This blog is aimed at rosacea subtype 1, with skin flushing, redness and burning. Many people suffer from subtype 2 rosacea however, with skin outbreaks. And very often the division lines between the various rosacea subtypes are not super strict and patients experience overlaps of symptoms. I get the odd pimple and skin outbreak myself at times too. Never long lived and not very often, but it seems interesting to also focus now on a relatively NEW rosacea treatment, that aims to treat the pimples and skin outbreaks from rosacea. The product is called IVERMECTIN. In itself it has been on the market for a long time already, but not as rosacea treatment. By itself ivermectin is as a medication that is effective against many types of parasites. It is also used to treat conditions like head lice, scabies and river blindness. But recently, topical ivermectin (Soolantra) has been approved by the FDA for treatment of the inflammatory lesions of rosacea. Researchers (Stein et al) reported back in 2014 that ivermectin 1% cream was safe and effective for the treatment of inflammatory lesions from papulopustular rosacea, based on two randomized, controlled, double-blind, identically designed studies of ivermectin 1% cream versus vehicle applied once daily for 12 weeks. Aside from the rather expensive Soolantra cream, people have also resorted to a very cheaply available form of ivermectin, as it is sold also in syringes and liquid form in veterinary care. The active ingredient is exactly the same. I will share information below about this option, and about how some people have used those forms of ivermectin successfully on their rosacea skin. And there is also the option to use ivermectin in oral pill (or powder or capsule) form, as ivermectin can be taken either by mouth or be directly applied to the skin. Applying it topically is what is approved now for rosacea, but some people have also taken ivermectin in pill form already, under doctor's guidance, with success.
See photos and video results at the bottom of this post, as well as quotes from user testimonials.
Long has it been debated whether or not rosacea could have a bacterial cause, or perhaps even a demodex mite cause. It is still not clear what exactly causes rosacea, and rosacea is also a gathering term for a ton of different skin problems that share the same red facial skin symptom but that can have very different causes, including bacterial infections, demodex mite infestations, autoimmune conditions, allergies, food intolerances, blood vessel disorders and so on. Ivermectin can kill demodex skin mites. Demodex folliculorum live in small hair follicles, especially those of the eyelashes. They eat skin cells. Demodex brevis live in the sebaceous (oil) glands of the skin and can be found on skin areas that naturally are producing more oil/sebum. Both are a natural part of the human skin and part of a natural balance with bacteria and other microorganisms, but science has highlighted recently that people with rosacea have more of these skin mites than people with normal functioning skin; up to four times as many demodex mites, in fact. And it has also been suggested that people with rosacea have an abnormal immune skin reaction to these mites, which causes our skin to break out, turn red and itchy.
Patients with demodicosis may suffer from eye irritation, itching and scaling of eyelids (blepharitis or eyelid dermatitis). There may be lid thickening, loss of lashes (madarosis), conjunctival inflammation and decreased vision. People also reported dry eyes, reddened, crusty, itchy, burning eyelids, abnormal eyelash growth and inflammation of the cornea [keratitis], abnormal corneal blood vessel growth and the development of nodular bumps of scar tissue on the cornea. People who have demodex folliculorum can have rough skin, slight redness and sandpaper-like texture of the skin, as well as skin irritation and burning sensations. They can develop rosacea symptoms, especially with p&p's, skin outbreaks and nodules. There can even be demodex infestation of the ear, giving symptoms such as frosted, gritty follicular scaling of the ear lobe and helix. But demodex is not just linked to rosacea. A 2012 Chinese meta-analysis found that people with acne vulgaris had almost three times the likelihood of demodex infestation. Because the mites have an aversion to light, they conduct most of their business at night (causing itching) and crawl back into the hair follicles in the morning.
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identified a specific peptide in the skin that is linked to the inflammation, redness and skin outbreaks of rosacea (as well as to other inflammatory skin diseases); peptide LL-37: "Chronic, common inflammatory skin diseases such as atopic dermatitis, psoriasis or rosacea are characterized by dysregulation of cutaneous innate immunity (aka; there is an issue in rosacea skin with the normal functioning of the immune system function). Cathelicidin LL-37 is an important effector molecule of innate immunity in the skin and atopic dermatitis, psoriasis or rosacea show defects in cathelicidin expression, function or processing. *In rosacea, cathelicidin processing is disturbed resulting in peptide fragments causing inflammation, erythema [skin redness] and telangiectasias [small dilated blood vessels at the surface of the skin]. Indeed, cathelicidin is strongly increased lesional skin in rosacea compared to the skin of non-affected individuals."
It is possible that demodex treatment solves a lot of rosacea symptoms when you have a demodex skin infection. But, not everyone sees results from it, and the more you suffer from skin flushing, burning and redness (instead of skin outbreaks, pimples and inflammation), the higher the risk that you don't see the same dramatic results. Because demodex mites are not the underlying cause of your symptoms. So it is very well possible that demodex mites are just one part of the rosacea puzzle. But that there are other things at play with several other rosacea subtypes. Research has for instance shown recently that people with rosacea tend to have immune related reactions inside the body that contribute to rosacea's development, involving such substances as kallikreins, the above mentions cathelicidins and also mast cells. Most rosacea triggers, from ultraviolet light damage to bacterial infections that trigger an immune response in the body, have one thing in common: they have been shown to activate the specific enzyme receptor-2 (TLR-2) which is linked to earlier mentioned cathelicidin LL-37, which normally is only used to fight off legit enemies for our own health. But in our case they are not triggered to fight a REAL invader (for example bacteria causing skin infections, a virus or a fungi), but instead are triggered willy-nilly, causing (unnecessary) skin inflammation, blood vessel dilation and redness and causes us to develop the well known symptoms of rosacea, including papules (bumps) and pustules (pimples). - Photos of a person with demodex mites:
Partly because it does not explain ALL cases of rosacea. But science has now confirmed that Demodex mite infestation is an important factor in some cases of rosacea. It is suggested that it especially plays a role in rosacea subtype 2 with skin outbreaks, bumps and pimples. Your doctor can do a simple skin scrape test and look for abnormal numbers of demodex mites under a microscope to diagnose this. My own dermatologists have said numerous times to me that for subtype 1 with flushing and burning, demodex mites often play no role. However, even this might be old news, as researcher Dr. James Del Rosso, adjunct clinical professor of dermatology at Touro University College of Osteopathic Medicine in Henderson, Nev. states: “The classic ‘subtypes’ of rosacea appear to reflect variations in inflammatory and immunologic responses which in some cases may be induced by Demodex mites. For example, in one study, individuals with erythematotelangiectatic rosacea (subtype 1) were found to have higher facial counts of Demodex mites than those with papulopustular rosacea (subtype 2). It has been suggested that the higher Demodex counts lead to degradation of the follicular wall as the mites attempt to improve their survival. This loss of follicular wall integrity then triggers an immunologic response that reduces the number of Demodex mites, with papules and pustules subsequently emerging from the augmented perifollicular inflammation that occurs.”
Symptoms of demodex skin infestations, called demodicosis, are (small) papules, pustules and fine scaling of the skin. Demodicosis can mimic rosacea symptoms, but usually does not respond at all to traditional rosacea therapy and treatments. It does respond well to treatments that kill the demodex mites. For instance Ivermectin or Permethrin cream. Other treatments that have been said to have effect are Borax, Tea Tree Oil, Sulphur or Hypochlorous acid (HOCI). You can best ask your dermatologist to do a skin scraping, and then have your doctor do a mite count under the microscope. He or she can then confirm if you have more than normal numbers of demodex mites on your skin. Another way of finding out if demodex mites cause YOUR rosacea symptoms to worsen or even to exist at all, is of course to try ivermectin cream for yourself. There is always the risk that some ingredients in it cause a skin reaction, but other than that, a skin clearance on ivermectin cream is another way to self diagnose. Here you can read many more pubmed research articles on demodex mites. And here is a good comprehensive oversight article on demodex mites and rosacea. In this research, rosacea was found to be a statistically significant risk factor for Demodex infestation in eyelashes, with a higher prevalence in papulopustular variety. Article.
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Ivermectin kills the demodex mites and indirectly eliminates the B. oleronius bacteria. The first thing ivermectin will do is kill the adult mites on your face. When they die, they release the bacteria they carry inside them (they can't "poop"..). These bacteria are released into your skin as the mite dies. This is part of the reason why some people with rosacea who start antimite treatments such as Ivermectin, see a worsening of their skin and pimples in the first weeks. This is a necessary thing to go through. The more mites you begin with, the more of a skin reaction you can expect when these mites are dying and releasing their irritating bacteria and toxins into the skin. This will pass and afterwards many patients see an improvement of their skin, often quite dramatically so. It is said to keep using ivermectin/ soolantra at least 6 weeks for this reason, although some people even mention a 12 week period before people can see the true results. Although Ivermectin is very effective at killing the adult mites, it does not affect the eggs and larvae inside the skin pores. Therefore there will be a second stage of healing, and therefore it is important to continue using the ivermectin, even when you see improvement. The mites also need to be killed by the ivermectin as soon as they mature, and before they deposit new eggs in the skin. The main good reason to stop using your anti-demodex treatment early, is when your skin is allergic or hypersensitive to the ivermectin itself, or to one of the inactive ingredients of the gel or paste. Propylene glycol is for instance in every single product one I found available. And propylene glycol can be a skin irritant for sensitive individuals. The initial skin worsening can be made less severe if you also take an antibiotic, usually one from the tetracycline group, until the papulas/skin bumps are gone. They will kill the bacteria that live in the guts of the demodex mites. You could also simultaneously use a cream like Finacea, containing Azelaic acid, or Metronidazole Cream. Also consider to continue using them after the bumps have cleared from your ivermectin course, for at least a month or two.
Soolantra or ivermectin creams work a little bit differently, as explained above. Metronidazole or Finacea cream can help make the die-off phase of the mites less noticeable. Metronidazole cream has anti-inflammatory and antibiotic effects on your skin, helping to kill specific bacteria that live in the Demodex mite and that can trigger papules and/or pustules. Finacea (Azelaic acid) is anti-inflammatory and also kills a specific bacterium that is related to acne. It works a bit similar to metronidazole cream. Some dermatologists prescribe all three creams together actually, but the downside is that you might not know then what cream is working and helping and which one is doing what. You can try all three together though or choose to just try one or two of them, best ask your dermatologist
Oral Ivermectin will also kill the Demodex mite that are related to some of rosacea's papules and pustules. With just 2 or 3 doses of oral Ivermectin, with an interval of 7-10 days, you eliminate almost all of them. Ivermectin in oral form might be better when you have also ocular Rosacea. Oral ivermectin is also an option when you have a demodex skin issue and your skin cannot tolerate topicals. The demodex mite is a normal inhabitant of the human facial skin, so it can come back after time. But its infestation can be controlled after your oral ivermectin course, for instance with Ivermectin cream form or tea tree oil. And you can also add some drops of Tea tree oil when you wash your bedding and pillow cases for instance (as they do like to live in beds also). - I tried a course of oral ivermectin and my skin did not change from it (but I don't have subtype 2 rosacea and neither p&p's).
Soolantra has been brought on the market recently. It uses the good old Ivermectin anti-parasite at 1%, and they have put this active ingredient in a gel base that is similar to cetaphil cream. Try using a drop of your soolantra cream on wet skin. It is easier to spread and absorb then. In red the ingredients that may be a trigger for those with very sensitive skin.
SOOLANTRA cream contains the following inactive ingredients:
*carbomer copolymer type B (a hydrophilic thickener; emulsion stabilizer; gel forming)
*cetyl alcohol (an emollient; emulsion stabilizer; thickener - not considered irritating for the skin)
*citric acid monohydrate (a buffering agent; pH adjuster - not considered irritating for the skin)
*dimethicone (antifoaming; emollient; skin protecting - not considered irritating for the skin)
*edetate disodium (chelating agent)
*glycerin (solvent; moisturizer - not considered irritating for the skin)
*isopropyl palmitate (solvent; fragrance; synthetic ester; moisturizer - can be comedogenic)
*methylparaben (Preservatives, Antimicrobial - can irritate the skin in very sensitive skin types. Parabens, including methylparaben, mimic the effects of estrogen in the human body.)
*oleyl alcohol (surfactant; viscosity control; emulsifier - can be comedogenic and can be a skin irritant)
*phenoxyethanol (preservative; fragrance stabilizer - can be a skin irritant as it dries out the skin)
*polyoxyl 20 cetostearyl ether (hydrophilic emulsifier; surfactant)
*propylene glycol is a solvent; it is a hydrating ingredient, a man-made organic alcohol that attracts/absorbs water. It is broadly used by food, drug, and cosmetic and personal care product manufacturers. Safe ingredient but can cause skin irritation or allergy for very sensitive skin types, so test on skin first. Usually, this happens in people who are allergic to the chemical and subsides after a short period of time after the body has had time to break down the compound. However it is used in many skin care and cosmetic products and also in most Ivermectin products, so either way, if you are sensitive to it, not even Ivermectin pastes might be suitable for your skin).
*propylparaben, (Preservatives, Antimicrobial - can irritate the skin in very sensitive skin types. Parabens, including methylparaben, mimic the effects of estrogen in the human body.)
*purified water
*sodium hydroxide (pH adjuster)
*sorbitan monostearate (emulsifier; non-ionic surfactant composed of sweetener sorbitol and stearic acid, a naturally occurring fatty acid.)
*stearyl alcohol (emulsion stabilizer; emollient; foam booster; thickener, composed of sweetener sorbitol and a naturally occurring fatty acid. Can be comedogenic and can be a skin irritant).
I mention all ingredients, as inactive (filler) ingredients can irritate our skin just as much as any active ingredient a cream may have. Read more about this here.
In some countries Soolantra can be a very expensive cream, costing several hundreds (!) of dollars. Think of countries like the United States, or countries where health insurance does not cover its costs. For people who cannot otherwise afford to use this cream (which basically took an already existing drug that outlasted its patency rights and is therefore dirt cheap to produce and sell nowadays, and put it in one of their own skin care creams, then whooped up the price ten or even 100-fold), there is an alternative if they want to treat their rosacea with ivermectin. Soolantra uses Ivermectin as an active ingredient, and all its other ingredients are inactive and therefore not the ones with the medical strength. They are simply added to make up a cream substance, a carrier, and to help the active ingredient penetrate the skin better. A cheap alternative to Soolantra is to simply buy Ivermectin online. As a pill it won a Nobel prize for its use in the treatment of various human infectious diseases. As a liquid, ivermectin is also used for animals including horses, rabbits, dogs and guinea pigs as an antiparasitic injection. Many hundreds of rosacea patients have so far purchased these creams or injections online and used a small drop of it on their skin daily, with really good results; clearer skin, paler skin. They have been writing about this in various health groups. There are some things you have to keep in mind, when taking such a detour. But the active ingredient is exactly the same.
There are several ivermectin pastes available, I am mentioning some below, and many have the same ivermectin strength as Soolantra (1% ivermectin), with exception of two brand who offer 1.87% ivermectin. Several patients have asked their dermatologists about these alternatives and received positive responses; one of my own derms also said that ivermectin is the same and as effective as Soolantra. Some already suggest to their rosacea patients to try ivermectin, as Soolantra is effectively the same but extremely expensive in countries like the United States. The Ivermectin products are available for as little as $5. Even at 1.87% instead of 1% strength, it is still considered safe to use, although I would personally start off with an ivermectin product that comes as close as possible to Soolantra (so I'd got for 1% ivermectin myself initially). But like I said, dermatologists who I have heard from so far have said that this percentage difference should be no problem. If anything, it might work faster, better and for a whole lot less money. But to be on the safe side, sticking to 1% is probably the safest option, given that Soolantra is the product that has been tested on human (rosacea) skin and found to be safe. Please check out the inactive ingredients of each of the ivermectin products available, and discuss its use with your dermatologist first. The inactive ingredients of most ivermectin products should not be a problem, unless you are allergic or very sensitive to them. I would also advise to test the ivermectin on a small patch of facial skin first, as it is always possible that one of the inactive filler ingredients can irritate your skin, depending on how sensitive you are. Make sure to use a very small amount and mix it with your skin care ideally.
If you can tolerate the Soolantra cream and have it covered by insurance or are otherwise able to buy it, then that is great. But not everyone can afford a whopping $500 or $600 cream each month (I'm talking about the situation in the USA now). The criticism is that ivermectin is not FDA approved for human 'consumption', and that it might cause long term health risks we don't know yet about. I like to repeat that like most rosacea treatments, the active ingredient is 'stolen' from existing medication. Just like Mirvaso 'stole' ("got inspired by" I mean) its active ingredient brimonidine from an eye drop and Rhofade got its active ingredient from a nose spray, Soolantra took the active ingredient ivermectin from an existing antiparasitic treatment. On The Rosacea Forum, it had been known for decades already. Well before Soolantra was developed. Several members tried ivermectin back in the days already, with decent success. All Galderma has done now, is take the active ingredient and added some of the same skin care base ingredients (Cetaphil moisturizer). No extra active ingredients. If Soolantra is deemed safe for human skin use, then Ivermectin pastes with similar inactive ingredients are too. The only 'but' is that you need to make sure that the ivermectin has NO other active ingredients, no other veterinary extra actions. But the ones I singled out above have propylene glycol (just like Soolantra) and a preservative. My own doctor prescribed me Soolantra (to try on my red chin and on my eyelashes and eyebrows that have lost so much hair over time), but the preservative in it or perhaps another ingredient makes my skin burn. I am therefore trying out an ivermectin injection (I just bought the one in the blue and white picture above), as it has far less inactive ingredients than Soolantra. With these injectables you should use in a small drop and apply it on your skin (NOT inject it in the skin or whatever!! And don't swallow it either). Be sure you purchase ivermectin alone, and not a combination of medications in one. And you have a relatively pure form of Ivermectin. And no, you will not end up whinnying or develop a taste for fresh grass :) Below I detailed the exact ingredients of a couple of ivermectin horse pastes, and as you can see they contain not many extra inactive ingredients, and the ones they do use are also widely used in skincare. Most even ended up in Galderma's Soolantra cream (propylene glycol for instance). But the active ingredient is the same.
IVOMEC Injection: 1% ivermectin
40% glycerol formal and about
59% propylene glycol
*Propylene glycol (also an ingredient of Soolantra) is a solvent; it is a hydrating ingredient, a man-made organic alcohol that attracts/absorbs water. It is broadly used by food, drug, and cosmetic and personal care product manufacturers. Safe ingredient but can cause skin irritation or allergy for very sensitive skintypes, so test on skin first. Usually, this happens in people who are allergic to the chemical and subsides after a short period of time after the body has had time to break down the compound. However it is also used in Soolantra and it is used in many skin care and cosmetic products, so either way, if you are sensitive to it, not even Soolantra might be suitable for your skin).
*Glycerol Formal is a clear colorless liquid from vegetal origin or synthetic glycerine, with very little odor that is antimicrobial. It is used as an emulsifying excipient, carrier and a solubilizer. It is used in a wide range of injectable and oral formulations (as it helps dissolve medication in water or liquids), as well as in cosmetic cleaning products for the skin. In skin tests on rabbits, glycerol formal was not found irritating (but for sensitive rosacea skin virtually anything can in principle cause skin irritation, so try on patch of skin first).
DURVET ivermectin injection for cattle and swine 1,87% with apple flavour Corn oil
Polysorbate
Apple flavor
Apple flavor
Aerosil
*Aerosil: is a silica product, used for cosmetic and personal care applications. It is used as a gel-former which can increase the viscosity of oils, waxes and emulsions, improving the structure and stability of creams, lotions, lipsticks and makeup preparations. It is also used as a light abrasive, in products like toothpaste, as well as in sunscreens.
*Polysorbates: a class of emulsifiers used in some pharmaceuticals and food preparation. Most often derived from lauric acid, which is derived from coconuts. Some polysorbates are derived from the food ingredient sorbitol, which occurs naturally in many fruits, while others have a fatty acid component. Polysorbates are considered non-toxic and safe as used in the concentrations found in cosmetics and food products (in food products, polysorbates function as stabilizers). Polysorbates are in fact used in a variety of skincare, haircare, makeup and cleaning products. They alter surface tension and their inclusion in formulations is usually to help dissolve oils into water.
*Aerosil: is a silica product, used for cosmetic and personal care applications. It is used as a gel-former which can increase the viscosity of oils, waxes and emulsions, improving the structure and stability of creams, lotions, lipsticks and makeup preparations. It is also used as a light abrasive, in products like toothpaste, as well as in sunscreens.
*Polysorbates: a class of emulsifiers used in some pharmaceuticals and food preparation. Most often derived from lauric acid, which is derived from coconuts. Some polysorbates are derived from the food ingredient sorbitol, which occurs naturally in many fruits, while others have a fatty acid component. Polysorbates are considered non-toxic and safe as used in the concentrations found in cosmetics and food products (in food products, polysorbates function as stabilizers). Polysorbates are in fact used in a variety of skincare, haircare, makeup and cleaning products. They alter surface tension and their inclusion in formulations is usually to help dissolve oils into water.
NOROMECTIN ivermectin injection for cattleHydroxypropyl Cellulose
Hydrogenated castor oil
Titanium dioxide
Titanium dioxide
Propylene glycol
*Hydroxypropyl cellulose; a derivative of cellulose and it is both water solubility and organic solubility. Useful as a binding agent, emulsifier, surfactant, stabilizer, adhesive and in the general control of the viscosity of the product. Hydroxypropylcellulose is most often used in skin care products as an emulsifier, film forming agent or binder and increases the viscosity of formulas. Functions: Hydroxypropylcellulose is a derivative of cellulose most often used as a topical soother of eye irritation and dryness
*Hydrogenated castor oil, also known as castor wax, is a hardened vegetable wax produced from pure castor oil through the chemical process of hydrogenation. Its anti inflammatory properties help to calm and soothe a sensitive skin. One of the main benefits of castor oil is that it retards the growth of harmful microbes; this is due to ricinoleic acid, a potent fatty acid which helps to protect the skin against invading viruses and bacteria.
*Titanium dioxide is an inorganic compound used in a range of body care products such as sunscreens and makeup. It is a common ingredient in sun creams. It has a white appearance when applied to skin.
*Propylene glycol - also an ingredient of Soolantra. It is a solvent; it is a hydrating ingredient, a man-made organic alcohol that attracts/absorbs water. It is broadly used by food, drug, and cosmetic and personal care product manufacturers. Safe ingredient but can cause skin irritation or allergy for very sensitive skin types, so test on skin first. Usually, this happens in people who are allergic to the chemical and subsides after a short period of time after the body has had time to break down the compound. However it is also used in Soolantra and it is used in many skin care and cosmetic products, so either way, if you are sensitive to it, not even Soolantra might be suitable for your skin).
*Titanium dioxide is an inorganic compound used in a range of body care products such as sunscreens and makeup. It is a common ingredient in sun creams. It has a white appearance when applied to skin.
*Propylene glycol - also an ingredient of Soolantra. It is a solvent; it is a hydrating ingredient, a man-made organic alcohol that attracts/absorbs water. It is broadly used by food, drug, and cosmetic and personal care product manufacturers. Safe ingredient but can cause skin irritation or allergy for very sensitive skin types, so test on skin first. Usually, this happens in people who are allergic to the chemical and subsides after a short period of time after the body has had time to break down the compound. However it is also used in Soolantra and it is used in many skin care and cosmetic products, so either way, if you are sensitive to it, not even Soolantra might be suitable for your skin).
Titanium dioxideHyprolose
Hydrogenated Castor Oil
Propylene Glycol
*Titanium dioxide is an inorganic compound used in a range of body care products such as sunscreens and makeup. It is a common ingredient in sun protection creams. It has a white appearance when applied to skin.
*Hyprolose is used to lubricate dry eyes, as a replacement of normal moisture in your eyes
8Hydrogenated castor oil, also known as castor wax, is a hardened vegetable wax produced from pure castor oil through the chemical process of hydrogenation. Its anti inflammatory properties help to calm and soothe a sensitive skin. One of the main benefits of castor oil is that it retards the growth of harmful microbes; this is due to ricinoleic acid, a potent fatty acid which helps to protect the skin against invading viruses and bacteria.
