivermectin for Skin Cancer

The American Academy of Dermatology explicitly recommends against using topical ivermectin for treating skin cancer. This recommendation is based on:

• Absence of clinical evidence supporting ivermectin's efficacy in skin cancer treatment
• Risk of delayed effective treatment if patients pursue unproven therapies 1
• No large-scale randomized controlled trials confirming therapeutic benefits of ivermectin in human skin cancer 2

Approved Uses of Ivermectin

Topical ivermectin is currently only approved for:

• Treatment of rosacea
• Management of parasitic infections like scabies
• Treatment of Demodex folliculorum infestations in blepharitis 1

Guideline-Recommended Skin Cancer Treatments

The American Academy of Dermatology recommends the following evidence-based treatments for skin cancer:

For Cutaneous Squamous Cell Carcinoma (cSCC):

• High-risk cSCC: Mohs micrographic surgery
• Low-risk primary cSCC: Standard excision with 4-6 mm margins
• Alternative for low-risk cSCC: Curettage and electrodesiccation (in non-terminal hair-bearing locations)
• When surgery is contraindicated: Radiation therapy (with understanding of potentially lower cure rates)
• Limited use: Cryosurgery for low-risk cSCC when more effective therapies are contraindicated 1

For Basal Cell Carcinoma:

• Surgical excision remains the gold standard
• Photodynamic therapy (PDT) has shown efficacy for superficial basal cell carcinoma 1

Research on Ivermectin and Cancer

While some preclinical research suggests potential anticancer properties of ivermectin, these findings have not translated to clinical practice:

• In vitro studies show ivermectin may inhibit cancer cell proliferation and induce apoptosis in melanoma cells 3
• Laboratory research indicates ivermectin may interact with multiple targets including multidrug resistance protein, Akt/mTOR and WNT-TCF pathways 4
• However, there is a critical translational gap between these preclinical results and clinical application 2

Risks of Using Ivermectin for Skin Cancer

Using topical ivermectin for skin cancer treatment carries significant risks:

• Delayed access to proven effective treatments
• Missing the window for curative surgical intervention 1
• Potential toxicity in oncology patients who self-medicate based on unproven claims 2

Clinical Implications

Healthcare providers should:

• Advise patients against using topical ivermectin for skin cancer treatment
• Recommend established, evidence-based treatments according to cancer type, location, and risk factors
• Emphasize the importance of early detection and prompt treatment with guideline-recommended interventions 1
• Counter misinformation about unproven therapies while guiding patients toward evidence-based interventions 2

While some patients may seek alternative treatments like ivermectin due to economic or social factors 5, the lack of clinical evidence supporting its use for skin cancer treatment makes it an inappropriate recommendation for clinical practice.