Loading...Rosacea is sometimes also called acne rosacea, although it is not at all the same condition as adolescent acne. Rosacea typically appears in adulthood, making cheeks and forehead red and creating fine red lines under the skin. The condition may often result in pimple-like blemishes as well. The eyes and nose can also be affected. A fascinating drug called ivermectin may offer an interesting treatment for rosacea.
W.C. Fields and His Famous Nose!
Chronic irritation and inflammation can lead to an enlarged, bulbous nose. W. C. Fields is often cited as the poster boy for this condition, called rhinophyma. It is not something to make fun of. You can see what it looks like by going to this link (Eplasty, May 1, 2015).
Most dermatologists will admit that there is no obvious cause of rhinophyma. It used to be believed that overindulgence in alcoholic beverages could cause a deformed nose. That is now considered bogus. The article in Eplasty notes:
“Historically, rhinophyma was erroneously considered to be linked with alcohol consumption because substances such as alcohol and caffeine can cause local vasodilation, which worsens the symptoms. This alleged association with alcohol has caused much social stigma and loss of self-esteem in patients suffering from the disease, with several nicknames for the condition such as ‘whiskey nose’ and ‘rum nose.’”
A Range of Treatments for Rosacea
There are many possible treatment for rosacea, but not everyone benefits from each intervention. Some people get relief using dandruff shampoo to cleanse the face. Here is an in-depth review of selenium sulfide in shampoos such as Selsun Blue. While this may help some people, others need a more aggressive approach.
The FDA has approved a fascinating cream (new for this use, though an old drug) that may be of interest.
Q. I have suffered with rosacea for a long time. People always stare at my blemishes and red face, which makes me extremely self-conscious. My doctor prescribed Metrogel, which had no noticeable impact on the pimples or on the redness. Is there a more effective medication?
Please do not recommend a home remedy. I have tried several to no avail.
A. We understand your reservations about home remedies. Such approaches are rarely, if ever, tested scientifically.
You may want to ask your dermatologist about a prescription cream called ivermectin (Soolantra). This medication was originally developed as an oral drug to treat a terrible parasitic disease called river blindness (onchocerciasis). It also works against many other parasites and has been used widely in veterinary medicine for worm infestations.
When used topically as a cream or lotion it has been found to be effective against scabies, lice and the mites (Demodex) that may trigger inflammatory rosacea skin reactions. A study suggests that ivermectin performed a bit better than metronidazole (Metrogel) in reducing rosacea symptoms (Springerplus, July, 2016).
Sadly, the drug is pricey. Without insurance, you might pay more than $200 for a tube of Soolantra, though the company (Galderma) does offer an online coupon.
A Disconcerting Treatment for Rosacea:
Q. I have suffered from rosacea for years. After I used metronidazole for too long and found it ineffective, my doctor recommended Soolantra.
When the drug store wanted $298 for a little tube, I researched the main ingredient (ivermectin). You can get a large tube of ivermectin paste at twice the strength for about $2.50 or less from veterinary supply stores. It’s used to treat horses for various types of worms.
My red skin is caused by Demodex mites. I think that is why ivermectin worked like magic for me.
The paste is quite drying, though. After a while, I was able to dab the ivermectin just on my red spots instead of my whole face. I also change my pillowcases every night and wash them in hot water to kill the mites.
A. Rosacea is an inflammatory skin condition characterized by redness and bumps. Demodex mites, which are normal inhabitants of facial skin, sometimes trigger this inflammatory response (Dermatology and Therapy, Dec. 2020).
Ivermectin is an anti-parasitic drug that is active against scabies mites and lice. The FDA approved topical use of ivermectin for the treatment of rosacea a few years ago. As you discovered, however, the brand name cream is shockingly expensive.
We cannot approve of ever using veterinary products! The higher concentration might cause unexpected complications. Generic ivermectin cream is now available at substantial savings. You may want to ask your dermatologist to prescribe the generic formulation.
A Meta-Analysis of Ivermectin:
An article in the journal Dermatologic Therapy (Jan. 2020) concluded:
“This meta-analysis gives strong evidence that ivermectin is the most effective topical treatment. Besides, this agent provides the greatest psychological benefit as it satisfies the stigmatization of rosacea patients as well as the impairment of social and working life with a sustained better QoL [quality of life] above other alternatives.”
photo credit M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara under CC license 2.0 (original photo cropped)
Gerry
I have used Vitamin A palmitate from Bronson Labs for over 40 years now; it was recommended to me by a doctor in Atlanta. I had suffered from adult acne for 15 years at that time. Since taking the Vitamin A I have not suffered as I used to; however I do have to watch food consumption carefully, as I am highly allergic to anything with salicylates in it (citrus, tomato, strawberries, etc.), also nitrates and nitrites. In the event of an outbreak I double the dosage of Vitamin A palmitate for a few days, and this takes care of the problem. Usually I take 4 every morning.