*Propylene glycol (also an ingredient of Soolantra) is a solvent; it is a hydrating ingredient, a man-made organic alcohol that attracts/absorbs water. It is broadly used by food, drug, and cosmetic and personal care product manufacturers. Safe ingredient but can cause skin irritation or allergy for very sensitive skin types, so test on skin first. Usually, this happens in people who are allergic to the chemical and subsides after a short period of time after the body has had time to break down the compound. However it is also used in Soolantra and it is used in many skin care and cosmetic products, so either way, if you are sensitive to it, not even Soolantra might be suitable for your skin).
8Hydrogenated castor oil, also known as castor wax, is a hardened vegetable wax produced from pure castor oil through the chemical process of hydrogenation. Its anti inflammatory properties help to calm and soothe a sensitive skin. One of the main benefits of castor oil is that it retards the growth of harmful microbes; this is due to ricinoleic acid, a potent fatty acid which helps to protect the skin against invading viruses and bacteria.
*Propylene glycol (also an ingredient of Soolantra) is a solvent; it is a hydrating ingredient, a man-made organic alcohol that attracts/absorbs water. It is broadly used by food, drug, and cosmetic and personal care product manufacturers. Safe ingredient but can cause skin irritation or allergy for very sensitive skin types, so test on skin first. Usually, this happens in people who are allergic to the chemical and subsides after a short period of time after the body has had time to break down the compound. However it is also used in Soolantra and it is used in many skin care and cosmetic products, so either way, if you are sensitive to it, not even Soolantra might be suitable for your skin).
1 % ivermectin
40% glycerol formal
1.5% benzyl alcohol (preservative)
propylene glycol, q.s. ad 100%
*Glycerol Formal is a clear colorless liquid from vegetal origin or synthetic glycerine, with very little odor that is antimicrobial. It is used as an emulsifying excipient, carrier and a solubilizer. It is used in a wide range of injectable and oral formulations (as it helps dissolve medication in water or liquids), as well as in cosmetic cleaning products for the skin. In skin tests on rabbits, glycerol formal was not found irritating (but for sensitive rosacea skin virtually anything can in principle cause skin irritation, so try on patch of skin first). Propylene glycol however was reported to be a possible skin sensitizer. BUT it is also used in Soolantra and it is used in many skin care and cosmetic products, so either way, if you are sensitive to it, not even Soolantra might be suitable for your skin
*Propylene glycol (also an ingredient of Soolantra) is a solvent; it is a hydrating ingredient, a man-made organic alcohol that attracts/absorbs water. It is broadly used by food, drug, and cosmetic and personal care product manufacturers. Safe ingredient but can cause skin irritation or allergy for very sensitive skin types, so test on skin first. Usually, this happens in people who are allergic to the chemical and subsides after a short period of time after the body has had time to break down the compound. However it is also used in Soolantra and it is used in many skin care and cosmetic products, so either way, if you are sensitive to it, not even Soolantra might be suitable for your skin).
*Benzyl alcohol is a tricky one! Depending on how firm your skin is, I'd be careful with this one. It is considered a "bad alcohol" in skincare (other than harmless fatty alcohols). Alcohols like ethanol, isopropyl alcohol, alcohol denat, methanol and Benzyl Alcohol are used to make creams feel lighter, help other ingredients to penetrate your skin, and as a preservative. But they can irritate sensitive skin.
This is an interesting (Long) pubmed article on the safety of ivermectin in human use. Small extract from it:
Ivermectin has continually proved to be astonishingly safe for human use. Indeed, it is such a safe drug, with minimal side effects, that it can be administered by non-medical staff and even illiterate individuals in remote rural communities, provided that they have had some very basic, appropriate training. This fact has helped contribute to the unsurpassed beneficial impact that the drug has had on human health and welfare around the globe, especially with regard to the campaign to fight Onchocerciasis. Today, ivermectin is being increasingly used worldwide to combat other diseases in humans, such as Strongyloidiasis (which infects some 35 million each year), scabies (which causes 300 million cases annually), Pediculosis, Gnathostomiasis and Myiasis—and new and promising properties and uses for ivermectin and other avermectin derivatives are continuing to be found. These include activity against another neglected tropical disease, Leishmaniasis. Of perhaps even greater significance is the evidence that the use of ivermectin has both direct and indirect beneficial impact on improving community health. Studies of long-term treatment with ivermectin to control Onchocerciasis have shown that use of the drug is additionally associated with significant reduction in the prevalence of infection with any soil-transmitted helminth parasites (including Ascaris, Trichuris and hookworm), most or all of which are
deemed to be major causes of the morbidity arising from poor childhood nutrition and growth. It is also known that the prevalence of head lice is markedly reduced in children taking ivermectin tablets and that scabies is markedly reduced in populations taking the drug regularly. Above all, ivermectin has proved to be a medicine of choice for the world’s rural poor. A recent study in Brazil, using locally produced ivermectin, looked at the impact on internal helminthes and parasitic skin diseases. The researchers concluded that “mass treatment with ivermectin was an effective and safe means of reducing the prevalence of most of the parasitic diseases prevalent in a poor community in North-East Brazil. The effects of treatment lasted for a prolonged period of time”. This study also represented the first published report of human medical intervention using ivermectin that had not been produced by the hitherto traditional manufacturer, Merck & Co. Inc., the patent on the drug expiring in 1997
Ivermectin therapy for papulopustular rosacea and periorificial dermatitis in children: A series of 15 cases (Read the results here)
"Treatment of papulopustular rosacea (PPR) and periorificial dermatitis (POD) can be challenging in children. Demodex mites, although part of the normal-appearing skin fauna, are more numerous in rosacea and POD than in normal-appearing skin. In 2014, we reported a case of severe oculocutaneous rosacea in a 12-year-old girl treated with a single dose of oral ivermectin; the excellent response encouraged us to use it in subsequent cases. The aim of this retrospective study was to assess the benefit and tolerability of oral and topical ivermectin therapy in pediatric papulopustular rosacea and periorificial dermatitis. Eight patients with PPR and 7 with POD were treated with either a single dose of 200 to 250 g/kg of oral ivermectin or a compound of 1% ivermectin in an oil-in water base cream applied once a day for 3 months. Oral ivermectin was prescribed for 6 children with PPR and 3 with POD. Oral or topical therapy was chosen depending on the severity of the condition. No other medications were allowed. [..] We considered treatment to be successful when lesions cleared or almost cleared. Recurrence was documented when a disease flare required a further course of therapy. Table I summarizes the demographic and clinical data. Complete or almost complete clearance (Investigator Global Assessment score 0-1) was achieved in 8 patients treated orally and in 6 children treated with topical ivermectin. One patient did not improve after oral therapy. The overall response to topical or oral ivermectin was excellent: 14 of 15 (93%) patients achieved complete or almost complete clearance of lesions (Fig 1); 3 of 14 patients experienced relapses (21%) and 11 of 14 remained disease-free for a prolonged period. Mean follow-up was 11.9 6 7.1 (range 2-42) months. The only adverse event observed was mild, transient desquamation of the affected skin in 3 patients receiving oral ivermectin and in 2 patients using topical ivermectin. In 2014, the US Food and Drug Administration approved 1% ivermectin cream for treatment of rosacea in adults. Topical ivermectin may produce a burning sensation, pruritus, and dry skin in 0.7% to 1.8% of patients. The only adverse event in our series was transient, mild desquamation (skin shedding) in 5 patients. This was observed in patients receiving either topical or oral therapy. We hypothesize the desquamation may be a result of a Mazzotti-like reaction resulting from an immunologic reaction to dying mites, as observed in systemic parasitoses after ivermectin therapy.
Fig 1. A 13-year-old boy with severe rosacea before (A) and 1 month (B) and 4 months (C) after receiving oral therapy with a single dose of 250 g/kg ivermectin. Note the facial desquamation after the first weeks of therapy, not attributable to any concurrent topical therapy. A 5-year-old boy with periorificial dermatitis before (D) and 1 month (E) and 4 months (F) after starting topical ivermectin therapy. In conclusion, both oral and topical ivermectin were well tolerated and beneficial for treatment of both PPR and POD in this small group of children. A well-designed prospective study with a larger number of patients is necessary to confirm our results."
-Benzyl benzoate solution
-Permethrin cream
-Sulfur ointment (for instance ZZ-cream)
-Crotamiton cream
-Selenium sulfide wash
-Metronidazole gel
-Salicylic acid cream
-Mercury oxide 1% ointment (very harsh on the skin, you much better use ivermectin)
Use mild shampoo on hair and eye lashes every day. Cleanse the face twice daily with a non-soap cleanser. Avoid oil-based cleansers and greasy makeup. Exfoliate periodically to remove dead skin cells. Wash sheets and pillowcases in hot water and dry with the hottest possible dryer setting to kill the mites that might otherwise jump from bedding to faces. Pillowcases should be changed regularly – up to everyday or every second day. Pillows should be properly washed with concentrated powder (full cap) and 10-15 drops of tea tree oil in washing machine. Realize that demodex mites love dead skin cell build up and old make-up: consider not using makeup for a week, and discard old makeup. Not washing your face at night or sleeping with makeup on your face can make you more vulnerable to an infestation of demodex mites. Women who wear mascara or a lot of eye makeup tend to have a higher prevalence of demodex mites on their eyelashes.
At high concentrations, tea tree oil is a potent killer of Demodex mites. Scientists discovered that Demodex mites can be killed by 100% tea tree oil application during 4 minutes and by 50% tea tree oil during 15 minutes. The problem is that solutions of 100% tea oil, and even of 50%, are very irritating to the skin and eyes. It should never be applied undiluted, as it can do major damage and is even toxic at this percentage. One possible approach is to thoroughly wipe the eyelashes and eyebrows with a diluted solution of tea tree oil, from 5% to 50%. Be aware of the potential of tea tree oil to really irritate at higher doses. In one study, a daily lid wipe with a 5% solution of tea tree oil reduced both the numbers of mites and the perceived itchiness of the eyes. Until recently, tea tree oil was the main method of keeping the mites in check. Duration of treatment should be at least 6 weeks, as demodex mites have a life cycle of 14-18 days, and could be up to 6-12 month in some cases. Tea tree oil seems to not be as effective as Ivermectin in controlling the skin outbreaks, and it also has a higher potential to irritate the skin. I would try Ivermectin before Tea Tree Oil, personally...
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An antibiotic steroid ointment can help prevent the mites from moving. It may even suffocate them. The combination of antibiotics and steroids is also a standard treatment for blepharitis. The steroid reduces inflammation, which is caused by the mites. In addition, the antibiotic helps control the bacteria, but most demodex mites survive applications of metronidazole cream. BUT, topical steroids are a known rosacea worsener (or can create Steroid Induced Rosacea). This is not a good treatment therefore for people with rosacea. Besides, steroids can worsen glaucoma, while chronic use of antibiotics can lead to the development of bacteria that are resistant to the antibiotics.
Hypochlorous acid (HOCl) is a naturally occurring substance produced by white blood cells as a first defense against microbial invaders. Its antimicrobial properties were recognized more than 100 years ago, when solutions containing HOCl were used to combat infections in the wounds of soldiers injured in WWI. Only recently, however, has it been possible to manufacture a stable, pure version of HOCl. HOCl has potent antimicrobial properties. Laboratory studies show that it effectively kills the nymph form of the Demodex mites, as well as the Bacillus oleronius and Staphylococcus aureus bacteria that live on eyelids and that are found inside the Demodex gut. In addition, HOCl also neutralizes the inflammatory toxins released by both mites and bacteria. Moreover, unlike tea tree oil, HOCl is completely non-toxic and non-irritating. Amazon and other online companies sell eye drops like these.
Permethrin also sometimes can be used against Demodex mites. Permethrin has also been used for rosacea. In rosacea groups people started experimenting with it many years ago already, around 2005 I think it was, and it is considered a mainstream rosacea product. It also kills mites and is anti-inflammatory. I suppose it has not yet been 'marketed' as a rosacea treatment by a pharmaceutical company, but that might change very soon. Here it is discussed on a rosacea forum. Here and here are two more interesting discussions on The Rosacea Forum, with patients detailing their experience with topical permethrin for rosacea. And here it is tested versus metronidazole cream for rosacea skin (permethrin was superior in the treatment of papules and skin redness).
In this scientific test, scientists treated demodex skin mites with a combination of oral ivermectin and topical permethrin cream "A 32-year-old man presented with a chronic rosacea-like dermatitis of the facial skin and the eyelids. The skin disorder had been present for 4 years and was unresponsive to multiple previous treatment attempts. Skin scrapings and a histologic examination of a biopsy specimen from the affected area revealed the presence of numerous Demodex mites. The patient was treated with oral ivermectin and subsequent topical permethrin resulting in complete and rapid clearing of the folliculitis. We believe that this case supports the view that Demodex mites may be pathogenic when they are present in large numbers. Oral treatment with 200 μg/kg ivermectin with subsequent weekly topical permethrin showed impressive treatment efficacy in a case refractory to conventional treatment. (J Am Acad Dermatol 1999;41:775-7.)"
On Amazon, quite a few rosacea patients have left reviews for Duramectin Ivermectin Paste 1.87% for Horses Mo Mom wrote on June 14, 2017: "I bought this for rosacea and it worked better than any of the expensive creams from the doctor. I put a small amount on the affected places on my face every night for a couple weeks until my skin was completely clear. Since then I use it at the first sign of reddening and it clears up in a few days. Used on such a small area, this stuff will last a long time. I've had zero bad effects and it's so nice to have clear skin again. Soolantra ought to be ashamed of themselves charge what they do."
Jocelynn Stewart wrote on July 2, 2018: "I bought this after several people in an online rosacea support group have said it has cleared up their rosacea miraculously! This is in a syringe. I mixed it with moisturizer and applied to my worst flare-up areas tonight and it instantly calmed down the heat/itching/discomfort I've been dealing with every day for a few years now! It was delivered very quickly and I am so thankful."
S. Anderson wrote on February 25, 2018: "Works great for my ROSACEA! I bought this for my rosacea after finding out about it as an alternative to the $450 prescription cream my dermatologist prescribed. I saved myself $444!! Within days my rosacea improved. I've only been using it for about 10 days now and have not had a single new breakout or a single episode of flushing. It's like I don't even have rosacea any more! I even had a glass of red wine the other evening and had no flushing or break out afterwards. It's really amazing! I mixed it with pure aloe vera gel, which made it turn into a cream and I only use a little on the areas where my rosacea used to be persistent."
Mike Hunt wrote on February 24, 2017: "Cleared up my scabby rosacea, mixed 50/50 with regular lotion, applied 1x daily and it cleared up in 1-2 weeks!"
Falon Cortez wrote on March 19, 2017: "Do you have Rosacea? Then use this to get rid of it. I started developing rosacea in my early 30's. First it was just a little redness, but gradually my entire face began to look like a tomato. It got to the point where I had to wear more and more makeup concealer just so people wouldn't stare at my red face when I was in public. If I didn't have makeup on, I wouldn't leave the house. I finally went to a dermatologist, and he prescribed Soolantra.......for $300 for a 1gram tube. I bought it out of desperation. My husband picked up the tube one day, read it, and said "The active ingredient in this is Ivermectin? That's what they use as a dewormer in livestock! If you can use this on your face, you could probably buy just regular Ivermectin instead." That's when I went on Amazon and found this. For around $6. I have used it for a week, and let me tell you.....my facial redness has already cleared by about 60%. I haven't seen my real skin tone in years, but thanks to this, I have my face back. If you have rosacea, don't wait until it gets worse. Use this to fix it now!"
Southernsoul wrote on May 4, 2017: "Works for my rosacea! I read about this product in forums for people with rosacea. My dermatologist signed me up for a program that gave me 6 months of Soolantra (1% ivermectin cream) for free. Soolantra worked better for me than anything else we had tried. At the end of the 6 month trial, I was astonished to learn how expensive it was going to be to continue using Soolantra. Even with insurance, my copay would have been about $90 per month. I went online to search for a generic version, but there isn't one on the market yet. Searching through rosacea forums, I kept coming across posts about ivermectin used for veterinary purposes. I read several accounts of people using the various ivermectin products to successfully treat their rosacea, so I decided to give it a try. I use it topically, rubbing a small dab of the product into my skin every day. The amount of gel paste in the syringe lasted me about a month. My skin has stayed clear and my redness is under control. I was definitely hesitant to try a veterinary medication on my face, but have noticed absolutely no adverse effects at all."Della Sacks wrote on September 2, 2017: "Skin infestation gone. I used it for myself as I had Demodex for years. My skin is as it was 10 years ago. Ivermectin for humans has been approved by FDA but is so expensive. I take one notch for each 50lbs of body weight orally. I am free of this horrible skin infestation. No side effects."
Amazon Customer wrote on November 30, 2017: "Used topically for Papular rosacea. After weeks of consistent use, everything cleared up."
Candace wrote on September 16, 2018: "Rosacea under control! Arrived on time and as described. It is a clear, yellowish gel that smells like apples. I am using this in place of Soolantra for my rosacea, which I can’t afford. I’ve been using it for three weeks and so far it has made a huge difference. I’ve a couple different types of rosacea - the kind that causes facial redness, flushing/blushing, bumps across my forehead and cheeks that I’ve thought for years was acne and redness around my eyes. I’ve been using just a small amount of this once daily, at night, as the only thing on my face for nighttime. I still flush/blush, but everything else is under control. I’m beyond grateful."
And Monica wrote on August 11, 2018 about Bimectin Ivermectin Paste Horse Wormer (1.87 Ivermectin) Single dose: "Worked for rosacea. I purchased this for my rosacea and wow. It has been a miracle. My cheeks have been rough and bumpy since I was a teen. It faded the redness after the first couple of uses. It was a crazy thought at first, to order Horse supplies, but wow. This really worked. And it didn't cost an arm or leg."
Tomato wrote on January 25, 2019: "There is 1% topical Ivermectin available for cats, which is definitely safe for topical use on humans (cats have very sensitive skin, and specifically cat and rabbit ears have been used as a “model” for sensitive human skin for decades) and also the same strength as Soolantra. There’s a version for ear mites (Otimectin in Europe, which is what I tried) and another for mange, which I think is a runnier consistency and comes in bottles. Since 1% Ivermectin is used on human skin, and the rest is just lotion, I don’t see why it should be unsafe. Now horse dewormer that’s something else entirely, it’s almost double the concentration of Soolantra, which could be irritating, and it might contain other stuff like sugar or salt that you wouldn’t want on your face. By the way, Ivermectin lice treatments have irritation, rashes, dandruff and dry skin listed as side effects, and that’s only at 0,5%. Which IMO is also a point for trying the cheaper cat lotion before you spend a fortune on human-approved Ivermectin. If you get a bad reaction at least you didn’t spend all your savings."
Anonymous wrote on January 25, 2019: "No it is not! Myself and numerous other people have come forward to show others links to side-effects of ivermectin aka horse paste, but so many are desperate to clear their faces and DO no research on their own. I had side effects in less than a week and I’m still dealing with it. I only used the horse paste 9x. A friend used it only 2x. Some people push it on others and don’t bother to educate themselves first. It also has serious drug interactions with other meds. Educate yourself.”
Anonymous wrote on January 25, 2019: "I learned a valuable lesson in all this. I was brand new to the group and everyone was suggesting horse paste but when it came down to it, no one knew what was in it other than the active ingredient and no one ever mentioned that there could be side effects. I even looked on the box and it doesn’t list any ingredients other than the first one. It does however have a couple of different warnings on it. Again, nobody mentioned that and I didn’t even read my box until after I stopped using it. So now I have to heal my face from what horse paste did to it. When I was just using my brand new facial wash, high quality moisturizer and tea tree oil, my face looked a lot better. I’m back on that and I’m using a barrier cream to protect my face while it heals."
Diana Chandler wrote on January 27, 2019: "For about two years, I have been using Horse Health 1.79% ivermectin horse paste topically but I dilute it about half/half with a moisturizer. It works just as well as Soolantra did, and I have noted no irritating or negative effects. I would not use it full-strength."
Anonymous wrote on January 27, 2019: "Wash your face with tea tree oil shampoo people! Ivermectin is a neurotoxin!!!”
Trillium wrote on September 6, 2021: "I had a very bad rosacea breakout after serious health issues and could not get in to see a dermatologist in my area for 2 months, they were all so booked up! I went online to see what I could use until I was able to see a doctor. My face was literally bleeding and scabbing from the infestation of demodex mites. In the past I had used the antibiotics and metrogel and creams and they never worked for long or well. Probably because it didn’t address the mite but just the inflammation. Yeah I had done strict Paleo AIP and that didn’t work either. I had actually given up on this sector to really want to find a cure for it. I tried the Duramectin and it helped! I still ended up with scarring from scabs falling off too soon, because it took too long to find out about this Duramectin. I also tried Agri-Mectin and used a syringe to get the oily ivermectin 1% sterile solution out and it also worked. But both were messy and rubbed off on pillow at night. I also used a sulfur soap SAL 3. I finally got into a dermatologist and showed her what I was using and she had NO problems with any of these DIY treatments I was using. Now Soolantra 45 grams is $617.00 and TEVA the generic is $409.00, which is also ridiculous and my crummy insurance will only give me a prescription for 40.00 after I have proven to them nothing else works. And that will be costly, to go to dermatologist over and over again and test out other medicines, after I had done that decades earlier! Basically, my insurance is discouraging me by creating roadblocks for our state to save money, thanks to our governor. I know the ivermectin cream works for my type of Rosacea which is Type II. I now buy Duramectin from a local store for $3.33 a tube and buy three, then add equal amounts of Gold Bond with propylene glycol for the ivermectin to mix better for a total of 54grams. I now have a cream that doesn’t rub off on he pillow so much and that has cleared up my face! Store in dark place or dark container. $9.99 for Duramectin and about 75 cents for cream is all. It smells good like apples, which is no big deal.
Soolantra with 1% ivermectin has been approved and sold since the 1990’s and was safe for topical use to humans. The egregious pricing that is allowed by the FDA for medications like Soolantra is appalling when it costs less than $10.00 to make, factoring in any wholesale pricing! Insurance companies are complicit with this, since they could partner with a compounding pharmacy to provide members with a reasonably priced generic ivermectin cream. But they are lazy about this. My dermatologist has hopped on the bandwagon and has a compounding pharmacy make up 30grams for $50.00. Honestly ivermectin cream should be an over the counter medicine, much like lice prescription drugs that are now over the counter. It really is the same strategy to kill off parasites on the skin and scalp. We can thank the greedy Galderma and TEVA for ripping off consumers. [..] I wished we had better options as consumers, but we just don’t so that is why we have to resort to horse paste today. Just another example where corporations are running our politicians no matter who they hurt. I just watched a Netflix episode on Explained about skin and I think I will experiment with toners to get a better skin ph which might help with Rosacea as well. Best of luck to all those who are looking for better answers."
On reddit a woman documented her long trial with Soolantra Her dermatologist wanted her to try metronidazole cream on one cheek, and Soolantra on the other. For a good period of time, in order to see if her rosacea was bacteria-related or mite related. She updated several times on reddit with photos and answering readers questions.
Ckreyn00 had written in August 2018: "Three weeks of Soolantra."
funnymastadon replied in August 2018: "Your skin is looking good! Crazy progress from the previous photo you posted weeks ago."
Ckreyn00 wrote in October 2018: "Dermatologist Visit - I had an appointment with my dermatologist this morning. While happy my skin’s texture remains very smooth after the bumpy hot mess it was in June, she noted that the redness has plateaued. The current treatment does not seem to be reducing redness much more. I’m off of doxy and only using Soolantra going forward. She also gave me samples of Rhofade to test. (Anyone have good experiences with it?) Finally, I am consulting with a different dermatologist on Thursday afternoon to see if I’m a candidate for laser treatment."
Ckreyn00 replied in August 2018: "This is the calmest my skin has been in MONTHS. This side of my face has been treated with Soolantra for three weeks. I’ve noticed the redness is fading a little and I don’t flare up as frequently as I have in the past."
aloharoxana replied in August 2018: "How long did you stick with Soolantra before you started seeing changes?"