Ruth
I use milk of magnesia on small patches of irritation.
Shirley
I don’t have rosacea. I have “mask rash” that is red, itches and burns. I’ve been using Desitin Ointment and it seems to help, but I don’t want to get it all over my masks, so wash it off when I have to go back to wearing a one. It reoccurs right away. Any ideas to help?
Terry Graedon
There are some recommendations in this podcast:
https://www.peoplespharmacy.com/articles/show-1223-how-to-care-for-summer-stressed-skin
Jana
I suffered from rosacea and found a cure. Laser treatment. It’s not cheap but it works, and you can get touch-ups as needed. IPL is the kind of laser that worked for me. I highly recommend it.
MKRay
Soolantra is not as new as your article implies. I’ve been a member of a rosacea support group on Facebook for over 2 years (probably longer), and Soolantra was being talked about by many members when I first joined. It would also help if you mentioned up front in the article, when you talk about cost, that generic ivermectin cream is an alternative. In addition, your article fails to mention that there are 4 subtypes of rosacea (erythematotelangiectatic, papulopustular, phymatous, and ocular), and using an ivermectin based remedy is not necessarily suitable even if other things have failed.
For instance, I have type 1 (along with ocular rosacea, type 4), and what I had to do was find a very gentle facial cleanser and follow a daily moisturizing regimen without fail to keep it under control. The moisturizer I use is a combination of three different products which I came up with on my own. It includes zinc based sunscreen (sunscreen is essential but chemically-based ones can make rosacea worse), tea tree oil (which is instrumental in controlling redness and burning), and a common body lotion which is labeled for itching.
Julie
I had Rosacea from 2008-2012. Being in a hot climate like Texas didn’t help. In fact it made matters worse. It got so bad that everyone thought I had shingles, including the doctor. I moved back to a cooler state, and instead of going on meds which were useless, I used the Selsun Blue mask treatment, which seems to work for me. I also use the Grampa’s Thylox sulfur soap on my face every day twice a day, which does an amazing job. I also use Emu oil (Longview farms) which heals the skin. Also, I don’t eat my trigger foods, like limes, lemons, and bananas, that seemed to ignite my Rosacea. My skin looks great now, and I haven’t had any break- outs.
Judi
I have suffered from rosacea for about 30 years. Metrogel worked well for a very long time. However, the last few years it really wasn’t getting the job done to control flair-ups. My doctor prescribed Soolantra. The sticker shock was enormous. However, it works incredibly well. I am finding that once I get the flare-up under control, I can stop using it for weeks at a time. At the first sign of a problem, no matter how small, I can apply The Soolantra to the problem area, and within a day or two the pustules are gone. This makes a tube last a really long time so the cost isn’t quite so staggering.
Al
After too long on ineffective metronidazole, my doctor recommended Soolantra. When the drug store wanted $298 for a little tube, I researched the main ingredient (ivermectin). You can get a large tube of ivermectin paste at twice the strength for about $2.50 or less from pet supply stores. It’s used to treat horses for various types of worms. I diagnosed myself as having demodex rosacea, which is why it worked like magic on me.
It’s quite drying, and after getting very flaky skin I gently abraded the flakes off with a fingernail board (the heavy type), and underneath was smooth skin. After that, I was able to dab the ivermectin on spots instead of my whole face. Also *very* important: I change my pillow cases every night and wash them in hot water to kill the demodex mites.
Zan
Cali
I found that you can get soolantra for about $75 using a mfg coupon. Walgreens, CVS, Walmart are a few that honor it.
I have mostly clear rosacea that is a version of thickening of the skin, some redness too. My dr also recommended a glycolic acid the dcl brand. It has helped a great deal. The swelling is decreasing.
Probiotics help, a ketogenic diet helps too.
I’m going to also have done laser electro cautery done at my dermatologist to work in the scars.
It is getting better but it takes time. I’ve been on soolantra for about 4 months
Janice
CT
Why is this so expensive? Ivermectn has been around for years. Soolantra is 1.0 % Ivermectin. Horse wormer in a paste or cream is 1.87% Ivermectin and costs between $3.00 and $8.00 for a 6 gram tube.
Rosie
03301
Is it safe to use Soolantra for blepharitis?
Terry Graedon
We don’t know. You’d have to be very careful not to get it in your eyes.
The research we found didn’t indicate that topical ivermectin (Soolantra) is effective for blepharitis, but oral ivermectin seems to work: https://www.ncbi.nlm.nih.gov/pubmed/21334593
finola
i should have added that at 25 euro its a lot cheaper than Soolantra..!! and just as effective against the demodex mites…
finola
Hi, just to let you know that there is a natural alternative to Soolantra available on rosacea. i.e.It’s a type 2 serum and is having great feedback.