Ckreyn00 replied in August 2018: "This is week three. I’d say it took maybe a week and a half before I began to see tiny changes. My dermatologist had warned me that this is a very slow process— she wasn’t wrong."Ckreyn00 updated: "Two months photo. The photo on the right: my worst flare up ever. It felt like windburn, sunburn, and bad acne combined. Dry, hot, itchy, and painful. The photo on the left: current condition. If the redness doesn’t fade more by my next derm appointment, the next course of action is laser therapy. [..] I take 50mg of doxy every morning. I wash my face in the morning and evening with Sulfacleanse. The left cheek, nose, and forehead receive Metro; the chin and right cheek receive Soolantra. (Dermatologist is experimenting to see which will knock down the redness better)."
mccartnm replied: "I'm surprised he suggested soolantra on just part of your face. I would assume the mites (which the ivermectin kills) would just keep migrating from the non soolantra side to the soolantra side and continue to cause problems while dying."
Ckreyn00 replied: "She is testing Metro and Soolantra simultaneously because the Metro targets bacteria (which can be associated with excessive demodex) while the Soolantra targets the demodex directly. I’ve had good luck with Metro for texture, but she wants to see which might be better for redness. If either side experiences another flareup, I’m supposed to go back in to reevaluate the treatment plan. It’s very likely I’ll be paying for laser treatment in a few months."
dancingsally replied in September 2018: "I’m happy for your improvement!!! Have you noticed a change in your flushing? Would you ever consider laser for fading the redness?"
Ckreyn00 replied in September 2018: "Thank you! I normally would feel weird sharing my face like this, but if it gives others some hope... Yes— my dermatologist and I are going to discuss it later this month as a possibility. The redness has faded some, but I still flush too easily."
YadiAre replied in September 2018: "Did you end up choosing Soolantra over metro? Or vice versa? If so, why? And are you still on doxy? Is it a low dose?"Ckreyn00 replied in September 2018: "I’m still using both until I see my dermatologist later this month. The Soolantra side is improving at a slower rate than the metro side. This is curious given the dermatologist prescribed Soolantra because I’d “failed” metro (which means she didn’t like the rate of progress and felt that other treatments might be better). I’m still on doxy for at least one more month; it’s a low dosage."
Luvmygr8life replied in September 2018: "Ivermectin is also found in Soolantra. I’ve been using it since July 2nd. I have type 1. For the last 3 weeks, I have not flushed at all after drinking alcohol. I paid $6.50 for my first syringe and $17.99 for a box of 6 syringes. Each syringe lasts 2 weeks for me. Ivermectin doesn’t help everyone, but there are many that are having success using it."
Ckreyn00 updated: "Progress: Early June to Late October. Above on the left, the worst flare up of my life (no hyperbole). Below it, my face after using doxy, Sulfacleanse, metro, and Soolantra for months before then having two laser facials. In the photo on the right, I’m wearing a light layer of foundation which hides the faint redness that is left. (I don’t know if I’ll ever have truly clear skin again, but I am okay with that given how far it’s come since June.) [..] I wash with either Sulfacleanse or CeraVe hydrating face wash in the morning and at night. I apply Soolantra at night— NOT in the morning. (It makes my face flush for a bit after application). Since I posted these pictures, I’ve done one round of Fraxel to address scarring; I’m coming a second round in a couple of weeks."Ckreyn00 updated: "It’s been a LONG process. I’ve cried a LOT. At the core of it, though, has been finding two dermatologists who listen to my concerns and have worked with me to find the right cocktail of drugs. After four months of drugs, I did two laser facials to address the persistent baseline redness. I have some acne scarring that we might try to address soon with a different kind of laser facial. I am stunned when I look in the mirror these days because I look more like me. I hope these pictures give other people some hope. In June, I felt completely hopeless. It such a crappy feeling. Reading others’ experiences and suggestions on here helped immensely."
Some quotes from it:
"In January 2013, I decided to try a new doctor. Dr. #2 heard me out, took a look at my face, and scraped a sample of my right cheek cells and disappeared for a couple of minutes. When she came back into the room, she announced “You have more demodex than anyone I’ve ever seen. Your cheek is crawling with them.” Dr. #2 told me to use Permethrin cream twice a day for a month to kill off the buggers. And she stressed sunscreen, sunscreen, sunscreen. When I went to fill the prescription, the pharmacist did a double take and asked me if I knew why I was using it, but the doc had prepared me for this -- Permethrin is typically used for scabies, which explained the pharmacist’s worried look. I assured her that I didn’t have scabies, and that it was being used off-label to treat a less scary infection. Using the scabies cream, coupled with a gentler cleanser and slathering my face with sunscreen helped, and the diagnosis seemed right to me. I’d always felt like I had some infection that was causing the rash; none of the other possible diagnoses seemed right.
The correct diagnosis had been made, but the rest of the journey was just beginning, because after the demodex overgrowth was gone, I had to figure out a regimen to heal my skin and keep it overgrowth-free. Over time though, my skin has healed, and returned to a balance. The last time I visited Dr. #2 was in spring of 2014, over a year after our first meeting. I went in to get a mole removed, but when she saw me she said she was amazed at how much my skin had healed. People no longer ask me if I got sunburned on one cheek. My skin is still sensitive with a tendency toward redness, which is more noticeable now that I am always covered in sunscreen and rarely tan, but I can handle that with tinted moisturizer. I’ve learned as I’ve gotten older that a mostly healthy diet coupled with lots of exercise, sleep and limiting caffeine, sugar and alcohol has a profound improvement on my skin." So, this medicine originally was used for treatment from scabies. It works similar to Ivermectin. Here is some more info links on permethrin for rosacea:
In summary:
She wrote on January 25th, 2015: "Where have we come in 5 weeks of using firstly Tea Tree Oil products and Ivermectin in the form of Ivomec? Here are the first images taken November 29, 2014 followed by the most recent images taken today January 26, 2015. Without a doubt, there has been an improvement. Without a doubt, there has been an improvement."
(Source) "Having both a bottle of injectable (livestock) Ivomec (10mg/ml, 1% Ivermectin) and Cetaphil cream on hand, I mixed up a small batch to see what would happen. I added 2 squirts of Cetaphil cream and 16 drops of Ivomec to a small stainless steel bowl and mixed them with a small metal spatula. The two ingredients combined easily with no distinct separation. I applied the mixture to my face, neck and decolletage."
Observations after 24 hours (3 applications):
"Face feels calm - not inflamed. Itching has diminished on face, neck and decolletage but seems more pronounced in my scalp. Small red dots have appeared across cheeks. Particularly on the right cheek which is the side I sleep on. My dermatologist is up to date regarding Soolantra but was not supportive about my use of Ivomec but put me on to a Permethrin cream for scabies called Lyclear. I've had good results so far but occasionally I have felt the need to use the Ivomec when I can feel excessive mite activity. Cheers, Kate"
And she updated: "I've focused on applying the Ivomec in the early evening (before the mites stir from their "homes") and again before I go to bed. The break outs are less common now. There hasn't been a deep hot bump for a couple of weeks and the white-headed pimples are no longer a daily occurrence. A dab of TTO comes to the rescue and quickly heals the spot. While the skin on my cheeks still appears to be red, I'm wondering if it's a combination of vein damage and that it's just going to take a long time for my skin to heal now that I seem to have the mites under control. I wouldn't want to address the issue of broken veins until I'm 100% confident that I can control the rosacea."
And she updated: "I've focused on applying the Ivomec in the early evening (before the mites stir from their "homes") and again before I go to bed. The break outs are less common now. There hasn't been a deep hot bump for a couple of weeks and the white-headed pimples are no longer a daily occurrence. A dab of TTO comes to the rescue and quickly heals the spot. While the skin on my cheeks still appears to be red, I'm wondering if it's a combination of vein damage and that it's just going to take a long time for my skin to heal now that I seem to have the mites under control. I wouldn't want to address the issue of broken veins until I'm 100% confident that I can control the rosacea."
She updated on May 26th 2017 in this blog post:
"One year on and still amazing results. It's been a year since my last photographs and I thought it would be great to update you on my skin."
And she updated very recently in this blog post: "Update after two years. Overall my dermatologist is pleased with the results however she can still see evidence of demodex activity on my face particularly around my nasal folds and chin and she reminds me to keep using the scabies lotion regularly as maintenance. This is evident in the images below, as a couple of small pustules. My face looks a little flushed in these shots and it's due to a couple of reasons. One reason is that we are now treating the strong veins around the nose and over the chin with a new laser called Genesis. We are also going over the cheeks to close off the veins to remove the background redness. [..] The second reason for the flushed appearance could be due to anti aging products recommended by my dermatologist which can both cause flushing." [See her blog post for more info on this] "At this point, I am very confident in my skin. My complexion is generally clear and even. ...and not bad for nearly 51! PS. At long last I got a sample tube of Soolantra and used all 10mg of it over the course of 5 nights (just around my problem areas). It was okay. No reaction, no nothing really. The Cetaphil base it consists of makes it easy to apply and lightly moisturizing. My feeling is that the Quellada or Lyclear is just as good and at a fifth of the price. I was glad for the opportunity to test it out though!"
Beefsweats1987 wrote on April 2018 on Reddit:
"My 1st week using Soolantra (& Doxy)! Make-up free in both. I wanted to post this because before starting Soolantra, I had read of lot of conflicting reviews and was nervous, too! But I am absolutely THRILLED so far! Doxy: I use 120mg once a day."
Juana_la_cubana wrote on July 2018 on Reddit:"Before and after a 40-day treatment! What I have been prescribed (link): From left to right: Cetaphil
moisturizing day lotion w/hyaluronic acid. Started using it a few weeks ago so I can’t really tell if it works or not, but my dermatologist said it helps if I use it, so that’s what I do. La Roche-Posay 50+ spf sunscreen. It’s perfect. And cause it’s tinted it leaves my skin glowing. Ivermectin. This is the second time I’ve been prescribed this along with Minocycline (box in the extreme right), first time was when I was diagnosed. It’s for whenever I have bad breakouts (like finals week, climate changes, sun exposure). They’re pretty expensive but if you suffer with papulopustular rosacea like I do, I highly recommend you consider talking to your dermatologist about them and get a prescription. For me, it works wonders. You begin seeing changes the day after you start using it. I’ll be posting my before-after pictures in a couple of weeks so you can see the result. Metronidazole. My dermatologist gave me some free samples for me to use after the intense treatment to keep the redness and pustules under control. I’ve never used it before (not even after my first treatment, which would explain why my current breakout was so bad), so I’ll have to see how it goes." "The last time I did this exact same treatment (which was also the first time I had ever had a flare up, around eight months ago) I was redness and pustules free around 20 days after starting it. Now, not only the redness is still there, but I can also see what I think are... pustule scars? I’m guessing it’s because this flare up was pretty bad, this time triggered by the cold weather and heated rooms. Anyways I’m happy with the result! The next step is metronidazole only on weekdays, and hoping the redness goes away. I thought it was acne at first but I already went to the derm twice, same diagnosis: rosacea triggered by harsh climate changes and sun exposure. Also, the antibiotics and creams he prescribed worked so I’m guessing the diagnosis was right :) "
Beetsbysasha wrote on July 29th 2018: "March 22nd to July 29th. Soolantra applied nightly."
Another great blog is called "Because Nicole" and the author describes on April 6th, 2018 the effects Soolantra cream has had on her rosacea: "Rosacea update –Soolantra and Lymecycline (6 weeks later) In February this year I finally managed to get my hands on a Dermatology appointment and started a new treatment regime. I wrote about the initial stages in this post, including what’s involved in my new treatment – Soolantra cream and Lymecycline antibiotics. I officially started taking both new medications on 28 February 2018, which at the time of writing this post, makes me about 6 weeks into treatment. The reason I’ve waited 6 weeks is that the long term antibiotic I’m taking (Lymecycline) reportedly takes around 5-6 weeks to have any real effect. Although I had some initial suspicions about how it would go, I wanted to wait to write this to make sure I allowed enough time. The best way to describe the treatment so far is to let the pictures do the talking… I took two pictures every week on the same day (except week 5 when I was on holiday) to show my progress: "As you can see, the results are pretty amazing. When the first pictures were taken I was actually in the process of recovering from a pretty awful breakout which happened after I did a charity sleep-out in a local Cathedral (covered by the news, here!) The result of ‘sleeping’ (lying down thinking about sleeping) in low temperatures had a really bad impact on my skin. But, as you can see – that’s all gone now. Things are so different. The biggest change is absolutely due to the Soolantra topical cream I have been using – There’s more about the medication itself in my previous post. It’s applied once daily at night and soaks in like a moisturiser. It has a moisturising base so there’s no stinging and although itching is listed in the side effects, I only had a bit of jaw itchiness for about 2 days. Not only has Soolantra made a massive difference to the colour tone of my skin and removed a large amount of the redness, the texture of my skin is I n c r e d i b l e. Like, I keep asking people to stroke my face because I honestly cant believe how soft and smooth my skin feels. Writing this I probably sound like I’m being a bit OTT and enthusiastic about it, but honestly, for the past 5 years my skin has been so bad that this feels ground breaking. I had entirely forgotten what it was like to put makeup on and have it glide over a soft, smooth texture – something most people think nothing of, but something I have been missing out on for so long. I am over the moon and have decided that Soolantra is the best thing on the planet. I have to say that, so far, I am less impressed with the impact that the Lymecycline has made. I am only 6 weeks in and as a long term antibiotic, it isn’t supposed to give overnight results. But when I look closely at my skin I can still see the tell tale red bumps under the surface of my skin. I’m hoping it just needs more time for my skin to work it out, so I’m going to persevere and wait to see my Dermatologist again in July. In the back of my mind is still the option of a low dose Roaccutane as there is a chance that could get rid of my rosacea long term – whereas if I stop Soolantra or Lymecycline now, everything will go back to how it was before. I’m honestly hoping that by writing these posts there is someone out there who with rosacea (or something similar) that might consider trying some active treatment, because so far, it is making a huge difference for me!"
lielai90 posted in June 2018 this update about her use of Soolantra cream:
Perfectly_imperfectskin updated: "I tried to use the #soolantra last night after omitting it for awhile. It isn’t as instant for me as the finacea has been and that’s to be expected. I was very fortunate to see such fast results with the Finacea Foam. The soolantra cream claims to have some moisturizing benefits to it. I feel like my skin feels a bit tight after I apply it and I almost can’t wait to get a moisturizer on top of it."
Perfectly_imperfectskin updated in January 2018: "I’ve been using the #soolantra cream at night successfully. I hope to have continue successful results with it. My forehead has a few very small bumps but nothing like what I started with. I can handle a few little bumps :)"
Galderma also released promotional before and after photographs of someone who has used Soolantra for 12 weeks
Soolantra Before (left) and after (right) Pictures
showing a decrease in skin outbreaks
showing a decrease in skin outbreaks
They stated that the treatment of Demodex infestations is often poorly and that it is difficult to properly treat it. They wanted to test how effective its treatment with the antibiotic ornidazole was. Two-hundred patients with de,odex mite infections (mites folliculitis) were treated with either an ornidazole- or metronidazole-based regimen (another type of antibiotic). They then scraped some sebum form the skin of the noses of the patients to test it for demodex mites under the microscope. When the mites returned after treatment they measured it to, and they followed the patients up after 2, 4, 8, and 12 weeks after the treatment. The scientists found that those patients that were treated with ornidazole showed an overall effective rate of 94.0%. And when they followed up with them, patients in this group had much lower rates of the demodex mites returning than those patients in the other group, who were treated with the antibiotic metronidazole. They concluded that their gel of ornidazole was very effective for the treatment of demodex mites on the skin. NOTE: there were more ingredients in this gel, also a steroid called betamethasone, and recombinant bovine basic fibroblast growth factor (rbFGF) gel. Steroid cream is not advised for rosacea skin!! But it is interesting that the antibiotic gel ornidazole was in itself possibly also effective, to a good degree.
These photos show the effect of different treatments of demodex mites folliculitis.
A: 6 weeks before treatment;
B: 4 weeks before treatment;
C: 2 weeks before treatment;
D: 1 day before treatment;
E: 4 days post-ornidazole treatment;
F: 3 days post-CBI treatment;
G: 1 week after rbFGF gel treatment;
H: 2 weeks after rbFGF gel treatment;
I: 6 weeks after ornidazole treatment.
CBI = compound betamethasone injection,
rbFGF = recombinant bovine basic fibroblast growth factor.
I have seen many dozens of pictures by now from rosacea patients who posted reviews and personal skin pictures on private social media health groups. These pictures are not to be used on a public blog post, and I had to look for public pictures to illustrate the effects Ivermectin can have on rosacea therefore. But what the many private user pictures have been showing, is that Ivermectin seems to be able to calm skin outbreaks, pimples, p&p's but also background redness and sandpaper-like red skin structure significantly down. Some people showed perfect calm skin with 'normal' skin colour. Others showed good improvement of rosacea symptoms. I have not seen pictures of severe facial flushers who found relief from Ivermectin. Some reviewers have mentioned that their face flushing has stopped since using Ivermectin/Soolantra however. I think that this is a rare result most likely, and users should expect only for Ivermectin to seriously reduce the number of skin pimples and outbreaks and also to bring dry red skin back to a better skin colour and structure. There are people who do not respond well to either Soolantra or Ivermectin. Some people have their rosacea worsened. Many have their rosacea temporarily worsened, as things seem to get worse before they get better (as written above, this might have to do with mite die off processes in the skin).
(Source) "These pictures take you through the first 6 weeks but I started Soolantra nearly 5 months ago. I used it every day for 3 months and dropped back to every few days until a recent, low key flare up. So I am currently doing every day. I am nearly at the end of my original tube, so it has lasted quite well! I am so much happier when I look in the mirror! I still have some light redness in my affected patches but I’m comfortable without base makeup again. I did learn some awesome ways to hide the redness with makeup when I choose to, so I will do a follow up post with those tips too. In these pics below I have minimal skin products, perhaps a dusting of powder foundation and maybe bronzer/blush, if anything at all. I really like to show of my new skin and go fairly bare. They are taken in evil supermarket lighting, in the op shop, in natural light, indoor light and even crap selfies. I am so proud of my new skin!!!" (Source)
(Source). Caption: "23 days using soolantra. Having less redness but still a lot of bumps. Trying to hang In there hoping it will keep getting better as time goes on."
(Source) "Skin update. (Using Soolantra) This time last year I was driving back from the doctors crying, with the words "chronic" and "progressive" going round in my head. As OTT as it sounds I will never forget that day and how completely hopeless it all seemed. I haven't done anything different since my last update except I've been out twice this week and had alcohol....I know the hermit has become a social whirlwind lol! ✌️ My face is definitely pinker this week and I have a few new patches of tiny skin coloured bumps on both cheeks but this is a world away from the flare I would have got a few months ago. The only thing that has changed in my life over the last two months is my stress at work is currently zero and this has honestly made me feel like a different person. Perhaps it's a combination of this and my body starting to heal? My main trigger is still the sun and heat and if anything this has got worse, but I live in the UK so I'm not going to worry about again for about eight months lol! (Top) Three weeks ago (Bottom) Today"
(Source) "Soolantra / heatwave update. I was really nervous about spending a whole day out in the heat yesterday mainly because I've learnt it takes over a week for my skin to recover from a flare. Towards the end of the afternoon my face, neck and arms were beginning to itch like mad and when I got home and took my make up off my skin was quite red with a few new bumps (L). However this morning the redness has gone down a bit and no new bumps so far although it is very blotchy (R). I do feel like I'm now supporting my body in its battle a bit more now and maybe that's starting to show. I obviously wore my SFP50 and my hat when I needed it, but I also stuck completely to my diet and didn't have any alcohol. A few months ago I probably would have thought fuck it and had a few drinks and the wrong food!"
(Source) "Rosacea is a pain in the neck! Finally a medication that works and finished this 6 year saga! [..] Update: I'm still with no more flare ups ever.just that once. I'm everyday grateful for having my skin back and thinking of soon having a little laser tidy up of sub cutaneous burst capillaries which are the ravages of 8 years in hell! I got in just in time people! Only a little orange peel (large open rubbery pores) beginning which is the bodies response to long term skin agro and irreversible!"
(Source) "Die mites 😂 No new bumps since I started using Soolantra and the ones I have are less prominent. My skin is also much softer. Before it was crazy dry and flakey. I am now also taking Olive Leaf Extract and Turmeric capsules. I have absolutely everything crossed right now. Going to try tea tree oil tonight so hopefully I can alternate between the cream and a natural approach long term. (L) Before Soolantra, (M) Day 1, (R) Day 5"
(Source) "Started Soolantra 3 days ago. Is it normal for things to get worse before they get better?"
(Source) "Severe Oculocutaneous Rosacea in an Adolescent Girl. A, Before treatment with ivermectin. Oral isotretinoin had been discontinued 1 month ago and the patient was using only topical tacrolimus twice daily. B, Resolution of the lesions after a single dose of oral ivermectin. The photograph was taken at the 6-month follow-up visit." (Update: I see now that this photo has been used online to show the result of many different treatments! Including ZZ-cream and accutane. So this result photo is iffy).
More Soolantra / Ivermectin success photos:
(Source) "Disclaimer: I am by no means recommending this treatment. I am simply sharing my experience because I feel that demodex mites aren’t frequently discussed in here as most people know very little about them. After years of research it is only recently that demodex mites are being accepted as a possible link to rosacea and other skin conditions. I advise against trying this treatment without doing extensive research on demodex mites and how they can contribute to skin conditions. Some dermatologists do offer testing for infestation if you request it. I highly recommend reading the post linked below, as she linked some valuable research articles on the topic. About 6 months ago, I discovered this post while combing through this sub for possible solutions to my myriad of skin problems. This post sent me on a full-on investigation into demodex mites and their possible connection with acne, rosacea, seborrheic dermatitis, and other common skin ailments that brought many of us to SCA. As a teenager and young adult, my acne was always very minor. I would get the occasional hormonal break out around that time of the month, but other than that, my skin remained mostly clear. Unfortunately, around the time I turned 24, my skin changed dramatically. My once even skin tone became red and blotchy. My cheeks, chin, nose, and forehead became extremely scaly. This wasn’t your run of the mill dry skin. The scales appeared in patches, and would always appear in areas that breakouts had recently healed. Here is a close up of my cheek from Jan of this year. And oh, the breakouts. My cheeks, chin, and forehead were the most problematic areas and were often covered with painful cystic acne. Now, upon initially reading the post that I linked above and doing a little research of my own, my thought was “meh, this seems a little farfetched.” For every study that suggested that demodex mites are the cause of the majority of skin issues that people experience, I would find five articles that argued that the whole thing was just hippy dippy nonsense. What REALLY turned me off from the whole thing was that it seemed like there was only ONE website (demodexsolutions.com) that offered a promising solution to this “problem.” The website looks like it was created in the 90s through angelfire or geocities, is mostly in broken English, and VERY FEW of the testimonials include before and after pictures. Not to mention, ONE MONTH of treatment came to close to $140 after shipping. I promptly said “screw that!” and embarked on a more conventional routine. I joined Pocketderm, got a great moisturizer, found the perfect face wash. Three months later I woke up and looked in the mirror and almost cried. I didn’t have a single blemish on my face. My skin was still rough and dry in places, but good lord did it look better than it had in years! I was nearly ready to post the sacred “before and after” pictures thanking all of SCA for guiding me to better skin. I celebrated too soon, however, because two days later my skin was back to its normal chaotic state. It was then that I was finally forced to revisit the potential of demodex mites being the cause of my issues. When I seriously evaluated my situation I really couldn’t ignore the signs anymore. I realized that my skin always seemed to clear up about two days before it was at its worst. I then went through my endless skin progress pictures on my phone, and noticed another pattern: my skin seemed to be on a cycle that recurred every two to three weeks. I would have approximately two days of clear skin, a horrible break out of pimples and dry, red skin that lasted about a week, and then my skin would improve slightly each day until the whole thing repeated itself. Demodex mites are said to have a life cycle of about 14-21 days.
It is suggested that breakouts are caused at the end of their life cycle when they collectively die off and expel waste (yum!) all over your mug. I noticed several more consistencies in my breakouts. I had recurring eye irritation and got frequent styes that got worse when my skin was broken out. If I woke up to a red face, I woke up to red and irritated eyes. Demodex mites especially love hair follicles, eyelashes and eyebrows being their favorite stomping grounds. On top of that, my face was always far more red and inflamed in the morning than any other day part. Demodex mites are most active in the dark, and like to mate and feast upon your sebum while you are sleeping. There were enough coincidences there that I was convinced it was worth at least trying the treatment from demodex solutions. I was tired of hating my skin and was willing to try anything. So I ordered ONE month of treatment which included two containers of both the fulminating cream and the ointment. Now that I am 30 days into this treatment, I am pretty confident that the amount of ointment/cream that they sent me will actually last me the recommended 3 months, if not longer. Let me be clear, this treatment was NO cakewalk. I knew going into this that if demodex mites were actually the cause of my skin’s condition that I should expect a pretty gnarly breakout as the first wave of mites start to die off. However, nothing could have prepared me for what I woke up to the third morning after I started this treatment. Nearly every inch of my forehead and nose were covered in pustules, to the point that I couldn’t see the slightest bit of healthy skin. The entirety of my face was fire engine red. My boyfriend, who has always been kind enough to refrain from commenting on the state of my skin in the three years that we’ve been together, actually suggested that I go to the urgent care center because it looked like I had suffered a chemical burn. I nearly threw the lotion and the ointment in the garbage and cried myself into oblivion. I am so thankful that I decided to stick with it. The first week was hellish, but right around day 7, things gradually started to clear up more and more each day.
Today is day 30. Zero new pimples have appeared on my face since day 14. I am going to continue using the treatment for two more months as recommended and will report back here with the results. I also found this blog written by a woman who found success in combating her demodex problem with tea tree oil. I personally decided against going this route because it seemed like it would be far too irritating." You can read many comments to this post here.
This inspiring woman has kept a great blog about her battle with rosacea and she had great results treating her demodex fueled rosacea with argan oil and tea tree oil (and she tried many other things too I think I remember from reading the blog).
This research has been predominantly sponsored by or done by scientists who are employers of galderma in one way or another but the test comes with a result photo I like to share anyway. Note however that these scientists are not objective or impartial most likely. They tested the treatment of rosacea with Topical Ivermectin 1% Cream and Brimonidine 0.33% Gel. Brimonidine gel (Mirvaso) has a very bad reputation. You can read all about it here and here. I wouldn't advise anyone who flushes to use it! Too many severe rebound cases and even worsening of rosacea. Not worth the risk. But the Ivermectin side of this study is more interesting. Although I suspect this type of research is done to somehow pimp the deflated image of brimonidine (Mirvaso, being another Galderma product). So I'll go straight to their results: there were better results when both creams were used than when just one cream was used. Yeh sure.. I am not buying this research, sorry folks, as the rebound report from galderma for Mirvaso was also around the 1%, which does not even come close to the real amount of backlash this cream had "in the field" (real life), so to say. Anyway, cool photo.
There are so many rosacea user posts and questions regarding Ivermectin and Soolantra, that I had to make a small selection. If you like to really dive into this topic, please go to the site of The Rosacea Forum, make an account and use this search engine to look for posts that deal with either Ivermectin or Soolantra (use both terms as keyword for a post search).
jessicadiamonds wrote in February 2019 on reddit about her success with ivermectin and also added a photo: "I have type 2, I've heard that is the main kind that Ivermectin is good for, and I don't really have flushing and I don't think this works for that. Both the Ivermectin and Cliradex (tea tree oil extract apparently?) are meant to treat demodex mites, which is obviously just a theory. I'm not a doctor and I know that these things aren't for everyone. There's a good Facebook group that has a lot of people with varying degrees of success. (the big breakout on my forehead happened between the time I ordered the horse paste and started using it, so that flared before I started using it. It's honestly better than it was at one point). AM: Wash with CeraVe Moisturizing Cleanser, Sparingly apply Durvet Ivermectin Apple Flavored Gel (called horse paste, but not paste, and it's a bit stick for daytime, so I only put a small amount) CeraVe Lotion, Honeyskin Face & Body Cream.(Here's where I'd put on SPF, but I'm kind of having a hard time with that one right now. Lately my EltaMD UV Clear 46 has been burning a little, going to wait a bit to add it back in to see if it causes a reaction after I'm feeling solid about my routine). PM: Wash with CeraVe, Apply Cliradex Foam to my eye area, Use the horse gel all over my face. I've only done this 4 nights/days now, and already my face is much smoother and the inflammation is down quite a bit. It for sure is not painful anymore. I'm cautiously optimistic."
Cricket_1981 replied in February 2019: "Thanks for posting this. I had just started a thread about which Ivermectin brand to buy. I always run Amazon products through Fakespot to check for phony reviews and Durvet received an F, so I was on the fence about buying it. After seeing your results, though, I’ll definitely add it to my wish list."
CutthroatTeaser replied in February 2019: "I've been using Durvet horse paste for around 6 weeks and can vouch it's been very effective for my rosacea. I also saw people on FB recommend the "Horse Health" brand. It is more of a paste while the Durvet is more of a gel. If you need moisturizing, get the Durvet. If your skin is oily, get Horse Health."
Graceeh67 wrote on March 22nd 2019: "Horse Paste = Dermatologist approved! I called my dermatologist to ask about switching from metronidazole to ivermectin and she actually brought up the idea of trying horse paste before I even mentioned anything! She said she doesn't like to prescribe Soolantra because it's so expensive and recommends the horse paste to patients very often. So relieved to have dermatologist approval on this and thought I'd share because I know there are a lot of folks who are skeptical about trying this method since it isn't "pharmaceutical grade."MoneyPranks wrote on March 22nd 2019: "Since we are on the subject, is there horse paste without a scent? I get migraines from the smell of the apple."
Graceeh67 wrote on March 22nd 2019: "I believe this one doesn't have the apple scent: It comes out as a paste/cream vs. a gel as well."
TinyTunaTown wrote on March 22nd 2019: "Does the horse paste get rid of the redness?"
Graceeh67 wrote on March 22nd 2019: "From what I've heard it's fairly hit or miss for redness. Some see improvement, others don't. Either way, it's only $4 a tube on Amazon so I think it's definitely worth trying."
Dnmt wrote on March 22nd 2019: "I've been using Soolantra (and doxycycline) for a few weeks now, and have noticed a decrease in redness. So I imagine the ivermectin horse paste would do the same."
SharonWit wrote on March 22nd 2019: "How long did it take you to see results? Did you have an initial flare from it? I'm thinking about trying it in the morning, but I'm reticent. I've tried many products over the years, and it takes my skin months to recover if something aggravates my rosacea (type 2)."
fldel1us wrote on March 22nd 2019: "Results were quick. Within 2 weeks, probably more like 1. I use it only in the mornings. I used it as my first product after cleaning, since it does dry the skin out a bit, but it's right after it goes on it that it looks its best."
nikehoke wrote on March 22nd 2019: "The $6 stuff from Amazon cured my pustules when nothing else did."
knrodriguez4 wrote on March 22nd 2019: "Exciting news! Do you know is this could possibly be effective for the 1 rosacea?"
Graceeh67 wrote on March 22nd 2019: "This is answered above! Seems 50/50 for those with type 1. But it's only $4 so I say it can't hurt to try."
spannerNZ wrote on March 20th 2019: "I had bad and worsening p&p for over 8 months. I got hold of horse paste - it is 4% ivermection here, so I diluted with three times as much skin gel (an anti-redness formula I had already been using for six months with no real effect) to bring it down to roughly 1%. I had an initial die off effect, then over three weeks my skin has really cleared up. After the p&p mostly cleared up, I added 20% Azelaic acid cream which I think is dealing with the skin redness and reducing flaking and dryness. Will restart IPL for redness once our summer is over as well. I had tried a lot of stuff before ivermectin. The Dr told me it was part of an allergy to medication (the whole saga was kicked off by a series of anaphylactic reactions to a new blood pressure medication). I think somehow the allergy and inflammation kicked off demodex allergy. I also got feet swelling, asthma, and most of my hair fell out over the past year. It is such a relief to get the pizza-face issue resolved at least. I will see if I can post some before and after photos. Edit: I can't work imgur. I will see about posting a montage."
PTLuxy wrote on March 20th 2019: "I was diagnosed severe, painful oozing and cracking skin from the p&p. I use the 1.87% and the first week of application I saw immediate results. Some people go through a die off period and skin gets worse, I didn’t have that. The first month I applied a very thin layer every other night until my face was clear. Now I use about once a week or so for maintenance. I don’t mix mine, I just apply directly. Edited to say that while my p&p are under control, that has helped my overall redness but I do still have constant red face/burst vessels and whatnot. So it hasn’t really helped the type 1 issue I have."
This reddit user added a photo and described (and showed) a bad skin flare which she developed several weeks into trying Ivermectin.
Hopeful83017 wrote on May 8th 2018: "Hi everyone. I started using Soolantra a little less than 2 weeks ago. Within a few days of starting it I got little red bumps all over my face. I have never had bumps on my forehead or the lower part of my cheeks/jawline but since starting it I do. I’m hoping that this is a good sign and it’s the effects of the dermodex die off. It doesn’t feel like a allergic reaction. I’d appreciate any advice. This is a real doozie! Thanks for your support."
Hunghung wrote on May 8th 2018: "Hi.. Yes this was what happened to me as well... I just ignored them, and they slowly disappeared... the redness seems to be better as well don't give up!!"
Ellie wrote on May 16th 2018: "Used Soolantra for 2 years and I've stopped for almost 5 months with no issues so far I'm just reporting back as a longer term user of Soolantra. I used Soolantra for two years and my rosacea was essentially in remission. In January I decided to stop using it and at the same time I gave up alcohol from Jan-March and then now just have 1-2 drinks every couple of weeks if I'm at a social event and I stick to lighter beers over red wine. I did a bunch of reading into how detrimental alcohol is to your health so I'm quite happy to essentially give it up. I've also been eating extremely healthy and have really cut back my carbs (I'm not doing keto but I do make a lot of keto type meals and I eat tons and tons of veggies). Anyway, all that to say that my rosacea is better than ever and I've had no issues coming off soolantra. Anyway, I wanted to wait for a while before reporting back to see if I'd have a flare up but so far I've been fine and my skin looks great."
BeckyK wrote on June 16th 2018: "Hi Everyone! I was recently diagnosed with type 2 rosacea by punch biopsy this year on Earth Day. I've always been a sun person and never had any issues until this year. I have olive colored skin and never had any problems with being outside. Dermatologist put me on Doxy 100mg x 2 a day with Clindamycin. After weeks of no change he put me on Plexicon and continue the doxy. The sulfur make it much worse. I researched Soolantra and changed up my routine at home. I started cleaning my face with Tea Tree oil and water and did a little bit of Apple Cider Vinegar toner. I washed my pillow cases every day with few drops of tea tree oil as well as anything I washed. My skin slowly started returning. Then I thought I most likely have Demodetic Mites! I started the Soolantra and within one week my face cleared up. Redness almost gone within 2 weeks. I am shocked how fast it worked, but then again I was already killing the mites with the Tea Tree oil. I do have a compromised immune system, I've been on antibiotics for over a year now due to chronic ear infection. I finally had the surgery to repair my ear. In my experience, I believe my Rosacea was brought on my compromised immune system, hormones, stress. Soolantra worked for me. I haven't been in the sun yet. I am so afraid but hopeful! I also did not change my diet and could not stop drinking my wine.. that was the deal breaker for me. I make my own wine and having that taken away was not acceptable! So keep plugging away and do your research! I know everyone is different but documenting was the key for me."Dontgiveup wrote on June 26th 2018: "Hi Becky, Thanks for sharing! Soolantra cleared up my face 100% so i'm sure I had demodecttic rosacea too. But mine took many many months to heal. This summer I am able to get a tan and get away with just temporary flushing, same thing for alcohol, I can get drunk (lol) and my skin stays perfect except a temporary flush. Now my skin is smooth 100% of the time and less oily!"
Annie wrote on June 20th 2018: "Hang in there. It takes up to 12 weeks for your skin to calm down and in my case it has been even longer. I’m still on Soolantra after 9 months and I still get occasional breakouts but only a few now so much less than before."
Bori wrote on June 20th 2018: "So I need some pep talk. I started Soolantra on 29.05.2018 so it’s been a little over three weeks. I never had any irritation caused by the medication like immediate stinging, burning or itching. I just had some crawling sensation for about 10 minutes but i think it might be just a mental thing. In the beginning it was fine and then at around day 7 I broke out. Not too badly but still noticeable. Keep in mind I have type 2 rosacea, no other. The pimples from that first breakout started getting better until like 5-6 days ago when I got pretty bad again. So according to my dermatologist I was supposed to get cured by the 20th day, which after I did my research is quite unrealistic and she said there shouldn’t be any worsening of the condition … again obviously not the case … she said that if by day 20 I am not experiencing quite a dramatic result then I am for Accutane which I am not going to take … I am only 21, I think I triggered my problems cause of a highly stressful year… I’ve had quite the severe acne when I was a teenager and I cured it with natural treatments. I was clear for about 2 years and now this. I am a female and this is just messing with my brain… I am so tired for looking like a pizza during what are supposed to be the years I look the best…I just can not deal .. Considering I am a pretty confident person, I am just tired. I do not wear foundation cause I believe it would make it worse. I was given a sunscreen to use by my dermatologist but i am quite hesitant to start so that it doesn’t make everything a little worse… What’s ur opinion on that one? I was also given a new moisturiser which just made it worse, it also stung my eyes. I started using oregano oil internally like 6 days ago but i guess it is too early for that to help (if it does at all). I am a holistic enthusiast and this is just ruining my vibe. I live a pretty organic and fit lifestyle so it’s not that part that is messing me up. The pros my skin is super soft like it hasn’t been like that in I don’t know how long, the peeling is gone, the itching is gone, the burning sensation is gone it’s just the ridiculous p&ps.This is my story and I just want someone to tell me that in the end I will be just fine. Cheers."
Annie wrote on June 20th 2018: "Since I started using Soolantra last Autumn 2017 my skin has slowly improved. I was also annoyed and desperate even after 12 weeks my skin was behaving badly but the kind people here advised me to keep using it Soolantra and now my friends even notice my skin is a lot better. I use foundation as I don’t like to reveal my red dry patches and scars as well as a few pimples on my skin but this has not made my skin worse. I use Dermalogica as my day time moisturiser with SPF 50 every day and it has helped a lot also I think. I might also be on track finding out the worst things causing my flare ups and one of them is sugar properly. I also think it will help if you change your pillow cases more often. Good luck with the journey! There is light at the end of the tunnel, you just need to be patient and forget the little crawlers."
Carrie wrote on June 20th 2018: "Just keep going. I look like a totally different person now. I had a very severe breakout after the first week. I looked like a pin cushion. My skin was red and bumpy and I had more tiny white dots than you would think I had pores to fill. Then it all went away. I got the VBeam laser for the redness from the veins and now my skin is pretty much totally clear. Change your pillow case at least every other night and change your pajama top that often too. Those things really seemed to help me when I started in May 2015. You don’t want to kill mites off your face just to have more jump back on that were on your pillow or top from the days before. I used to just change my bedding once or twice a week like everyone else, but that isn’t enough for people with rosacea. The pillow cases have to be changed 3 or 4 times a week. I barely have to use the cream at all now, but I still change the pillow case and top like I used to, so that must be working. I also wash the bedding in very hot water and dry it on high heat."
Bori wrote on June 20th 2018: "Carrie, how long did it take you to notice an actual difference and did you use sunscreen during the process? Thanks"
Carrie wrote on June 20th 2018: "About 2 months before the dots (red bumps and white dots) were pretty much totally gone. The redness stayed until I got the vbeam treatments. I have not had breakouts since that first week. No, I stopped using sunscreen because I am very oily. Which is part of why my rosacea was so bad. The mites LOVE oil (sebum). I wear a very large sunhat every time I spend more time outside than just walking to my car from work. [..] I actually have not (knock on wood) had the P & P horrific redness and monster skin since that first horrible week on Soolantra exactly 3 years ago. It wiped mine out. I used the cream daily after that for about 18 months or so, then stopped to just once a month. Which is good, cause it’s expensive."
Griffy wrote on June 12th 2018: "I have the papulo-pustular form of rosacea, mild redness and texture/bumps. Antibiotics have worked well in the past but were not suitable long-term so my Derm recommended Soolantra. I experienced no stinging or irritation. The first few days I saw mild improvement and then a slight worsening of skin after 3 days - a lot of papules and some pustules and texture but not terrible. After the first week things improved, particularly the texture in my cheeks. I could not believe how soft they were. My redness was also nearly gone (bear-in-mind it was very mild to begin with). The end of week 2 into week 3 things were worse again - lots of new pustules, papules and even blackheads. After a few days they resolved and my skin has improved again as I enter the fourth week. My skin feels so soft now and I get no papules anymore (but still some pustules). I still have a bumpy forehead but it has improved and hopefully by the end of 12 weeks they will be gone!"
Btc wrote on May 24th 2018: "I developed rosacea 9 years ago. It’s only ever been on my cheeks. I tried various topical creams but the only one that has worked has been soolantra. I’ve been using it for one year now and it’s rare to get any spots on my cheeks which is what I would get before. My cheeks are a little red from the years of having this but makeup always covers that. I do think that if I’d been given this at the start it would have kept things at bay. At night a use a Simple wipe to remove makeup (clinique foundation). Then I use Clinique rinse off foaming cleanser. Followed by the soolantra on my cheeks. I use a Clinique moisturising gel cream for the rest of my face but not cheeks when I’ve put the soolantra on. I only use it at night. It’s been really good and the best I’ve used so far! I tried antibiotics but they didn’t help. Definitely give soolantra a try!"Anonymous wrote on May 15th 2018: "Applied Soolantra cream samples to entire face and neck for 3 nights. Developed intense itching, redness and multiple red bumps and pustules on my cheeks and neck after the 3rd dose. I went from mild redness with no bumps, to broken out and itching like crazy... I sure hope this goes away soon! Waiting on a call from my dermatologist to find out what to do..."
Tee Jay wrote on May 9th 2018: "I have been struggling with my skin for a year from long term use of topical steroids. It has been such a roll coaster. I've been on many regimens of antibiotics and creams nothing worked. My self confidence was so low and depression was at an all time high. My doctor wanted to put me on Accutane but I declined because of the numerous side effects. I started yet a new regimen of Tetracycline and Soolantra on 4/27/18 and my skin has improved 95%. The first 3 days my skin purged with small white zits then each day they were less noticeable. After a week they were gone and my skin was smooth. I'm experiencing redness and mild itching but remember my skin is hypersensitive due to steroid use so this may just be me. I will take red skin over "Frog Skin". The price was $160.00 with insurance but it was worth it. I'm a little scared to write this review so soon but I know how it feels to think that nothing will work. So far it's amazing! Don't give up hope."
SLJ wrote on May 5th 2018: "I am 45 years old and have suffered with an itchy, red and irritated face since 16 years of age. I have been on Accutane, Retin A and too many antibiotics to count. Thank goodness for Soolantra. I have normal skin. I have used it for about a year (3 months daily and once every 2 or 3 weeks after that) and the itching is gone. Pustules are GONE. I never knew the texture of my skin could be normal. Thank You Soolantra."
SJ wrote on May 3rd 2018: "This medication worked well for me. When starting this medication my face was worse, not significantly, for about ten days—then it improved . The final result has been no outbreaks or redness."
John Whyte wrote on April 30th 2018: "This was recommended by my skin doctor in Harley Street in London. It is the only cream that has ever worked effectively. Very rare to have any spot at all now. He advised me to use factor 50 sun cream on my skin at night. Again , a tremendous improvement."
Bfreshh wrote on April 27th 2018: "After 2 years of buying countless cleansers etc, a lot of tears and depression over my vile appearance.. .I finally went to the doctors yesterday. I was prescribed this cream. Day 2 no change but I knew that anyway. Cross fingers this will help as I'm at the end of my tether."
Trashcansally wrote on April 12th 2018: "I'm so happy I've been prescribed soolantra for rosacea. I've been using it for six days now and tonight when I came out the shower I didn't have a big red face, when I was in the shower I thought wow my face feels silky. I had a 2 month course of doxycycline prior to the cream which worked a bit but as soon as I stopped taking it my rash came back. Now after Soolantra I'm one happy lady "
Sashy Girl wrote on April 10th 2018: "Ok I have been using this product since Jan 15th 2018 every night. I cannot tell you how much it has turned my world around! My skin looks 100% improved. I will continue to use it until my dr tells me to stop. It beats taking antibiotics for 3 years! My body is healing itself from all the antibiotics taken in the past. CRAZY! but please persist with this, it will help you too. Good luck :-)"
Aprilprim wrote on March 26th 2018: "This medicine has changed my life! I had terrible itchy pustules that burst and wept then crusted over for 5 years. The doc wrote it off as adult acne and rosacea. Prescribed doxycycline - which I did not take because of the side effects. I had been using coal tar shampoo to wash my face every day, followed by Aveeno cream. It was the only way to stop it breaking out into groups of lumps all over my face. I have been using Soolantra for a month. Yes there are ups and downs but I have not had a weeping itchy spot since day one. It really is a miracle. I can sleep again! The main difference is the quality of skin. I'm 40 but was looking 50... wafer thin skin under the eyes etc... now my skin feels and looks amazing and back to looking 35(lol). Obviously this won't work for everyone but its worth a try if you suffer with weeping itchy spots."
Ahha! wrote on March 25th 2018: "I am a 56 years old with rosacea for at about 20 - 25 years. Used Soolantra every night for a month. Used only tepid water or a very mild non lathering cleanser to clean face. Rosacea significantly improved. I had none of the “terrible breakouts before it got better” experiences but I began with a pretty bad condition. I’m to the point I will run errands without makeup- for first time in about 10 years! Three months out I still use it at night once every week or two when I notice more redness."
Anonymous wrote on February 27th 2018: "Not just good. Amazing! (so far). Only been using this for 4 days but I can tell you this cream has already worked incredibly! I'm 31 and I had my first breakout of rosacea 5 months ago. It started with red pustules that started on my upper/inner cheeks and then my cheeks started itching and burning and the pustules spread to the entire surface of the cheeks down to my jaw. This drove me crazy for months and I tried everything: removing foods I was eating, changing skin products, taking oregano oil, etc. No joke, after the FIRST application the reduction in itching and volatility of my skin was noticeable. After 4 days, my skin continues to itch/sting less and everything is continuing to fade. I don't know if this cream works for all subtypes of rosacea, BUT, if your rosacea is predominantly itching and stinging, with red bumps and pustules, PLEASE try this cream."
Golf wrote on February 27th 2018: "If you have rosacea papules this will get rid of them. Takes about a month to work, but after that works quickly. If your a few weeks in and its the same or getting a little worse hang in there this stuff will work trust me I have been there. Cheers,"
Tm0311 wrote on February 18th 2018: "At first I wanted to throw it through a window, but I read some other reviews and stuck with it. So happy I did- my face is totally clear!! First time in over 20 years sad to say. It was rough going at first. It will cause you to break out worse before it gets better. I don't think I wanted to leave my house for about 3 weeks. But it finally started to clear up at around week 5 and face was clear by week 7. I know, I know it sounds like a long time, but I won't go without it now. A little goes along way, don't over use it cause it's not needed and this stuff is expensive!! Now that my face is clear I use it only a few nights a week and not every night. I have to say STICK WITH IT."
Sashy Girl wrote on February 12th 2018: "Hi guys, its now been 4 weeks today and the improvement is visible! please hang in there even if it gets worse in the beginning. Less redness, less bumps etc. I only apply sparingly after washing my face with a mild face wash at night before bed. This is a great product which takes time, but it does work. Good luck! :-)"
JAL66 wrote on February 8th 2018: "Here is my experience with Soolantra. Week 1 - 2 : Burning, itching, tingling. Sometimes very intense. Week 3 - 4 : Things got very bad during week three. I looked horrible. End of 4th week I started to noticed some slight improvement. Weeks 5 - 6 : Major improvement in skin texture, papules diminished, redness decreased. Week 7 - 8 : Very frustrating. Good one day, bad the next. Towards the end of week 8 things began to clear again. Week 9 - 12 : Continued improvement during the 3rd month with mostly good days. After 3 months I stopped using it daily and my skin has never looked this good. Redness has improved considerably but not 100%. Suggestion for those considering this medication is to start off using very little. And stick with it. Cost for 45 gram tube is $400 in Southern California. With my insurance it was $200. Adding the manufacturers coupon it was $75. After 6 months I just got my first refill. A little goes a long way. Good luck to all."
Kate and Peter wrote on January 24th 2018: "Very itchy and sore after a week. My GP advised a two week break. I tried again and my papules slowly improved over the next few months. I am really pleased as I hardly have any papules now. (I still have redness on my cheeks though.) Very pleased as I had no improvement with metrogel or finacea. This is much more effective. My skin is dry so the richness of the cream helps too."
Almost there part 2 wrote on January 20th 2018: "I just wanted to give an update on my previous post which was after a few weeks of use. My skin went in the cycles as people suggested but by 3 months got really bad. I started putting rosex on in the morning and soolantra at night which calmed things down for a few days but my skin is terrible again now. I have used Soolantra for four months every night and my skin is overall much worse than when I started. I’m going for two more weeks then getting Doxy from the doctors to try. So disappointed and only kept going because of reading all the comments on sites like these. Me advice which I wish I could follow would be to stop googling and follow your instincts."
TBCay wrote on January 15th 2018: "I've been using it now for 18 months. I started using Soolantra in the middle of a business trip. Not smart! Your face will break out worse for the first 14 days. I read that it is killing excess dust mites so that is why your face reacts. I also read killing was sped up by strong acne wash. So I would wash my face, wipe with Stridex wipe, put on my Soolantra and go to bed. After a month, my face was better than ever and I stopped the Stridex part. I now only have to use it about twice per month for maintenance. I am SO thankful for this cream. Still on that same first tube 18 months later."
Cion wrote on January 14th 2018: "Used essential oils (Eucalyptus & Peppermint) on my temples & forehead & acne developed (never had it before) which got progressively worse with red pustules, etc. Dermatologist diagnosed Type 2 Rosacea & prescribed Soolantra. Pustules got progressively smaller after 1-2 weeks. However, small red marks, black and whiteheads appeared. Started using Plexion sulfacymide cleanser which dried up all pustules and got rid of blackheads & whiteheads. However, if I applied Soolantra in the evenings after cleansing w/ Plexion, I would wake w/ blackheads. So, after 5 weeks of using Soolantra, I am going to stop and just try the Plexion cleanser to see what happens. Will keep you posted."
Ingridka wrote on January 11th 2018: "Dermatologists were not able to help me a lot of years. Then I tried Soolantra. Suddenly am I pretty woman with clean skin. Thanks to the producers."
Rgpar68 wrote on January 3rd 2018: "If I could go back and never touch this stuff I would. It’s been a month since I stopped using this garbage after using for about nine weeks. This did nothing for my rosacea but it gave me CYSTIC acne on my chin. I just keep getting huge under the skin bumps, to the point where I am now on two different oral acne meds and can’t put anything on my face topically without making matters worse. Awful horrible experience."
Amuu wrote on December 29th 2017: "While my skin condition hasn't been diagnosed despite going to more than 3 dermatologists, I was told it is a rare form of rosacea, whatever that means. While Soolantra reduces the inflammation of the weeping red bumps on my face, it does not get rid of them. It has also made my skin break out with more bumps than I would normally get, despite the fact that they are less inflamed, its now all over the side of my face so it looks worse. Really disappointed."
ChucklesBay wrote on December 29th 2017: "I have only been on Soolantra for two weeks. It is the only reason I am not able to give it a higher ranking than what I have given it. My face is not nearly as bright red as it had been. But, it is patchy pink--ranging from bright pink patches to lighter pink patches. My dermatologist thinks I will ultimately need laser surgery to shrink the enlarged capillaries caused by the rosacea but that is yet to be seen. Since taking the medicine, I can finally see the enlarged (broken capillaries) that was hidden under the bright redness. So, the medicine is working. Time will tell if this is actually a magic bullet."
30rosacea wrote on December 16th 2017: "I have been using Soolantra for about 4 weeks. For two weeks prior to this was using an off brand ivermectin cream that I got in the pharmacy (I switched to soolantra because the off brand stuff was really really drying although to be honest was just too scared to continue with it as it made my skin a little crazy). Soolantra - The first few weeks were terrible. I totally broke out. Black heads everywhere. My skin is a little better after 4 weeks but just in comparison to how bad it was when I initially started the medication. To be honest my skin had gotten so bad and is slightly on the mend so I am willing to give it the 12 weeks that they say you should give it. It's hard though. I really didn't want to leave the house some days."
KJBr wrote on December 1st 2017: "I was soooo hopeful after reading all of the reviews that Soolantra would be my magic ticket to clear skin after 3 months of a severe rosacea breakout. I have been using the cream once daily for almost 4 weeks and I haven't noticed the slightest change in my skin. It's possible the papules are even worse. I am really hoping things turn around soon...not going to give up yet, however I am thinking about taking antibiotics in conjunction as I don't think I can stand it much longer. I will post another update soon!"
hate soolantra wrote on November 29th 2017: "Soolantra is a terrible cream, it make my smooth skin flare up , and lots of pimples at two side of my face, throw this cream into rubbish can."
Ajummaml wrote on November 29th 2017: "I've suffered from rosacea after the birth of my second child 4.5 years ago. Horrible red bumps all over my face. I've spent thousands of dollars between makeup, creams, medications and diet changes to try and remedy the problem. But it wasn't until I tried Soolantra that I actually felt true hope. I've been using it for 5 days now and the symptoms of rosacea have almost completely cleared from my face. My skin texture has changed completely, and I can actually stand looking at my face without makeup for the first time in 4 years. It's a miracle product!! I have NO idea why no dermatologist or doctor ever suggested it to me. They only ever suggested Metrogel or birth control pills. Oh well, I can't recommend it enough!"
Blush, flush, bad English skin wrote on November 29th 2017: "1) It clearly doesn't work for everyone but it does VERY well for me - I've been using it now for several months and use it 4 or 5 times/week now instead of daily. My skin is not perfect but I'm very happy with it. Maybe it's too late for my nose after years of rosacea (scarring?) - and I am 60 years old so come on :-). It works where doxycycline was mildly effective and Metrogel even less. I haven't tried anything else. 2) As far as expense goes, my insurance rejected it a couple of different times when I tried through a national drug chain but a local pharmacist was able to work with my doctor to point out that the other drugs hadn't worked and got it covered - the copay was $35 the first time and my refill this week was free (!)."
NikolasSuisse wrote on November 22nd 2017: "I have been using Soolantra for almost 5 weeks and honestly this is the best cream I bought in a long time. My skin looks and feels wonderful. The little red bumps are completely gone (although they looked terrible during the first 2 - 3 weeks). I wash my face with Lubex (Disodium Undecylenamido-MEA-sulfosuccinate) every morning and in the evening before applying Soolantra. Monthly cost: Soolantra USD 38 and USD 12 for 150ml of Lubex in Switzerland. I can highly recommend this combination."
NikolasSuisse wrote on November 21st 2017: "I have been using Soolantra for 6 days now. I have read the reviews and I am trying to hang in there but my outbreak is horrible. Don’t want to leave the house. I am experiencing burning, itching and tingling. My cheeks have bumps all over them with pustules and extreme dryness. It is sore to touch. I am trying to suck it up hoping that the reviews I have read are true and it will get better? Has anyone gone through this? I had mild rosacea so this horrible."
Kayla wrote on March 14th, 2015 about Soolantra: "Miracle cream! Tried everything and this cleared me up in 1 week!"
Derik wrote on September 26th, 2015 about Soolantra: "I agree. I started using just three days ago and was very skeptical. I have the exact same issues as you. No P&P, only extreme flushing and the burning, stinging sensations that comes with. Soolantra has diminished those sensations and my skin feels much less reactive. I still don’t know if this is placebo. I also bought Mirvaso but will not use it if this amazing progress continues."
Erika wrote on December 31st, 2014 about Soolantra: "I participated in the year long study. I am very excited about this medication as my face was absolutely beautiful by week 2 and persisted the entire study and even a few months after it ended. No dryness for me, no peeling, no irritation, it was awesome!! I just hope it’s not an arm and a leg cost wise. There was no more burning or stinging. My face felt “normal” instead of warm/flushed like now without it. (Took about 3 months for flaring to start up again and I’m convinced it was because I started swimming). There was a substantial decrease in redness but it did not go away completely. It was not bothersome at all and I was very pleased."
Gillian Rolfe wrote on August 2nd, 2015: "I have used it for 5 weeks now and my skin is 100% worse. My nose is very spotty and sore… is this normal?"
Kayla wrote on March 14th 2015: "This cream is 100% effective! I tried everything and soolantra cleared all rosacea pimples and redness within 2 weeks! I’m thrilled with the results and amazed at how quick I saw results."
Annabelle wrote on March 16th 2015: "My husband has been using Soolantra now for almost three weeks and we really have not seen any improvement. I keep telling him to be positive and to give it a chance to work, but I am starting to worry, too. When will he start seeing some improvement?? He is so desperate, he is now putting his Desowen cream at night, and putting the Soolantra in the morning. Does anyone know how fast this cream will work?? Does it work on everyone with Rosacea??"
e. wrote on April 6th 2015: "I like soolantra, so far, however I will not continue use once this $270 tube runs out. I’m not sure I can afford that forever!!"
Rich wrote on June 16th 2015: "I’ve had papular and pustular rosacea for 3+ years and nothing has worked, including metrogel. Day 5 of Soolantra and this is the best my face has looked in a long, long time. I hope it’s not just a fluke, so I’ll report back in in a few weeks. So far, so good!"
Joanne Seil wrote on July 15th 2015: "After trying everything else out there, my doctor gave me trial samples of soolantra, and it by far surpasses everything else I have tried. I use Elidel cream once a day and also the soolantra once a day. What a huge difference it has made on my face and in my life! It has helped me with some of the redness at the itchiness and everything else is gone! I LOVE THIS STUFF!!!"
Dre updated on November 12th 2015: "I would say I’ve been through about 4 tubes in 6 months. I don’t seem to need or use a full tube per month. The soolantra is still working perfectly for me. If I do miss a day or two I notice it immediately with increased redness. I don’t notice any dryness, peeling or tenderness anywhere. Sometimes if I miss a night I’ll put it on the next morning. I had a *horrible* reaction to the Mirvaso – it turned only the areas I applied ghost-white and then I had even more reactive and extreme flushing in all other areas and rebound redness. I’d say flushing has been a big problem for me for 18 years! There are so many of us out there struggling with this. My life was so different before I started the soolantra!!"
Anthonyavery wrote on March 20th, 2017 about Soolantra: "I love this Soolantra! I’ve been on it for like 6 months and the redness has been reduced by 98%. I still get the weekly pimple so using Accutane. The question is when do I stop using Soolantra?"
Patrick wrote on December 25th, 2014 about Soolantra: "In my experience as a test subject for this compound it significantly reduced redness."
Ciara wrote on July 9th, 2016: "Hey, the 3rd week with Soolantra was not so successful for me.. More p&ps and overall the face feels less calm than in the previous weeks. But skin is still better than before starting Soolantra."
Hope please...wrote on July 13th, 2016: "So first week done. when I put it on, I don’t know whether it’s a placebo or not for me so far – but it does feel calmer; it doesn’t aggravate at the very least. 2 episodes of bad flushing so far this week. one very bad one. at work there’s a room i have to go into sometimes and it’s very hot – always makes me flush. still made me flush badly, but i’ll see how it goes further on treatment. Other time bad flush was after I washed with sulphur soap after a few hours – which is drying. in the past sulphur has calmed my skin. i’ve had sulphur soap for probably 2 years. back then, i didn’t know about demodex and how the condition gets worse before it get’s better when a correct treatment is hopefully picked, so i gave up on it. i started using sulphur soap on and off again the past month, which has probably altered where i am in the demodex cycle compared to if i had just started soolantra with no sulphur before. i’m going to quit the sulphur for now, and just do soolantra for the course. my gp didn’t want to prescribe the soolantra so i was lucky to get it. i don’t know if she’ll prescribe it again. has anyone else had that problem with gp’s? i’m also coming off sage as it was giving unbearable side effects (thujone free sage doesn’t agree with me either) and starting seabuck thorn oil it’s blurred showing which treatment will work/ not work i know, but i’m just pressing ahead. cheers"
She updated on September 20th, 2016: "11 weeks tomorrow. No difference in flushing than before the start of treatment. I’ll probably only post here again if there is an improvement."
Andrea Newton wrote on September 20th, 2016: "Been using soolantra for nearly six weeks but I’m still getting bumpy skin on my chin, really fed up with it all."
RedRecluse wrote on August 19th, 2017: "I am 99% convinced that Rosacea Subtype 2 is Demodectic Rosacea, caused by Demodex Mites. The 'traditional' and commonly known Rosacea, Subtype 1, is not caused by Demodex Mites. It is a 'vascular' and caused by mostly unknown reasons, not Demodex Mites. Please read here. If you still have pustular breakouts, then you really ought to move onto ZZ Cream (correctly at night)."
Sks42 wrote on August 19th, 2017: "My experience with Soolantra was that it moved really fast with me also. Things would be night and day different sometimes from day to day. It's an interesting experience! I had an obvious increase of pustules within the first 24 hours. I think "dontgiveup" experienced the same thing as far as a very quick increase of symptoms. My first week started with increased pustules within 24 hours and then it peaked at day 6 and 7. My worst weeks on Soolantra were week 1 and week 3."
MariaSt wrote on August 19th, 2017: "I am back after 5 months of using Soolantra. I didn't experience any die-offs. My "healthy" skin areas became even more white, but the problematic areas didn't change. I still had to stick with my diet not to get new p&ps and I even developed one new food sensitivity, to nuts. The good thing with this cream is that it doesn't sting, doesn't smell at all, it isn't drying, hydrates the skin and doesn't clog the pores. But clearly it wasn't the ultimate solution for me. I still encourage anyone with rosacea to try Soolantra as the first line therapy, because of all the pros I mentioned before."
AlbaVF wrote on August 27th, 2017: "Hello, I also used Soolantra and my face is worse than ever... before I only had a little red zone on my right cheek and now is all over my right side of the face and it is itching a lot, included my neck... I really don't know what to do."
QTee wrote on August 2nd, 2017: "I have been using Ivermectin cream (aka Soolantra or Rosaver in Canada) for a month. Initially had very good results then a major breakout. Ivermectin is very drying. My skin tends to be dry so I need to do some extra hydration to ensure I don't have a problem."
MissM updated on August 25th, 2017: "Hi Everyone, I just wanted to give an update on being on Soolantra for the past 7 days. Again, I don't have the usual pustules and papules associated with subtype 2 (more of an inflammatory response to demodex), but instead, I believe I have a demodectic condition called pityriasis folliculorum, which symptoms include: dry flaky skin, folliculur scales, and dead skin build up, along with very superficial pustules here and there (maybe like 1-2 on my face at any given time). I really can't believe what has happened to my skin in the last 7 days. I actually don't want to post this because I'm afraid I'm going to "jinx" my progress. After a year of dealing with flaky, dead skin build-up and sandpaper like texture of the skin.....my skin is FREAKING SMOOTH!!!!! There is still minor white flakes coming out of my pores in some places, but my skin overall has down a 165 degree turn around. I keep running my hands on my cheeks and I can't believe how smooth they feel. I thought my skin barrier was shot due to my subtype 1 rosacea, but it may have been demodex the whole time!!!! This past week, I still have gotten my usual 1-2 pustules at a time, but they are much less inflamed and go away in record speed (like within 4-6 hours). I have not yet had a major "die-off", but I'm heading into week 2 and 3, so things may change. Overall, my skin has tolerated Soolantra very well (my skin is SO extremely sensitive that I had big concerns about this). Soolantra seems to actually sooth my skin. Anyway, I will be posting weekly. I really hope my skin stays this smooth and doesn't build-up again....this is a dream come true, seriously."
MissM updated on September 1st, 2017: "Hi All, I just wanted to post my 14 day update! My skin is completely smooth. All the follicular scaling is gone now. I haven't had a single pustule this week. I don't think I had an initial die-off...at least not yet. The first week I seemed to have more pustules within the first 24 hours of application and then usual breakouts all week, but this week has been smooth sailing. I still experience flushing (I have subtype 1), but the irritation I have experienced in the past has markedly decreased over the course of this past week, and the overall quality of my skin is unbelievably better---it's like my skin barrier is healing. I still have some skin "peeling" or "rolling off" my face around my nose and chin after I wash my face...but not all over my face like before. Anyway, I'll be back to report next week! -M."
MissM. allowed me to post these close-ups of her skin, before (top 2) and after Soolantra use (bottom 2 picture close ups):
MissM updated on September 9th, 2017: "Things are still good! One little pustule at the beginning of this week. It's such a relief to wake up every morning and not be scared to look in the mirror. My skin is smooth and no more flakes at all! Here are some before and after pics (unfortunately, you can't see the flakes in these photos. I tried to take pictures of them, but they just don't show up on my cell phone. However, you can see...no more pustules, yay!). [..] As I'm typing this, I'm sitting in front of the fan with a monster flush. If there was only a cream that took away the flushing too!!"
MissM updated on September 19th, 2017: "I only wash my face once per day and then put the Soolantra on in the evening afterward and keep it on until I wash my face again the next evening. Do you wash your face in the evening as well? I'm wondering if there is something in your face wash?? From what I understand, a flare-up from a die-off reaction would be an increase in pustules and papules, not necessarily increase in redness and burning..."
Dontgiveup wrote on August 20th, 2017: "So if I get more pustules vs papules ratio now, it means I am effectively mass murdering my mites? Before treatment I had, like you say, good and bad days. Like 1-2 good days every 3-4 weeks and then BAM they come back.. and I was NEVER able to figure out my triggers, my p&p are really random so, yeah, I'm pretty sure my problem is mites. I just gotta keep myself from putting soolantra twice a day.. Maybe my skin will heal better if I let it breathe. I just want them gone as fast as possible so that i can think of other things than my skin and like, enjoy life.."
Dontgiveup updated on September 11th, 2017: "I completed a month (started on august 10) and I do NOT see improvement yet..some days I am presentable, but most days i am WORSE than before. I am getting more and more discouraged as it is hard for me to get out of the house when I feel so ugly. The only reason I continue is because I read success stories that took a long time to see results (like Angela in this thread).. but it's soooo hard and I try to avoid mirrors Ok now i am crying. Soooo fed up i feel like a monster."
Dontgiveup updated on September 11th, 2017: "I have papules and pustules mostly on my cheeks and sometimes on chin/nose and rarely on forehead. It is worse on one cheek than the other and its completely different patterns on each sides which makes me think its demodex. And i cant find out my triggers except heat. By worse i mean WAY more spots, and on one cheek they seems to be spreading?! While the other cheek is more stable. On some days they seem more inflamed and lots of white liquid tips (sorry for details) I flush too but i don't mind flushing if i can get rid of the damn p&p. I really don't know if i could continue, because since i started i feel like crap and don't want to go out in public. I don't know if i can tolerate it much longer it has negatively impacted my quality of life. But who knows, maybe its just constant die off and i will look normal soon?"
Dontgiveup updated on September 12th, 2017: "What scares me is that i seem to be on a CONSTANT mite die off since i started. This does not follow the regular pattern! I may have had like 3 or for "not so bad" days since i started on august 10. And these days were BY NO MEAN an improvement from before soolantra. I'm getting paranoid now that i am putting myself through this for nothing!! Concealer might be a really good idea, but i am too scared to make things worse by putting on makeup. And wayyy too embarrassed to go makeup shopping with the state of my skin. Oh and, when did you start to notice initial improvement? After 1 month + 2 days it would have been encouraging to at least see a small improvement. I'm going crazy staying 24h a day in the house. Lucky to be on maternity leave right now and not work for another 5 months!"
Dontgiveup updated on September 12th, 2017: "Only thing I use right now is Soolantra, and i wash my face twice a day with dove sensitive just like before. I don't know why my face is so ITCHY today, normally it just itches briefly in the afternoon on areas i will get new p&p. Some days i don't itch at all and still get p&p. I don't know what kind of die off i am having but it it surely not an allergic reaction because on SOME days i get zero new p&p and the ones i already have flatten. Sunday morning my face was okay, i wasn't embarrassed to go grocery shopping, and then i got a big flare up at maybe 4-5pm... and it got worse on monday, and then worse today. With all that itching i am scared of what i might look like tomorrow.. and i have to get out of the house tomorrow. My SO is not supportive at all, he just came home for his lunch hour and said something about my cheeks. I know he didn't choose me like that 8 years ago, but it's not like it's my fault.. this is life. Things happen!"
Dontgiveup updated on September 13th, 2017: "Little update since my "worst day ever" yesterday: I woke up with NO new p&p, and my face doesn't feel inflamed and itchy anymore. Of course I still have yesterday's p&p, but half of the inflamed papules have shrunk and now have a white liquid tip. So i still look like a monster, but at least i don't feel like scratching my face off anymore.. i'm REALLY surprised to look a bit better than yesterday, because normally the more it itches, the bigger the flare up. Oh well maybe it's delayed until tomorrow.."
Dontgiveup updated on September 19th, 2017: "Argh this is SO frustrating. Last week's massive angry flare up cleared in a few days, and i had skin better than before during the weekend. And now, another flare up since monday evening. Not as bad as last week (for now) but still, I don't know what to think anymore.. i thought i finally got rid of the bad skin. Should i continue? Thursday i will be starting my 7th week of diligent use and i still flare.. i'm going crazy! I actually had hope with the "great" skin i had during the weekend."
Dontgiveup updated on February 19th, 2018: "Wow, I never thought that one day I would be PLEASE. DO. NOT. QUIT!!!! I persevere only because of the experiences I read here, and am SO SURPRISED to have a pustule on my cheek! I got used to being smooth those awful pre-soolantra days are behind me, but this single pustule reminds me how lucky I am to have overcome this!! The first 8ish weeks of treatment I suffered from horrendous die off where I had clusters of angry pustules.. I've come a long way. For people new to it.. glad I did"
IrishRich wrote on January 8th, 2018: "Is this bad!? Yesterday and today my face is burning red and stingy. In fact I can feel it tingling at times. I’m actually on week 4 now of soolantra (thought it was 3) and this is the first I’ve experienced this. Is this a big die off or has my skin now decided it is allergic to Soolantra?? Should I stop using it?"
Elmo wrote on January 8th, 2018: "I was like this for a week on day 5 or so ....can't remember seems so long ago. But I do know I had a massive wobble at the time wondering if it was an allergic reaction. It was either a die off or complicated by the fact i was using witch hazel which I didn't realize isn't compatible with soolantra. I'm 15 weeks now; smooth clear skin but still pinkish cheeks & veins. hang in there if you can."
Elmo wrote on January 11th, 2018: "It did work for me in the sense that it cleared up the follicular scale, reduce eyebrow loss and pustules - had a huge die-off phase so must have killed a lot of demodex. But it didn't change the pink on my cheeks and I have some bold thread veins left. My skin is lovely and smooth really pleased ! So part of me thinks its time to quit. My GP advised me not to use for more than 4 months (and its written formally by her on the prescription label), so I don't think I'd get the prescription even if I wanted to continue. She didn't believe in the mite theory and only gave it to me based on my veins. since they are still there she'll probably just say 'I told you so'. But I do feel the demodex are more under control based on the fact that I don't get anymore die-off and the scales haven't come back. Interesting that you've been on it 1.5 years. Did you think you've had any side effects? Some ppl have said that they felt that the demodex became resistant to soolantra.... clearly not in your case!"
Ellie wrote on January 11th, 2018: "I never come to this site anymore because my rosacea is essentially gone. I still flush every so often but now that doesn't last and I don't get pustules. Anyway, soolantra continues to work for me so I apply a very small amount every night. Despite living in a cold climate, my skin doesn't get dry like it always used to. I use clinique redness relief cream in the morning by itself and also at night with a pea size amount of soolantra (I apply the clinique cream beforehand), cerave hydrating face wash, avene thermal water and I've really cut back on drinking (doing dry January now). My skin was pretty good but not perfect before when I was just drinking socially on weekends but I've noticed a difference since I cut it out completely. Anyway, just wanted to report back that soolantra has done wonders for my skin for anyone who is thinking about trying it. I never had any irritation from it and have been using it long term. Also, as an aside, I used to have a lot of GI issues as well that have cleared up since I started eating less sugar, stopped snacking and started doing intermittent fasting (I feel so much better after skipping breakfast and have lost weight etc. - I fast for 20hrs and only eat in an 8 hr window) Anyway, sometimes I wonder if all this stuff is related somehow but I've been getting compliments on my skin since I made those changes. I do think it's the soolantra that's making the difference but given how well everything is going, I'm thinking about cutting back on soolantra eventually and seeing if my lifestyle changes are enough to keep my rosacea from coming back. My dermatologists said there were no issues with using it long term - I don't even see him anymore, I just get it prescribed by my GP. I did notice improvement within the first couple of months though so I kept using it and over time my skin has completely cleared up. I've been using it for 1.5 years so far. I know it's a new medication so I always come back here and report back that it's still working for me in case it's helpful to others. I also never had any negative side effects from it. I wasn't even counting how long I had been on soolantra - it's actually 2 years, 4 months because I essentially went on it after it came out in Canada."
MissM wrote on January 12th, 2018: "Hi! My derm has not given a timeline for Soolantra usage. I’m under the impression that she will prescribe it for as long as I want to take it. Also, based on what I have read on many forums, it looks like a maintenance dose may be necessary to maintain results in people who are prone to demodex infestation. When I decide to come off Soolantra sometime in the future (I have been on it since August), I will most likely use it twice per week for maintenance. M"
Angela1979 wrote on January 15th, 2018: "Hello! I wanted to give an update form a long term Soolantra user. I started using Soolantra in september 2016. I still use it (every day) and it is still working like a miracle. I don't have any itchy bumps on my face anymore. I do get them on my arms and the upper part of my back, and in the back of my neck. And on my scalp too. I think the mites just migrated. I tried a tea tree shampoo and bodywash but that didn't work. It's okay though, even if they itch for a long time, it is not nearly as bad as when my face was covered with itchy bumps. My face isn't dry anymore, it is more oily now, especially on my forehead. Every now and then I get a pustule, mostly on my neck (I apply Soolantra there too). I am still very happy with Soolantra!"
Nfeatherston wrote on January 25th, 2018: "Soolantra- worth a second try. Hi! I was here reading about Soolantra weeks ago after a disastrous first try- my entire face broke out in raised red bumps and pustules. Fun times! My doc told to me stop the treatment and start again in a month. When I tried it again, I used a VERY small amount, and used it every other day for three weeks...gradually worked up to every night, but again, with the same tiny amount. I had RESPECT for that cream now After I moved up to daily use my skin got more red, irritated, and bumpy- but that only lasted for a few days, and was much less severe. Everything looks fantastic now-- I am really glad I gave it another shot. Best my skin has looked in 15 years! Just wanted to share in case any of you had a horrible initial experience -- in my case, it really did get better with a second try."
IrishRich wrote on February 14th, 2018: "So I’m now 10 weeks in and have hit a bit of a wall. The redness is pretty much gone however this past weeks I am getting breakouts of pimples. Red ones not just small puss filled ones. It’s quite depressing. Has anyone else had this around the same time frame? Is this still die offs?"
Pennylane366 wrote on February 15th, 2018: "I'd love to know the same. I'm experiencing the same thing and have honestly given up. I went back to my prescription sulfur wash and the pustules are all gone. I was just honestly feeling like sulfur was working better for me than the Soolantra -- however, after hearing so many of you say the waiting period is worth it, now i'm having second thoughts! Did I give up too soon? Should I give soolantra another try? I'm going back to my derm next week..."
SilverbackWithAHammer wrote on December 3rd, 2016:
"Worst case of subtype 1 rosacea imaginable (Demodex mites?) I can't believe how bad my case it. It is by far the worst I have seen. I have doubts almost anybody has it this bad. This is just pure cruelty. It started at the age of 12. Even then, my rosacea tormented me; extremely red face, swollen nose. I lacked self awareness back then so I had no idea it was even that bad until years later seeing photos. For the past 10 years my life has been a living hell. My nose is unbelievably swollen, my face now an extremely dark red like somebody threw acid at my face. I don't even know what to to anymore. I cut back on sweets, supplement fish oil, take MSM, topical green tea & aloe vera...Aloe vera made it worse than I could ever imagine so I'm not sure why people praise it. I don't eat for days straight & try to shovel cordyceps, apple cider vinegar, with MSM all mixed with around 10 grams of fish oil. Absolutely nothing. I drink massive amounts of water but now I am a very skinny, red faced mess with thick glasses & vision worsening every year. No alcohol intake (Maybe 1 drink for 1 day every couple months) but my face explodes into a flared up, swollen up, hellishly red nightmare. A vegetarian diet has done nothing. I honestly want to kill myself & even attempted to slit the vein of my arm. It's too much. It hurts too bad & I'm too poor to treat it because I already spent so much money, and now it's all wasted. It has absolutely destroyed my life. I quit my job, denied relationship opportunities, never leave the house, never see my friends, never speak face to face with anyone...I cry everyday. Pathetic, I know. But what else can I do? I now have nothing but a charred red face that I know will never go away, or even be treated. I now have absolutely nothing in my life, I'm not exaggerating. My question is: How effective is killing demodex mites for Subtype 1 Rosacea? I don't know if I can afford surgery but I heard Tea Tree Oil has been very effective, but I'm afraid treatments like that are limited to other forms of rosacea. Has anybody beaten this monster? Or at least tamed it in absolutely any way whatsoever even for a little bit. Because I now have no future. I'm 22 & the past 10 years have been a horrid nightmare."
Kwamex replied on December 5th, 2016: "I feel you man...! Don't give up! You will find your treatment! Why Aloe Vera made it worse, my guess: Did you use a 100% pure Aloe Vera? If not, that's the case. Even if 91% pure it's probably some alcohol and other **** in it. However, here are some things you can try: Tea tree oil and Argan oil. There is a member of this forum who had a REALLY bad case of redness and P&P, she fixed it using this method. Just buy a plastic bottle from the pharmacy and mix these 2 together. Make sure it's 100% Pure argan oil and tea tree oil. Get a like 5/10 ml measurement. Use 5 ml Tea tree oil and then about 20 ml Argan oil. Then you get a 20% concentration of Tea tree oil, use this on your face every morning and night. If it's to bad for your face, lower the concentration to 5-10%. Tea tree oil is a really good demodex mite killer! Make sure you wash & change your bed sheets often. Use high temperature! Especially your pillow."
Rosacea patients reviews of Ivermectin (Soolantra's active ingredient)
Forum member Rachzon wrote about the participation in an IVERMECTIN trial, all the way back on October 4th, 2008: "I have been on an Ivermectin trial for just over a week now with quite positive results. I have moderate Rosacea with frequent papules and pustules. My most recent flare up started in July and had continues until this week when I started the topical Ivermectin. My skin had improved a little after I started applying Megan Gales Invisable Zinc about a month ago but the change in the last week has been quite dramatic. My skin is still far from perfect but as the trial goes for about a year I hope it continues to improve. Initially I was getting about 20 papules on EACH cheek, forehead and even on my neck, so it was pretty ugly, the inflammation was not pleasant either. I have the occasional papule left, the worst place is still on my neck but the texture of my skin is soft, no burning or itching and life is a hell of a lot more pleasant. My 3 year old son hasn’t been patting my cheek and asking me if it still hurts this week either. Looks like those beastly mites have a lot to answer for in my case.
Rachzon updated: "It is a 30 gram tube with what I presume is 1% Ivermectin. [..] I asked about other peoples experiences, they have about 10 on the trial at the Coast and all but one have had results similar to mine. The Derm mentioned that up to this point it has been very hard to treat Papular Pustule Rosacea so is very pleased with these results. [..] 10 weeks I have been on the trial now and my face continues to be fantastic. I get the very occasional bump but it is gone within a few days."
Rachzon updated on October 9th, 2008: "I know this sounds very vain but I can not stop looking at my skin in the mirror. If my skin could stay this fabulous I will be eternally ecstatic. It is smooth, even the pores seem to be smaller. I'm not at all red. I had a stressful shift at work the other day, I felt myself flush but it seemed to settle very quickly. There are still a couple of papules on my neck but my face is completely clear. I will stand by the Megan Gales Invisible Zinc and say it is the best product EVER and that in combination with the Ivermectin cream is for me an absolute Godsend. I stopped my Doxy and Rosex (had not done a thing in 2 months) 2 weeks ago and my face has stopped flaking. I hope that this cream is on the market soon as I will hate to have to stop it after the trial. I have also started using an Avene moisturiser in the morning before the Invisible Zinc which is really soothing. It seems like a really nice product."
Mistica replied on October 9th, 2008: "Hi Rachel, That is indeed great news! And I totally understand about wanting to check your face in the mirror. Just to clarify about the redness. Are you talking about permanent background redness you had, or the inflamed areas caused by the outbreaks? The former is so hard to treat."
Rachzon replied on October 13th, 2008: "Mistica, I think I am lucky and at this point don't seem to have permanent redness. It was always hard to tell as the same spots seem to have been constantly inflamed. But now as my face is completely clear I couldn't have had any permanently red spots. I still have a few broken capillaries around my nose but I'm sure laser is the only way to get red of them. And I plan to put off that path as long as I possibly can. Face is getting better every day. My husband can't believe the difference, he has never seen my skin like this (wish I had this on my wedding day). So for those of us with papules and pustules caused by mites it looks like there may be a solution. I just hope that my skin continues to stay this good and doesn't relapse for any reason. Will let you all know if it does. I asked about other peoples experiences, they have about 10 on the trial at the Coast and all but one have had results similar to mine. The Derm mentioned that up to this point it has been very hard to treat Papular Pustule Rosacea so is very pleased with these results. I haven't taken any Doxy, Propanolol or used any Rosex now for 3 weeks. The only think I'm taking is mutivitamins, flaxseed, fishoils, grapeseed and probiotics. Supose it is hard to know intil more studies are done what comes first. Do the mites in the case of papular Rosacea cause or mimic the rosacea or do they just make the symptoms of Rosacea worse."
Rachzon last updated on December 5th, 2008: "Sorry my face is looking sooooo good that I haven't been on here for a while. 10 weeks I have been on the trial now and my face continues to be fantastic. I get the very occasional bump but it is gone within a few days. The bumps aren't red, itchy or scaly either. I have no flushing, burning or stinging. We are in the height of summer here with 32 degree days and I look just like anyone else. I have been spending a lot of time with the kids in the pool as well (the sun was my worst enemy). I really could not be happier. I am very thankful for the day I spent on Google looking for a "Cure" and came up with this trial.
But two years later Rachzon wrote again, on July 5th, 2010: "Has anyone tried Ivermectin in a cream that they have made up themselves? I have been doing lots of reading about Ivomec and its use on Demodectic Mange in dogs and scaley face in budgies and wondered if anyone has been game to try it themselves. I have been waiting in vain for the trial of Ivermectin to recommence but it has almost been 2 years and I am ready to give up hope. Even for over a year after finishing the trial my skin was wonderful. My face has been a constant battle since Christmas. I have managed to keep it under reasonable control with Manuka honey and Tea Tree in coconut oil but it is so much work in comparison to the Ivermectin Cream that I used on the trial."
Flying_er also started an Ivermectin trial as a result, and wrote on August 7th, 2010: "I've started down the demodex treatment path. I'm currently using 1% topical ivermectin 2 nights per week and Eurax all other nights. I'm on day 11 and have some observations. My skin does seem calmer using these products but it also seems to be getting a bit dry. I'm trying to not use moisturizer as I've heard the ingredients in the moisturizers may feed the mites, not sure if that's true or not. In the last couple of days I've been getting some new red bumps on my forehead. These bumps have a white center and look a bit like a whitehead but the center is hard and can't be squeezed. I'm wondering if these new bumps are mite die-off related and I'm also wondering how bad the breakout will get. I guess I'll just have to wait and see. I'll continue to post results. -Dave- [..] I'm definitely breaking out more than normal since starting the mite killer routine. It's either from mite die-off or my skin doesn't like the topicals and is reacting to that. Either way I'm going to stick to this routine long enough to either kill off the mites or prove that mites are not my problem. I'm using the Ivomec 1% 50ml bottle, same as what you found on Amazon. I wet a cotton ball with the ivermectin and dab it on my forehead/scalp/cheeks until all areas are wet, not dripping wet but clearly wet. The liquid almost beads up on the skin. I just let it sit like that and it eventually dries up or gets absorbed. I'm currently doing this 2 times per week."
Flying_er updated on August 29th, 2010: "I'm now 30 days into the mite killing routine. I'm using topical Ivermectin every other night and sulphur cream the other nights. I stopped using Eurax, and replaced with sulphur cream. I figure the sulphur adds some healing properties to the equation. My skin is still up and down, a few days of clearing followed by a few days of breakouts, mostly in the form of papules. I feel like my skin is trending towards improving but time will tell. My Dr. also gave me some new shampoo to use 2x per week. It's called Aliclen, so far I like it, seems to be helping my scalp. [..] we are not injecting the the liquid, we are just applying it to our face using a cotton ball. -Dave-"
Flying_er updated again on November 18th, 2010: "I used Ivermectin once or twice a week for around 3 months. I never saw a total clearing of my P&Ps but it did seem to help calm my skin and reduce the breakouts. About 3 weeks ago I stopped using the Ivermectin to see what would happen. At first no difference was noticed but during the last week I've noticed that a lot of the little bumps I had previously are starting to return. I had forgotten how many of these little bumps I had before using Ivermectin and now they are returning. I'm going to start using the ivermectin again tonight and see if the issue clears up. I'll report back when I have more info. [..] I find it to be harsh on my skin, it dries it out and irritates it. -Dave-"
Michael_V wrote on September 1st, 2010: "I also tried oral ivermectin in the past without success, although I realize now how optimistic that approach is. While it likely did eradicate or at least substantially thin my resident demodex population for a couple of weeks, the continued dermal inflammation, increased facial blood flow, and enlarged follicles (these things take time to resolve) left my face like a freshly painted and swept waterfront condo with plenty of new tenants eager to move in. Remember that the demodex (or their commensals) are only part of the problem. For most of us, a large part is also our own dermal immunity, which either (1) reacts too easily, (2) reacts too strongly, (3) reacts for too long, or (4) all of the above. Any successful approach will require a sustained, multipronged approach that includes some combination of ongoing demodex and/or commensal bacterial control, trigger avoidance, improved general health and immune function, and the promotion of dermal healing."
Michael_V updated on September 5th, 2010: ""5 weeks so far using topical Ivomec twice daily with excellent results and no side effects. Will continue for one more week and then go down to once weekly for maintenance. I also took oral ivermectin (stromectol), two doses five days apart, and the benefits seemed additive and synergistic."
Mrsmoof wrote on September 1st, 2010: "I am curious if anyone also took an antibiotic while taking Ivermectin as in the patent? I wonder if the antibiotic would add or enhance the effects of Ivermectin?"
Betise wrote on August 20th, 2010: "Hi there everyone - I was recently diagnosed with Rosacea (2 days ago) and discovered this forum today. I have been reading your posts in regards to Ivermectin with great interest. I am a veterinary nurse and am very familiar with Ivomec - it is a product we use off label routinely to treat Demodex in not only dogs - but also Guinea pigs, rats and mice (one tends to think if it is safe for them, us humans should be ok <lol>). Before my diagnosis I kind of suspected I had rosacea and had wondered if mites could be involved. I did consider using Ivomec so was absolutely delighted to find out others have done so with some success. I have redness across my nose and both checks, probably on average once a week I get small papules and pustules. Sometimes my face feels like it is sunburnt and it does get itchy every now and then (hence my thinking along the lines of mites). My nose is the worst affected area."
Supramom2000 wrote on October 13th, 2010: "It was really working well for me! I did it for 4 weeks. But after talking to Auburn, I am trying the honey mask route for 4-6 weeks and then seeing if I need the Ivermectin as maintenance."
Bambi wrote on February 13th, 2011: "Haven't been on the forum for a long, long time and just tried to ignore my rosacea. However, about 2 months ago I did some lurking on this thread and ordered ivomec just in case it would help. Well, it made a big difference. I'm so very grateful to all you rosacea pioneers who led the way. I use 3-4 small drops on a wet cotton disk every night before bed. I also change my pillowcase every night. I'm not going to claim that I now have a peaches and cream complexion, but the redness has faded to an acceptable pink. It's true that it's a bit itchy when you apply it, but for me it calms down pretty quickly. Now if someone could come up with a way to take the dye out of my hair I'd be in heaven!! [..] Ivomec is helping with both, more so with the redness, but also with P&Ps. Thanks to you all, Jodi"
Gumbo wrote on March 28th, 2011: "Since the majority in this thread are using Ivermectin and treat for demodex I thought I should just make a note here in regard to treatment. The dermatologist I saw in Europe has published extensively on demodex and rosacea, and outlined a treatment for me. The interesting thing to note though is the need to treat the scalp, as my dermatologist has noted that most heavy infestations on the face will most likely have a lot of demodex on their scalp. I was given a scalp solution to use twice a week in my treatment. Further, after treating for 2 months, a recent biopsy showed 20 mites in a small section of my cheek. The deeper the biopsy went, the more mites. I mention this because I don't believe people get re-infested by their pillow, dog, cat, neighbor or whatever the excuse is. It is best to treat the entire head, and for many many months. I do believe this sterile liquid is effective. I also like the fact it lasts a long time and only requires dabbing a bit on the face every couple of days."
Dontgiveup updated on September 11th, 2017: "I completed a month (started on august 10) and I do NOT see improvement yet..some days I am presentable, but most days i am WORSE than before. I am getting more and more discouraged as it is hard for me to get out of the house when I feel so ugly. The only reason I continue is because I read success stories that took a long time to see results (like Angela in this thread).. but it's soooo hard and I try to avoid mirrors Ok now i am crying. Soooo fed up i feel like a monster."
Dontgiveup updated on September 11th, 2017: "I have papules and pustules mostly on my cheeks and sometimes on chin/nose and rarely on forehead. It is worse on one cheek than the other and its completely different patterns on each sides which makes me think its demodex. And i cant find out my triggers except heat. By worse i mean WAY more spots, and on one cheek they seems to be spreading?! While the other cheek is more stable. On some days they seem more inflamed and lots of white liquid tips (sorry for details) I flush too but i don't mind flushing if i can get rid of the damn p&p. I really don't know if i could continue, because since i started i feel like crap and don't want to go out in public. I don't know if i can tolerate it much longer it has negatively impacted my quality of life. But who knows, maybe its just constant die off and i will look normal soon?"
Dontgiveup updated on September 12th, 2017: "Only thing I use right now is Soolantra, and i wash my face twice a day with dove sensitive just like before. I don't know why my face is so ITCHY today, normally it just itches briefly in the afternoon on areas i will get new p&p. Some days i don't itch at all and still get p&p. I don't know what kind of die off i am having but it it surely not an allergic reaction because on SOME days i get zero new p&p and the ones i already have flatten. Sunday morning my face was okay, i wasn't embarrassed to go grocery shopping, and then i got a big flare up at maybe 4-5pm... and it got worse on monday, and then worse today. With all that itching i am scared of what i might look like tomorrow.. and i have to get out of the house tomorrow. My SO is not supportive at all, he just came home for his lunch hour and said something about my cheeks. I know he didn't choose me like that 8 years ago, but it's not like it's my fault.. this is life. Things happen!"
Dontgiveup updated on September 13th, 2017: "Little update since my "worst day ever" yesterday: I woke up with NO new p&p, and my face doesn't feel inflamed and itchy anymore. Of course I still have yesterday's p&p, but half of the inflamed papules have shrunk and now have a white liquid tip. So i still look like a monster, but at least i don't feel like scratching my face off anymore.. i'm REALLY surprised to look a bit better than yesterday, because normally the more it itches, the bigger the flare up. Oh well maybe it's delayed until tomorrow.."
Dontgiveup updated on September 19th, 2017: "Argh this is SO frustrating. Last week's massive angry flare up cleared in a few days, and i had skin better than before during the weekend. And now, another flare up since monday evening. Not as bad as last week (for now) but still, I don't know what to think anymore.. i thought i finally got rid of the bad skin. Should i continue? Thursday i will be starting my 7th week of diligent use and i still flare.. i'm going crazy! I actually had hope with the "great" skin i had during the weekend."
IrishRich wrote on January 8th, 2018: "Is this bad!? Yesterday and today my face is burning red and stingy. In fact I can feel it tingling at times. I’m actually on week 4 now of soolantra (thought it was 3) and this is the first I’ve experienced this. Is this a big die off or has my skin now decided it is allergic to Soolantra?? Should I stop using it?"
Elmo wrote on January 8th, 2018: "I was like this for a week on day 5 or so ....can't remember seems so long ago. But I do know I had a massive wobble at the time wondering if it was an allergic reaction. It was either a die off or complicated by the fact i was using witch hazel which I didn't realize isn't compatible with soolantra. I'm 15 weeks now; smooth clear skin but still pinkish cheeks & veins. hang in there if you can."
Elmo wrote on January 11th, 2018: "It did work for me in the sense that it cleared up the follicular scale, reduce eyebrow loss and pustules - had a huge die-off phase so must have killed a lot of demodex. But it didn't change the pink on my cheeks and I have some bold thread veins left. My skin is lovely and smooth really pleased ! So part of me thinks its time to quit. My GP advised me not to use for more than 4 months (and its written formally by her on the prescription label), so I don't think I'd get the prescription even if I wanted to continue. She didn't believe in the mite theory and only gave it to me based on my veins. since they are still there she'll probably just say 'I told you so'. But I do feel the demodex are more under control based on the fact that I don't get anymore die-off and the scales haven't come back. Interesting that you've been on it 1.5 years. Did you think you've had any side effects? Some ppl have said that they felt that the demodex became resistant to soolantra.... clearly not in your case!"
Ellie wrote on January 11th, 2018: "I never come to this site anymore because my rosacea is essentially gone. I still flush every so often but now that doesn't last and I don't get pustules. Anyway, soolantra continues to work for me so I apply a very small amount every night. Despite living in a cold climate, my skin doesn't get dry like it always used to. I use clinique redness relief cream in the morning by itself and also at night with a pea size amount of soolantra (I apply the clinique cream beforehand), cerave hydrating face wash, avene thermal water and I've really cut back on drinking (doing dry January now). My skin was pretty good but not perfect before when I was just drinking socially on weekends but I've noticed a difference since I cut it out completely. Anyway, just wanted to report back that soolantra has done wonders for my skin for anyone who is thinking about trying it. I never had any irritation from it and have been using it long term. Also, as an aside, I used to have a lot of GI issues as well that have cleared up since I started eating less sugar, stopped snacking and started doing intermittent fasting (I feel so much better after skipping breakfast and have lost weight etc. - I fast for 20hrs and only eat in an 8 hr window) Anyway, sometimes I wonder if all this stuff is related somehow but I've been getting compliments on my skin since I made those changes. I do think it's the soolantra that's making the difference but given how well everything is going, I'm thinking about cutting back on soolantra eventually and seeing if my lifestyle changes are enough to keep my rosacea from coming back. My dermatologists said there were no issues with using it long term - I don't even see him anymore, I just get it prescribed by my GP. I did notice improvement within the first couple of months though so I kept using it and over time my skin has completely cleared up. I've been using it for 1.5 years so far. I know it's a new medication so I always come back here and report back that it's still working for me in case it's helpful to others. I also never had any negative side effects from it. I wasn't even counting how long I had been on soolantra - it's actually 2 years, 4 months because I essentially went on it after it came out in Canada."
MissM wrote on January 12th, 2018: "Hi! My derm has not given a timeline for Soolantra usage. I’m under the impression that she will prescribe it for as long as I want to take it. Also, based on what I have read on many forums, it looks like a maintenance dose may be necessary to maintain results in people who are prone to demodex infestation. When I decide to come off Soolantra sometime in the future (I have been on it since August), I will most likely use it twice per week for maintenance. M"
Angela1979 wrote on January 15th, 2018: "Hello! I wanted to give an update form a long term Soolantra user. I started using Soolantra in september 2016. I still use it (every day) and it is still working like a miracle. I don't have any itchy bumps on my face anymore. I do get them on my arms and the upper part of my back, and in the back of my neck. And on my scalp too. I think the mites just migrated. I tried a tea tree shampoo and bodywash but that didn't work. It's okay though, even if they itch for a long time, it is not nearly as bad as when my face was covered with itchy bumps. My face isn't dry anymore, it is more oily now, especially on my forehead. Every now and then I get a pustule, mostly on my neck (I apply Soolantra there too). I am still very happy with Soolantra!"
IrishRich wrote on February 14th, 2018: "So I’m now 10 weeks in and have hit a bit of a wall. The redness is pretty much gone however this past weeks I am getting breakouts of pimples. Red ones not just small puss filled ones. It’s quite depressing. Has anyone else had this around the same time frame? Is this still die offs?"
Pennylane366 wrote on February 15th, 2018: "I'd love to know the same. I'm experiencing the same thing and have honestly given up. I went back to my prescription sulfur wash and the pustules are all gone. I was just honestly feeling like sulfur was working better for me than the Soolantra -- however, after hearing so many of you say the waiting period is worth it, now i'm having second thoughts! Did I give up too soon? Should I give soolantra another try? I'm going back to my derm next week..."
"Worst case of subtype 1 rosacea imaginable (Demodex mites?) I can't believe how bad my case it. It is by far the worst I have seen. I have doubts almost anybody has it this bad. This is just pure cruelty. It started at the age of 12. Even then, my rosacea tormented me; extremely red face, swollen nose. I lacked self awareness back then so I had no idea it was even that bad until years later seeing photos. For the past 10 years my life has been a living hell. My nose is unbelievably swollen, my face now an extremely dark red like somebody threw acid at my face. I don't even know what to to anymore. I cut back on sweets, supplement fish oil, take MSM, topical green tea & aloe vera...Aloe vera made it worse than I could ever imagine so I'm not sure why people praise it. I don't eat for days straight & try to shovel cordyceps, apple cider vinegar, with MSM all mixed with around 10 grams of fish oil. Absolutely nothing. I drink massive amounts of water but now I am a very skinny, red faced mess with thick glasses & vision worsening every year. No alcohol intake (Maybe 1 drink for 1 day every couple months) but my face explodes into a flared up, swollen up, hellishly red nightmare. A vegetarian diet has done nothing. I honestly want to kill myself & even attempted to slit the vein of my arm. It's too much. It hurts too bad & I'm too poor to treat it because I already spent so much money, and now it's all wasted. It has absolutely destroyed my life. I quit my job, denied relationship opportunities, never leave the house, never see my friends, never speak face to face with anyone...I cry everyday. Pathetic, I know. But what else can I do? I now have nothing but a charred red face that I know will never go away, or even be treated. I now have absolutely nothing in my life, I'm not exaggerating. My question is: How effective is killing demodex mites for Subtype 1 Rosacea? I don't know if I can afford surgery but I heard Tea Tree Oil has been very effective, but I'm afraid treatments like that are limited to other forms of rosacea. Has anybody beaten this monster? Or at least tamed it in absolutely any way whatsoever even for a little bit. Because I now have no future. I'm 22 & the past 10 years have been a horrid nightmare."
Kwamex replied on December 5th, 2016: "I feel you man...! Don't give up! You will find your treatment! Why Aloe Vera made it worse, my guess: Did you use a 100% pure Aloe Vera? If not, that's the case. Even if 91% pure it's probably some alcohol and other **** in it. However, here are some things you can try: Tea tree oil and Argan oil. There is a member of this forum who had a REALLY bad case of redness and P&P, she fixed it using this method. Just buy a plastic bottle from the pharmacy and mix these 2 together. Make sure it's 100% Pure argan oil and tea tree oil. Get a like 5/10 ml measurement. Use 5 ml Tea tree oil and then about 20 ml Argan oil. Then you get a 20% concentration of Tea tree oil, use this on your face every morning and night. If it's to bad for your face, lower the concentration to 5-10%. Tea tree oil is a really good demodex mite killer! Make sure you wash & change your bed sheets often. Use high temperature! Especially your pillow."
Kwamex replied on December 16th, 2016: "I'm using Tea tree oil 100% together with argan oil 100%. I mix these together (20 tea tree/80 argan ratio). In the beginning it get worse, when you kill the mites. First my face got worse than ever, then it got better. Took maybe 2-3 weeks before it went from worse to better."
Nisha wrote on January 11th, 2024: "Soolantra was very good for my rosacea. I was diagnosed 7 months ago. I tried putting turmeric, but nothing worked and I was upset because of the red bumps and flushing. I felt so embarrassed to go out. One day, I found these reviews and read them all. I started using Soolantra and it's now been one month. The red color is gone for about 3/4 and the flushing as well. But now I have noticed black dots appearing on my face. I believe it's a side effect of Soolantra because it's a strong cream. I feel so bad because I don't want to stop using Soolantra. I tried one week without applying Soolantra and the flushing and red bumps came back. This means I have to apply this cream for the rest of my life because I know there is no cure for this condition. Now I may try putting Soolantra twice a week. I spoke to a dermatologist and she said we have to continue using Soolantra on and off."
GanXie wrote on November 11th, 2023: "Taken for 6 months to 1 year. Thank you so much to everyone who has left messages here - you guys got me through the rough patch when dealing with the intense side effects. I went through all the side effects listed in the Soolantra instructions, and they were like the deluxe edition. I was genuinely scared, my mind filled with all sorts of doubts and worries: Did I make a mistake? Is this medication really working for me? Can I bounce back from these terrifying side effects? I remember reading every single comment on the forum over and over again. That was my source of mental strength at the time. Here is my experience: My face was all red, swollen, and feeling like it was on fire, covered in more tiny pustules during the 7-10 days... the worsening stops in about two weeks. My skin started peeling, and the swelling went down. After 1 month, my skin returns to a soft and smooth state. Yes, the red marks from inflammation were still there. Be patient - it takes about 6 months for them to fade."
Irish wrote on May 14th, 2023: "I have suffered from mild rosacea and facial flushing for many years. I think it's an Irish thing. Anyway, after looking up this site, I asked my GP for Soolantra along with a course of Minocycline for 2 weeks. I can honestly say that this has been a great combination. After 8 weeks my skin improved significantly. The redness has greatly reduced and I'm getting compliments on how smooth my skin is. Give it a try and your confidence may once again return."
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Becky wrote on May 10th, 2023: "I was prescribed Soolantra after having mild-moderate pustules which turned out to be rosacea. This review is to tell anyone who has started to keep going … it works!!! But it gets so much worse before it gets better. During week 1 I didn’t see much of a difference in my skin at all. by day 10 - 14 my bumps and skin texture were 1000 times worse than it was before Soolantra. I cried nearly every day but kept reading reviews and powered through. By day 15 they basically disappeared overnight and my skin is looking amazing. They are nearly completely gone! Please please please keep going. It is true that it gets a lot worse before it gets better but so worth it."
Berko wrote on May 1st, 2023: "I've struggled with rosacea for the past four years through the lockdown. I put it down to menopause and tried a variety of cosmetics advertised as anti-redness that helped to a point. Finally got a GP appointment and the doc prescribed Soolantra. The recommendation is for 3 months treatment. This cream is considerably cheaper in the UK by prescription than over the counter. The effect was pretty immediate. Pustules and a lot of whiteheads are gone, redness right down. My skin is better than it has been in years. I'm hoping that this has the long term effect that is needed."
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Berko wrote on May 1st, 2023: "I've struggled with rosacea for the past four years through the lockdown. I put it down to menopause and tried a variety of cosmetics advertised as anti-redness that helped to a point. Finally got a GP appointment and the doc prescribed Soolantra. The recommendation is for 3 months treatment. This cream is considerably cheaper in the UK by prescription than over the counter. The effect was pretty immediate. Pustules and a lot of whiteheads are gone, redness right down. My skin is better than it has been in years. I'm hoping that this has the long term effect that is needed."
MJ2023 wrote on April 22nd, 2023: "Like so many other people, I’m here to attest this is a miracle cream if your rosacea is caused by demodex. I take steroids daily due to a medical condition which is a common cause of rosacea. For three years, I have had rosacea across my cheeks nose and chin and have tried everything from antibiotic and anti redness creams to cutting out dairy. I had a recent outbreak that was so terrible, I was completely miserable. Someone recommended Soolantra and my doctor was skeptical but I am so grateful she finally wrote the prescription as my rosacea was literally almost entirely gone after ten days. I looked in the mirror tonight and felt so moved to see how much I look like the old self I haven’t seen looking back at me for years now. Also for what it’s worth, my rosacea only worsened for 2-3 days. I know some people on here have suffered much longer than that but just to add to the full spectrum of testimonies, I was very lucky that my window of worsening was short."
Sue wrote on July 28th, 2022: "My rosacea was increasing and I had tried Rozex which helped a little. Two weeks ago I started Soolantra after a friend recommended it and my Doctor was happy to prescribe it. It’s been amazing! Within days my pustules had gone and my skin was smoother and has no redness. Hope it continues!"
Life wrote on March 14th, 2022: "I have been suffering 30+ years, nothing from GP really worked, I just lived with it, always a red burning face and painful horrible lumps. I was embarrassed to meet new people. It had a massive impact on my self esteem. Got Soolantra after reading online reviews. I can't explain how good this product is. First time use it did sting, but after 2-3 days 80% cleared up. After a week didn't look like I had rosacea. I now use it only once a month, just a small smear when the redness starts to reappear. Then the next day it has vanished. This is wonderful and has changed my life."
Kit wrote on February 25th, 2022: "Horrible experience with this drug. My face is horrible after 7 weeks use. Wish I had never heard of Soolantra"
Alexa wrote on February 18th, 2022: "I've been diagnosed with papulopustular rosacea in August 2021. My face was covered in red inflamed pustules and my skin was itching and burning. My dermatologist prescribed me Soolantra and said if there weren't changes after a month of using it, then she would add Doxycycline for 3 months. I was so desperate so I didn't want to wait another month to see if will be any results so I took the antibiotic in parallel with Soolantra. After a month my face got cleared up like 80% and I continued with Soolantra and Doxy with 2 more months and then stopped both of them because my skin was fully cleared. After a month, my rosacea came back even worse. I started to apply again Soolantra without the Doxy this time and now I'm in my 4th week since I started to use it again. So far my skin is worse since the beginning, I don't know if it's the Demodex die off or my skin is not reacting well to it, but I feel like Soolantra is not the cure for me. I will keep pushing with it though for a few weeks."
Rachzon updated: "It is a 30 gram tube with what I presume is 1% Ivermectin. [..] I asked about other peoples experiences, they have about 10 on the trial at the Coast and all but one have had results similar to mine. The Derm mentioned that up to this point it has been very hard to treat Papular Pustule Rosacea so is very pleased with these results. [..] 10 weeks I have been on the trial now and my face continues to be fantastic. I get the very occasional bump but it is gone within a few days."
Rachzon updated on October 9th, 2008: "I know this sounds very vain but I can not stop looking at my skin in the mirror. If my skin could stay this fabulous I will be eternally ecstatic. It is smooth, even the pores seem to be smaller. I'm not at all red. I had a stressful shift at work the other day, I felt myself flush but it seemed to settle very quickly. There are still a couple of papules on my neck but my face is completely clear. I will stand by the Megan Gales Invisible Zinc and say it is the best product EVER and that in combination with the Ivermectin cream is for me an absolute Godsend. I stopped my Doxy and Rosex (had not done a thing in 2 months) 2 weeks ago and my face has stopped flaking. I hope that this cream is on the market soon as I will hate to have to stop it after the trial. I have also started using an Avene moisturiser in the morning before the Invisible Zinc which is really soothing. It seems like a really nice product."
Mistica replied on October 9th, 2008: "Hi Rachel, That is indeed great news! And I totally understand about wanting to check your face in the mirror. Just to clarify about the redness. Are you talking about permanent background redness you had, or the inflamed areas caused by the outbreaks? The former is so hard to treat."
Rachzon replied on October 13th, 2008: "Mistica, I think I am lucky and at this point don't seem to have permanent redness. It was always hard to tell as the same spots seem to have been constantly inflamed. But now as my face is completely clear I couldn't have had any permanently red spots. I still have a few broken capillaries around my nose but I'm sure laser is the only way to get red of them. And I plan to put off that path as long as I possibly can. Face is getting better every day. My husband can't believe the difference, he has never seen my skin like this (wish I had this on my wedding day). So for those of us with papules and pustules caused by mites it looks like there may be a solution. I just hope that my skin continues to stay this good and doesn't relapse for any reason. Will let you all know if it does. I asked about other peoples experiences, they have about 10 on the trial at the Coast and all but one have had results similar to mine. The Derm mentioned that up to this point it has been very hard to treat Papular Pustule Rosacea so is very pleased with these results. I haven't taken any Doxy, Propanolol or used any Rosex now for 3 weeks. The only think I'm taking is mutivitamins, flaxseed, fishoils, grapeseed and probiotics. Supose it is hard to know intil more studies are done what comes first. Do the mites in the case of papular Rosacea cause or mimic the rosacea or do they just make the symptoms of Rosacea worse."
But two years later Rachzon wrote again, on July 5th, 2010: "Has anyone tried Ivermectin in a cream that they have made up themselves? I have been doing lots of reading about Ivomec and its use on Demodectic Mange in dogs and scaley face in budgies and wondered if anyone has been game to try it themselves. I have been waiting in vain for the trial of Ivermectin to recommence but it has almost been 2 years and I am ready to give up hope. Even for over a year after finishing the trial my skin was wonderful. My face has been a constant battle since Christmas. I have managed to keep it under reasonable control with Manuka honey and Tea Tree in coconut oil but it is so much work in comparison to the Ivermectin Cream that I used on the trial."
Wistar replied on July 6th, 2010: "Hi Rachzon, you have probably already read about my comments on it in this other thread. It is the best stuff out there for papules. I have used it for over 12 months on a frequent basis. Go with the Ivermectin 1% sterile liquid. You shouldn't need a syringe. Peel off the foil surrounding the cap and the rubber bung underneath is removable. Dab some on cotton wool and rub onto face. Lightly glaze the face with it. Let it air dry. After 2 hours a calm feeling will happen to the face. Two days later you will notice no new papules. Any existing papules will clear in their own sweet time as normal. After two weeks, still no new papules. By then you should maybe be clear of the old papules. Repeat every 3-4 weeks for as long as necessary. If you don't use enough, it won't have the clearing effect and you will have to repeat again a few days later. If you use too much you may feel restless for a couple of hours or even notice a little muscle twitching. It is the total amount absorbed into the skin that determines the effectiveness as it works systemically (like taking a tablet). As you become familiar with applying the liquid, you will discover the right amount. Plan on using it for at least 6-12 months to prevent any relapse. Here you go. Search for ivermectin on amazon for more choices." [..] I have used Eurax intermittently for 6 months. Still not sure if it make a difference. If anything sort of works it would be Tea Tree Oil. It only sort of controls it, I still got new papules, just not as many."
Rachzon updated on July 24th, 2010: "Pleasing results. Initially I bought Ivomec in the form of the dip which is what they used on cattle topically. After the initial chemical smell I was very reluctant to use it on my face and bought the Ivomec injection. Here in Australia I could order it on a pet online store. I could only buy it in 200mls so hesitated until my face got so bad I was desperate. I started using it 3 days ago and I have already noticed a difference. I have also been taking antihistamines, anti inflammatories and propranolol so something is working. I found when I was on the Ivermectin trial I could stop everything else that I was taking. My face went into a remission for about 18 months. When I was using the 1% cream we were using it every night before bed as that was when the mites were supposed to be more active. Today no new papules have arrived and my face has stopped peeling, the redness has also diminished. I have been using the Ivomec sparingly as I still have some fears as it hasn't really been used on humans. This solution is also 1% Ivermectin. My mother used to have a lot to do with animals and even though the use of Ivermectin is not FDA approved on dogs they used it to treat demodectic mange with good results. Dogs are very sensitive to many things, but I am still very much aware of long term effects that we can't know about. I also am aware of how I feel when I have a bright red peeling face full of papules and my children are patting my skin and asking me if my face hurts. So at the moment I am prepared to take a little risk and hope that I can put my face back into remission for another 18 months." (Note; this Ivermectin is the exact same Ivermectin that is used in Soolantra).
She updated on September 5th 2010: "I have been using the Ivermectin 1% Injection topically now for a month and a half. Results are good, not quite perfect but I will never have perfect skin, The odd papule but they only last a day or two. My pore size seems to have reduced too. I can not tell you the last time I flushed either. I have come home from work with a reddish nose on occasion but that seems to decrease once I am out of the air-conditioning. I have even stopped wearing makeup."
She updated on September 5th 2010: "I have been using the Ivermectin 1% Injection topically now for a month and a half. Results are good, not quite perfect but I will never have perfect skin, The odd papule but they only last a day or two. My pore size seems to have reduced too. I can not tell you the last time I flushed either. I have come home from work with a reddish nose on occasion but that seems to decrease once I am out of the air-conditioning. I have even stopped wearing makeup."
Flying_er updated on August 29th, 2010: "I'm now 30 days into the mite killing routine. I'm using topical Ivermectin every other night and sulphur cream the other nights. I stopped using Eurax, and replaced with sulphur cream. I figure the sulphur adds some healing properties to the equation. My skin is still up and down, a few days of clearing followed by a few days of breakouts, mostly in the form of papules. I feel like my skin is trending towards improving but time will tell. My Dr. also gave me some new shampoo to use 2x per week. It's called Aliclen, so far I like it, seems to be helping my scalp. [..] we are not injecting the the liquid, we are just applying it to our face using a cotton ball. -Dave-"
Flying_er updated again on November 18th, 2010: "I used Ivermectin once or twice a week for around 3 months. I never saw a total clearing of my P&Ps but it did seem to help calm my skin and reduce the breakouts. About 3 weeks ago I stopped using the Ivermectin to see what would happen. At first no difference was noticed but during the last week I've noticed that a lot of the little bumps I had previously are starting to return. I had forgotten how many of these little bumps I had before using Ivermectin and now they are returning. I'm going to start using the ivermectin again tonight and see if the issue clears up. I'll report back when I have more info. [..] I find it to be harsh on my skin, it dries it out and irritates it. -Dave-"
Michael_V wrote on September 1st, 2010: "I also tried oral ivermectin in the past without success, although I realize now how optimistic that approach is. While it likely did eradicate or at least substantially thin my resident demodex population for a couple of weeks, the continued dermal inflammation, increased facial blood flow, and enlarged follicles (these things take time to resolve) left my face like a freshly painted and swept waterfront condo with plenty of new tenants eager to move in. Remember that the demodex (or their commensals) are only part of the problem. For most of us, a large part is also our own dermal immunity, which either (1) reacts too easily, (2) reacts too strongly, (3) reacts for too long, or (4) all of the above. Any successful approach will require a sustained, multipronged approach that includes some combination of ongoing demodex and/or commensal bacterial control, trigger avoidance, improved general health and immune function, and the promotion of dermal healing."
Michael_V updated on September 5th, 2010: ""5 weeks so far using topical Ivomec twice daily with excellent results and no side effects. Will continue for one more week and then go down to once weekly for maintenance. I also took oral ivermectin (stromectol), two doses five days apart, and the benefits seemed additive and synergistic."
Mrsmoof wrote on September 1st, 2010: "I am curious if anyone also took an antibiotic while taking Ivermectin as in the patent? I wonder if the antibiotic would add or enhance the effects of Ivermectin?"
Betise wrote on August 20th, 2010: "Hi there everyone - I was recently diagnosed with Rosacea (2 days ago) and discovered this forum today. I have been reading your posts in regards to Ivermectin with great interest. I am a veterinary nurse and am very familiar with Ivomec - it is a product we use off label routinely to treat Demodex in not only dogs - but also Guinea pigs, rats and mice (one tends to think if it is safe for them, us humans should be ok <lol>). Before my diagnosis I kind of suspected I had rosacea and had wondered if mites could be involved. I did consider using Ivomec so was absolutely delighted to find out others have done so with some success. I have redness across my nose and both checks, probably on average once a week I get small papules and pustules. Sometimes my face feels like it is sunburnt and it does get itchy every now and then (hence my thinking along the lines of mites). My nose is the worst affected area."
Bambi wrote on February 13th, 2011: "Haven't been on the forum for a long, long time and just tried to ignore my rosacea. However, about 2 months ago I did some lurking on this thread and ordered ivomec just in case it would help. Well, it made a big difference. I'm so very grateful to all you rosacea pioneers who led the way. I use 3-4 small drops on a wet cotton disk every night before bed. I also change my pillowcase every night. I'm not going to claim that I now have a peaches and cream complexion, but the redness has faded to an acceptable pink. It's true that it's a bit itchy when you apply it, but for me it calms down pretty quickly. Now if someone could come up with a way to take the dye out of my hair I'd be in heaven!! [..] Ivomec is helping with both, more so with the redness, but also with P&Ps. Thanks to you all, Jodi"
Gumbo wrote on March 28th, 2011: "Since the majority in this thread are using Ivermectin and treat for demodex I thought I should just make a note here in regard to treatment. The dermatologist I saw in Europe has published extensively on demodex and rosacea, and outlined a treatment for me. The interesting thing to note though is the need to treat the scalp, as my dermatologist has noted that most heavy infestations on the face will most likely have a lot of demodex on their scalp. I was given a scalp solution to use twice a week in my treatment. Further, after treating for 2 months, a recent biopsy showed 20 mites in a small section of my cheek. The deeper the biopsy went, the more mites. I mention this because I don't believe people get re-infested by their pillow, dog, cat, neighbor or whatever the excuse is. It is best to treat the entire head, and for many many months. I do believe this sterile liquid is effective. I also like the fact it lasts a long time and only requires dabbing a bit on the face every couple of days."
Bob4324 wrote on May 22nd, 2015: "4 days ago, I decided to experiment with ivermectin. I bought the little bottle with a rubber lid intended for cattle injection, and applied it topically using a dropper and my fingers. I was very liberal with application, spreading it all over my face and scalp and re-applying multiple times throughout the night. I hadn't really intended to apply so much, but after the first application there was such an immediate visual improvement that excitement got the best of me. For several hours, my face was better than I've seen it in years (maybe ever). It just looked like a normal person's face who doesn't have Rosacea. It's surreal to look at a mirror and see that. Well, it didn't last unfortunately. About 4-5 hours later, I started to have some sort of a reaction where the skin became very red. Over the next few days, I methodically tried all of my old standbys to reduce the redness back down to baseline. Of course, living with rosacea for so long, there are plenty of things in my bag of tricks. But oddly, none of the usual treatments were helping. There was clearly something "different" about this reaction. Having read a fair bit about demodex all over the internet (including this forum and this thread in particular), I've noticed that this sequence of "Holy crap I'm cured" turning to "Holy crap my face is on fire" fits in with the theories about a demodex holocaust being proceeded by die off symptoms caused by dead demodex and their associated bacteria etc. With that in mind, I did something which I'd never dream of doing otherwise -- I applied antibacterial hand sanitizer directly to my face. After an hour, checking up and reapplying. I ended up applying quite a bit, and it's the first thing which has reduced the redness back to baseline since the ivermectin. So now my skin looks about how it was 4-5 days ago before the experiment, maybe a bit better. The quick return to baseline via antibacterial hand sanitizer gives me hope that it's worth another attempt. Next time, I'll respond to any die-off symptoms immediately with antibacterial. If the two can work together, one productively flushing demodex and the other fending off die-off symptoms, then there's a comfortable route forward with ivermectin."
As many people who started with Soolantra/ Ivermectin noticed, it can take up to 6 to 8 weeks before your skin sees the benefit of this treatment. Especially those with skin outbreaks can notice a worsening of their skin for the first month at least, which can be very frightening and discouraging. The mites have a life cycle of around 2 weeks however, and when they die off, their 'corpses' release substances in the skin that can cause an extra inflammatory response, before things are cleared up and improved. Some people try to ease this phase with oral or topical antibiotics.
Ayesha wrote on February 1st, 2017: "Hey, I have been prescribed soolantra for papillae rosacea. I have been using the cream once a day for only 5 days. My face is bad. It has brought out red spots all over my face and nose. Before they were just bumps in the skin now they are showing on the outside. Not sure if it is meant to get worse before it gets better. I am getting married in 7 months and do not want to look like this."
Stuart wrote on February 1st, 2017: "In 7 months time your skin will be better than its ever been believe me. 5 days is nothing. You will have weeks worse than others as the mite kill off happens until the mites are gone.but you will be happy. About 12 weeks plus you should be clear but in the weeks leading up to that your skin will continually improve dramatically."
Ayesha wrote on February 3rd, 2017: "Thank you for your advice Stuart. I have an appointment with the dermatologist tomorrow so will show him my face and see what he says. I was hoping someone would say it gets worse before it gets better. Today the redness is not to bad and the bumps are not as bad as yesterday. Not sure if that is because I have been in bed all day due to a sickness bug and not had the opportunity to go out and about. Hope soolantra works for me. I honestly do not know how I have developed papular rosacea. I have Asian skin, I am pretty fair in colour may be that’s why. Thank you for your support. Your words give me hope."
Stuart wrote on February 3rd, 2017: "Its fine. I had antibiotics to combat the mite die off for the 1st few weeks. Its 3 weeks, 6 weeks , 9 weeks that u will most probs have further mite die off. But you have to stick with it. That's the number 1 rule."
Carrie wrote on February 3rd, 2017: "Your face will get soooooo bad before it gets better. Once it gets better though, it will be better than it’s ever been. I look totally different than I did 18 months ago. V Beam Laser helps a lot too. Don’t give up. The only reason I got past day 3 was because I saw a man on here begging people to just keep going. You will feel like a monster for several days, but don’t stop! All the bumps are the mites dying and you have to kill them all before you clear up. Good luck!"
MT wrote on February 4th, 2017: "I suggest to keep more moderate words than “better than it’s ever been” mate. Soolantra is quite good, but not magic, and not for everyone. Worse before it gets better overall, we all know that now. But after about 2 years of Soolantra medicine, I can say it’s not always for the best in a pink glasses tinted world. Soolantra isn’t THE miracle product for all rosacea pathologies. Regards."
Claude caron wrote on February 19, 2017: "Hi I hope you enjoyed the magnificent results that I did. I had terrible papules diffuse over my forehead chin and cheeks after 4 weeks of soolantra I found an improvement of 70%. 3-4 weeks beyond this my condition cleared, amazing!!"
Chris wrote on February 3, 2017: "Doxycycline is a life saver. I got big red bumps after a few weeks on ivermectin cream. Doxycycline made them disappear within a week. It means I need to stay on an antibiotic for a while, but I don’t notice any side effects from it during the 6 months. Now that my skin is much improved from the combination of ivermectin and doxy – much less flushing, burning, inflammation and swelling– I decided I’m ready for IPL. So far I’ve had one light treatment with small but noticeable improvement. I’m going back next week for the next one, which will be stronger. I figure once my skin improves enough, I’ll be able to go off the doxy (does anyone have experience with this?)."
Susan wrote on April 20th, 2017: "My dermatologist ordered a Rx. for Soolantra and ordered it to be compounded. Soolantra averages about $350.00 and compounded Soolantra is $35.00 The people suffering with Rosacea and Demodex mites need to know this."
Irene McDonald wrote on July 3rd, 2017: "I have just finished my first tube of Soolantra and am delighted with the results. When I used it first I though it didn’t work well but now think I didn’t persevere long enough. I now use Soolantra every night and my skin hasn’t looked this good or clear for 15 years. Finally there seems to be a solution. I first heard of Soolantra at a Beauty Therapists seminar. A dermatologist gave a great talk on Rosacea and was convinced the demodex mite was to blame for the pustules. Now I agree, having been a sceptic for years. Irene"
Carrie wrote on July 4th, 2017: "Your face has to get really really bad on Soolantra before it gets better. Most people get very red and bumpy for days. This is the mites dying off. I looked like a monster, but you have to let the whole cycle finish or you will never get better. Go back to some comments that I and others made on this page from 2015 and 2016. Everyone explains the process they went through."
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Bumps wrote on March 22nd, 2014: "I did see a benefit, even when self-medicating with the bovine ivermectin. Within 2 weeks or so, my skin had cleared. I have been using Ivermectin since then--about 18 months or so. Now I am using the medication prescribed by my doctor and compounded at the pharmacy. I use it no more than twice per week--Wednesday and Sunday. Some weeks I forget and don't use it at all, but generally I try to keep up with the therapy. My skin looks completely normal at all times. You could never tell I had trouble with Rosacea. I hope this works for others, because I remember how much discomfort and embarrassment this condition caused for me. Try it for yourself if you have P&P Rosacea. I'm confident it will help. I'd like to know whether it helps people with redness only."
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-Soolantra for Rosacea User Reviews, Drugs.com
-Ivermectin for demodex, The Rosacea Forum
-Soolantra, The Rosacea Forum
-Topical ivermectin vs permethrin vs crotamiton (Eurax), The Rosacea Forum
-Stromectol (Ivermectin) for Demodex Rosacea
-Less Expensive Alternative To Soolantra, Rosacea Forum
-Sulfur vs. soolantra? The Rosacea Forum
-Bad reaction to Soolantra? The Rosacea Forum
-Demodex and rosacea: Is there a relationship?
-Mite-related bacterial antigens stimulate inflammatory cells in rosacea
-Reddit Rosacea sub
-Mite-related bacterial antigens stimulate inflammatory cells in rosacea
-Reddit Rosacea sub
-Soolantra before and after, The Rosacea Group
About oral Ivermectin for rosacea
Nbapoker wrote on January 28th, 2008: "Ivermectin (Stromectol)- To kill the mites. My derm prescribed me Ivermectin (Stromectol) 6 mg a night (an hour before dinner, w/ water), to attempt to kill the mites. But I have not started it yet.... anybody have any experience with this med? p.s.- I have seb derm/rosacea/acne. And I am taking low dose accutane which has helped with my skin texture."
Mistica replied on August 14th, 2009: "I used topical Ivermectin for about two or three months and it had no impact whatsoever upon my severe vascular rosacea. The formula I used was very similar to the one used by Rachzon ( same derm). She had a complete resolution of her type of rosacea. P&P with associated redness and some flushing. It appears that ivermectin is only affective in her type. What type do you have, Colander?"
Colander wrote on August 15th, 2009: "I have just ordered this (60 pills). I will take one pill in the morning and one before I go to sleep. Maybe this dosage is too small to help, but if I just see any little improvement I will tell my doctor and demand prescription."
Beth83 wrote on January 28th, 2014: "HI. My doctor prescribe Stromectol to me because I was having issues with Rosacea and skin mites. I was getting certain type of acne (that really wasn't acne and something to do with the skin mites) that had a hard and deep cylindrical center that needed to be removed with tweezers to be able to heal. I took 3 pills, then a week later 3 more. It was an instant help with those hard bumps. They were gone after a few weeks and no new ones for about 8-9 months. I still got some regular acne but I could deal with that. Those hard/deep bumps were horrible. I went about 9 months without them, then started to get a few small ones lately so I ran back to the doctor and an currently taking a second dose."
Davem81 wrote on January 28th, 2014: "Very much my thinking too for my P&P rosacea. I think the consensus now is that topical ivermectin is likely to be more help than the tablet form. Phase 3 clinical trials for a human licensed version have just completed on this product."
In this scientific article, three cases of rosacea are described, where oral ivermectin treatment cleared the rosacea symptoms
"Three adult rosacea patients with varied clinical presentations and with varied disease durations are
selected to illustrate the disclosed invention. These patients' cases illustrate the effectiveness of ivermectin treatment on the different clinical manifestations of the disease.
Patient 1
This 44-year old Caucasian female had exhibited clinical evidence of rosacea for 1-2 years and had been treated with limited success with oral tetracycline, topical and oral metronidazole, and cortisone creams. Her facial skin exhibited mid-facial erythema and flushing with papule and pustule formation. In addition, her eyelids exhibited chronic blepharitis and repeated loss of eyelashes, which is quite typical of rosacea. She was treated with ivermectin, 200 micrograms per kilogram of body weight in each of two oral doses with an interval of four days between doses. Oral tetracycline was continued at a dose of 500 milligrams per day for the first 30 days after ivermectin was given and then was discontinued. After a mild initial flareup of mid-facial papules, the condition improved rapidly to the point that by 60 days no papules were present, all eyelashes were growing back, and she had no more flushing with heat or spicy foods. Symptoms had not returned after three months.
Patient 2
This 33-year old Caucasian female had the acute onset of papular and pustular rosacea involving nearly all of her cheeks and chin two months prior to her evaluation. Marked itching and redness were present, but no eye symptoms were noted. Ivermectin in two 200 microgram per kilogram oral doses given three days apart was administered along with a four-week course of oral tetracycline. The clinical signs abated quickly, with itching being gone after one week and papular lesions clearing by three weeks. At two months from the onset of treatment and one month after cessation of tetracycline, no clinical signs or symptoms of rosacea remained.
Patient 3
This 65-year old African-American female had suffered from severe papular and pustular rosacea of the mid-face and nose for 15 years. Tetracycline, in doses of 500-1000 mg per day had proven to be the only partially-effective medication for her. Oral ivermectin was administered in two 200 microgram per kilogram doses given four days apart and tetracycline was continued for one month in a dose of 500 mg per day. Followup at three months from the start of ivermectin therapy revealed only mild hyper-pigmentation at the sites of previous inflamed papules and pustules. The patient reported that no new lesions had been noted for six weeks prior to that 3-month evaluation. While these examples illustrate the preferred embodiment of this invention, the treatment of rosacea using oral ivermectin, exposure of Demodex mites to ivermectin from any route of administration will result in the elimination of the organisms and secondary amelioration of the signs of inflammation that are typical of rosacea. Therefore, the topical use of ivermectin in any vehicle that allows it to adequately penetrate into skin follicles to reach the level occupied by Demodex folliculorum will be an effective treatment for rosacea and is considered to be entirely within the scope of this invention. Changes of dosages, dosing schedules, concentrations, vehicles, and frequency of repetition of ivermectin regimens are also not considered to be outside the scope of this invention."
Some more science info on the link between rosacea and demodex mites
According to The Irish Times, Irish Scientists blame bacteria as the cause of rosacea according to a different study. This study is the result of researcher Dr Kevin Kavanagh, a senior lecturer in biology at NUI Maynooth. According to The Irish Times, “Working with the Mater hospital, the researchers previously identified a Bacillus bacterium inside Demodex mites. The bacteria release two proteins that trigger an inflammation in patients with facial rosacea.” At least one type of bacteria is associated with demodex mites and rosacea. This bacteria is Bacillus oleronius according to an NRS press release which quotes Dr. Kavanagh as saying, “This indicates that the Bacillus bacteria found in the Demodex mite produce an antigen that could be responsible for the tissue inflammation associated with papulopustular rosacea.” A study released in September 2007 by Dr. Frank Powell, et.al, also concluded, “Antigenic proteins related to a bacterium (B. oleronius), isolated from a D. folliculorum mite, have the potential to stimulate an inflammatory response in patients with papulopustular rosacea.” Another study released in January 2010 also said, “The strong correlation provides a better understanding of comorbidity between Demodex mites and their symbiotic B oleronius in facial rosacea and blepharitis.” Now, another bacteria, Bartonella quintana, may be implicated with the mites according to a report by David Pascoe. A number of other bacteria has now been added to list connected to demodex. The consensus has grown that demodectic rosacea is a variant of rosacea. Read more on this in the original post by Brady Barrows from the RRDi
A new study funded by the National Rosacea Society (NRS) demonstrated for the first time that demodex mites may be a cause or exacerbating factor in rosacea.
"While it is well established that Demodex occur in far greater numbers on the faces of people with rosacea, it was uncertain whether they play a role in the development of the disorder," said Dr. Frank Powell, consultant dermatologist at Mater Misericordiae Hospital in Dublin, Ireland, who conducted the study along with colleagues at the National University of Ireland-Maynooth. "In other words, which came first, the mites or the rosacea? And now there is evidence that it might be the mites." In the new study, published in the British Journal of Dermatology, the researchers identified Bacillus oleronius as distinct bacteria associated with Demodex mites. When analyzing blood samples using a peripheral blood mononuclear cell proliferation assay, they discovered that B. oleronius stimulated an immune system response in 79 percent of 22 patients with subtype 2 (papulopustular) rosacea, compared with only 29 percent of 17 subjects without the disorder.
"The immune response results in inflammation, as evident in the papules (bumps) and pustules (pimples) of subtype 2 rosacea," Dr. Powell said. "This suggests that these bacteria found in the mites could be responsible for the inflammation associated with the condition." Dr. Powell noted that the potential role for the bacteria in subtype 2 rosacea is also supported by the fact that effective treatment includes antibiotics that destroy B. oleronius. Interestingly, he said, antibiotics that are not harmful to these bacteria generally are not effective in the management of rosacea. "Although the mechanism of antibiotics in treating rosacea is not definitively understood, it has long been suggested that they work through anti-inflammatory action," he said. "However, other anti-inflammatory drugs are ineffective in treating rosacea, and immunosuppressive agents such as steroids can ultimately make the inflammation worse." The researchers concluded that their study shows consideration must also be given to the potential for antibiotics to affect microorganisms such as B. oleronius or other follicular or mite-related bacteria. Publication of results: Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. British Journal of Dermatology 2007;157:474-481.
About oral Ivermectin for rosaceaNbapoker wrote on January 28th, 2008: "Ivermectin (Stromectol)- To kill the mites. My derm prescribed me Ivermectin (Stromectol) 6 mg a night (an hour before dinner, w/ water), to attempt to kill the mites. But I have not started it yet.... anybody have any experience with this med? p.s.- I have seb derm/rosacea/acne. And I am taking low dose accutane which has helped with my skin texture."
Mistica replied on August 14th, 2009: "I used topical Ivermectin for about two or three months and it had no impact whatsoever upon my severe vascular rosacea. The formula I used was very similar to the one used by Rachzon ( same derm). She had a complete resolution of her type of rosacea. P&P with associated redness and some flushing. It appears that ivermectin is only affective in her type. What type do you have, Colander?"
Colander wrote on August 15th, 2009: "I have just ordered this (60 pills). I will take one pill in the morning and one before I go to sleep. Maybe this dosage is too small to help, but if I just see any little improvement I will tell my doctor and demand prescription."
Beth83 wrote on January 28th, 2014: "HI. My doctor prescribe Stromectol to me because I was having issues with Rosacea and skin mites. I was getting certain type of acne (that really wasn't acne and something to do with the skin mites) that had a hard and deep cylindrical center that needed to be removed with tweezers to be able to heal. I took 3 pills, then a week later 3 more. It was an instant help with those hard bumps. They were gone after a few weeks and no new ones for about 8-9 months. I still got some regular acne but I could deal with that. Those hard/deep bumps were horrible. I went about 9 months without them, then started to get a few small ones lately so I ran back to the doctor and an currently taking a second dose."
Davem81 wrote on January 28th, 2014: "Very much my thinking too for my P&P rosacea. I think the consensus now is that topical ivermectin is likely to be more help than the tablet form. Phase 3 clinical trials for a human licensed version have just completed on this product."
"Three adult rosacea patients with varied clinical presentations and with varied disease durations are
selected to illustrate the disclosed invention. These patients' cases illustrate the effectiveness of ivermectin treatment on the different clinical manifestations of the disease.
Patient 1
This 44-year old Caucasian female had exhibited clinical evidence of rosacea for 1-2 years and had been treated with limited success with oral tetracycline, topical and oral metronidazole, and cortisone creams. Her facial skin exhibited mid-facial erythema and flushing with papule and pustule formation. In addition, her eyelids exhibited chronic blepharitis and repeated loss of eyelashes, which is quite typical of rosacea. She was treated with ivermectin, 200 micrograms per kilogram of body weight in each of two oral doses with an interval of four days between doses. Oral tetracycline was continued at a dose of 500 milligrams per day for the first 30 days after ivermectin was given and then was discontinued. After a mild initial flareup of mid-facial papules, the condition improved rapidly to the point that by 60 days no papules were present, all eyelashes were growing back, and she had no more flushing with heat or spicy foods. Symptoms had not returned after three months.
Patient 2
This 33-year old Caucasian female had the acute onset of papular and pustular rosacea involving nearly all of her cheeks and chin two months prior to her evaluation. Marked itching and redness were present, but no eye symptoms were noted. Ivermectin in two 200 microgram per kilogram oral doses given three days apart was administered along with a four-week course of oral tetracycline. The clinical signs abated quickly, with itching being gone after one week and papular lesions clearing by three weeks. At two months from the onset of treatment and one month after cessation of tetracycline, no clinical signs or symptoms of rosacea remained.
Patient 3
This 65-year old African-American female had suffered from severe papular and pustular rosacea of the mid-face and nose for 15 years. Tetracycline, in doses of 500-1000 mg per day had proven to be the only partially-effective medication for her. Oral ivermectin was administered in two 200 microgram per kilogram doses given four days apart and tetracycline was continued for one month in a dose of 500 mg per day. Followup at three months from the start of ivermectin therapy revealed only mild hyper-pigmentation at the sites of previous inflamed papules and pustules. The patient reported that no new lesions had been noted for six weeks prior to that 3-month evaluation. While these examples illustrate the preferred embodiment of this invention, the treatment of rosacea using oral ivermectin, exposure of Demodex mites to ivermectin from any route of administration will result in the elimination of the organisms and secondary amelioration of the signs of inflammation that are typical of rosacea. Therefore, the topical use of ivermectin in any vehicle that allows it to adequately penetrate into skin follicles to reach the level occupied by Demodex folliculorum will be an effective treatment for rosacea and is considered to be entirely within the scope of this invention. Changes of dosages, dosing schedules, concentrations, vehicles, and frequency of repetition of ivermectin regimens are also not considered to be outside the scope of this invention."
According to The Irish Times, Irish Scientists blame bacteria as the cause of rosacea according to a different study. This study is the result of researcher Dr Kevin Kavanagh, a senior lecturer in biology at NUI Maynooth. According to The Irish Times, “Working with the Mater hospital, the researchers previously identified a Bacillus bacterium inside Demodex mites. The bacteria release two proteins that trigger an inflammation in patients with facial rosacea.” At least one type of bacteria is associated with demodex mites and rosacea. This bacteria is Bacillus oleronius according to an NRS press release which quotes Dr. Kavanagh as saying, “This indicates that the Bacillus bacteria found in the Demodex mite produce an antigen that could be responsible for the tissue inflammation associated with papulopustular rosacea.” A study released in September 2007 by Dr. Frank Powell, et.al, also concluded, “Antigenic proteins related to a bacterium (B. oleronius), isolated from a D. folliculorum mite, have the potential to stimulate an inflammatory response in patients with papulopustular rosacea.” Another study released in January 2010 also said, “The strong correlation provides a better understanding of comorbidity between Demodex mites and their symbiotic B oleronius in facial rosacea and blepharitis.” Now, another bacteria, Bartonella quintana, may be implicated with the mites according to a report by David Pascoe. A number of other bacteria has now been added to list connected to demodex. The consensus has grown that demodectic rosacea is a variant of rosacea. Read more on this in the original post by Brady Barrows from the RRDi
A new study funded by the National Rosacea Society (NRS) demonstrated for the first time that demodex mites may be a cause or exacerbating factor in rosacea."While it is well established that Demodex occur in far greater numbers on the faces of people with rosacea, it was uncertain whether they play a role in the development of the disorder," said Dr. Frank Powell, consultant dermatologist at Mater Misericordiae Hospital in Dublin, Ireland, who conducted the study along with colleagues at the National University of Ireland-Maynooth. "In other words, which came first, the mites or the rosacea? And now there is evidence that it might be the mites." In the new study, published in the British Journal of Dermatology, the researchers identified Bacillus oleronius as distinct bacteria associated with Demodex mites. When analyzing blood samples using a peripheral blood mononuclear cell proliferation assay, they discovered that B. oleronius stimulated an immune system response in 79 percent of 22 patients with subtype 2 (papulopustular) rosacea, compared with only 29 percent of 17 subjects without the disorder.
"The immune response results in inflammation, as evident in the papules (bumps) and pustules (pimples) of subtype 2 rosacea," Dr. Powell said. "This suggests that these bacteria found in the mites could be responsible for the inflammation associated with the condition." Dr. Powell noted that the potential role for the bacteria in subtype 2 rosacea is also supported by the fact that effective treatment includes antibiotics that destroy B. oleronius. Interestingly, he said, antibiotics that are not harmful to these bacteria generally are not effective in the management of rosacea. "Although the mechanism of antibiotics in treating rosacea is not definitively understood, it has long been suggested that they work through anti-inflammatory action," he said. "However, other anti-inflammatory drugs are ineffective in treating rosacea, and immunosuppressive agents such as steroids can ultimately make the inflammation worse." The researchers concluded that their study shows consideration must also be given to the potential for antibiotics to affect microorganisms such as B. oleronius or other follicular or mite-related bacteria. Publication of results: Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. British Journal of Dermatology 2007;157:474-481.
My rosacea has cleared up. I used dermalmd rosacea serum along with another that is very drying to my skin. My redness cleared up except I did not have a very bad outbreak to begin with. I started with red cheeks and nose, no pimples or sores. I may have used the dermalmd just in time to save me from sever outbreak. The only issue I had was around my eyes was sensitive from the cream and made my eyes water.
ReplyDeleteCan troy please tell me more about what you do with diluting ivermectin for your eyelids? I definitely have the problem of stuff (not gunk, more like flakes) forming and eyelashes falling out frequently.
ReplyDeleteHoly crap, get rid of the horrible background stuff!!! It's an assault on the senses. I'm really interested in what you have to say but I can't read it because of the shit-show you call a website. Clean it up......get rid of all the background and just say what you need to say.
ReplyDeleteHi Anonymous, you're the second person in 8 years time who mentioned this (the other person had eye problems). Hence, it hasn't been on my radar. I'm not sure if you viewed this page on a smartphone perhaps? it should be well readable on a laptop and tablet, and I checked on my dads smartphone tonight, and for him the pages automatically come up with a solid dark coloured background, so very well readable.
DeleteI found a shortcut to this issue; for whichever blog post you like to read here, go to the web address of it at the top of the screen, and behind the html at the and, paste ?m=1 (those 4 characters). Then you see the page with a solid coloured background and different lay out.
Thanks for the input!
Perhaps "Anonymous" did have issues while using a smartphone, hence the reason for their comment... but, in case not, I just wanted to say: please don't change the way in which you format your blog. I SO appreciate all the interspersed non-rosacea images (paintings, photographs, etc.) and the diary-esque accounts of your day-to-day activities and personal thoughts and interests (history, art, society, etc.) It makes dealing with rosacea (and finding information about treating it) so much more bearable.
ReplyDeleteIn combination with the wealth of information about rosacea, your voice and curation really make this blog something special. It's unfortunate that it is probably viewed *mostly* only by those of us dealing with this awful "disease..." because I think it would make great reading for anyone (and would provide non-sufferers a great deal of insight, as well.)
Thank you for spending the time and energy.
Thank you Brain Filter, it was lovely reading your comment.
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