HENRY
UK
Hi! I’m 73 yrs old & suffered from Rosacea for 20 yrs or more along with Eczema on my face! I used all the old Favourites like Metronidazole, Finacea etc with litle or no success! I was prescribed Soolantra (Ivermectin) by a hospital Dermetologist a year ago! Used it on my forehead initially! Within two weeks? No Roseacea there or very little evidence of it? I have frequent outbreaks of Eczema on my face so now I use it there also! It works for me! I read all about what it is & it’s history! No Worries! It works for me!
Nisa
New Orleans
What IS this alternative?? Please post the name and/or where you can purchase it.
Elaine
What’s a VBeam?
Elaine
NC
Months of Soolantra use did not touch my red face. Erythema.
No pustules. Just red ugly face.
I’m a microbiologist & placed great hope on this new drug.
I’m actually questioning the Dermodex theory
My skin is usually flawless but when Rosacea strikes, I’m devastated.
I think no one knows anything about this freakish condition.
Elaine
patricia hale
Florida
Of all the products I have used for my Rosacea, Soolantra and a yearly V-beam treatment seem to give me the best results. The medication stopped the burning, acid on the face sensation that I feel when I have a flare up!! I give this product a 5 stars except in is a bit pricey. But it is money well spent.
K. Alexander
Hot Springs, AR
For treating my rosacea I have been alternating using the prescription Metronidazole Topical Cream and Oil of Oregano [Oreganol]. I purchase Oreganol from Vitacost.com and the price is less than at pharmacies.
Valerie
Tennessee
My insurance too would not cover this medication, coupon only worked if my insurance would cover. My dr sent prescription to a compounding pharmacy who made an equivalent for $45. My face looks better after only one application last night. Very excited about what this might do for me.
Jody
Ohio
Another medication that I can’t afford. I’ve had to stop my COPD inhaler and the autoimmune for my lupus. High drug prices will kill me.
Ajennifer
Canada
Day 4 of using soolantra and so far I am liking the noritate I was on better. I seemed to clear ant pimples faster . I will give it a little more time yet though.
Elouisa
I’ve been using Ivermectin 1% cream for about 8 days — day 1 was great. Then my skin has gotten progressively worse, and is now worse than it has ever been — tons of the tiny white heads all over, in places I never have had them, burning and flaking skin. Has anyone experienced this, stuck with it, and then it got better?
mike
If there is one thing you have to be with the usage of soolantra, its patience. There are so many posts in the web from people who evaluate their therapy after a few days or weeks. To be honest, thats ridiculous. Soolantra needs time to take a sustainable effect – I see it and also my derm who is specialized for rosacea told it to me in the beginning.
Im at week 16 now and see more and more improvements since around 4 weeks. The first 10 weeks were differently, one week good condition, the other week very bad, also lots of the small white heads on places where I never had them. The mites are dying all around your face, keep in mind.
At the end I’m able to say that it looks like soolantra can help me better than every medicine before – just be patient.
Joe
Boston, MA.
After dealing with Rosacea for many years, with Metronidazole Gel .75%, and Doxycycline 100mg caps for flareups for 18 years. Know the triggers but there is no cure. For some reason
the flareups got real bad last summer. Got a Rx from my doctor for Soolantra. Had good health insurance and got it for $45 a 30 gram tube.
Now on Medicare with an Rx supplement plan and have to search for a reasonable price.
Using Metro in morning and Soolantra (only on real bad areas, Nose ) at night.
Hopefully, Soolantra will come down in price.
Leanne
Ohio
I just don’t understand why they would only give the discount to people who have insurance. $300 and $25 is a big difference. We have been getting it for $25 every month for over a year with a RX Discount Card because we have no insurance and now this month they refused it. My pharmacist was really angry that they won’t let it go through anymore. No way in the world are people going to be able to pay $300 for a tube of cream. It’s just crazy.
Ben
AZ
Leanne, I am also uninsured and I called Galderma and they have a mail order pharmacy they work with that will let you get it for $50 tube. Give Galderma a call.
Suzanne
L.A.
I just started on soolantra (about a week now), it has cleared up the worst of the rosacea really quickly. However I now have a rash on my forehead, little raised bumps that are not inflamed. I will keep on with the cream, maybe use a bit less, but will stop if the rash gets worse.
I don’t have prescription coverage, but I asked the pharmacist (Walgreens) if there were any discounts available. I don’t know what she did, she spent a while on her computer, but I paid $25.00 in the end. I was so grateful
Mary
I found the $300 for Soolantra too much for me to pay. Funny that it is so expensive and the same drug that it contains, ivermectin is dirt cheap in the Veterinary setting.
Heather
United States
Soolantra has worked like a miracle for my skin.
I have had horrible pustules for years, and they were becoming worse and worse. They were extending down my neck and the itching and burning was horrible. I have tried all other topicals and oral antibiotics.
There was an improvement but Soolantra has KNOCKED IT OUT. I look like I did 10 yrs ago! So obviously I had a mite infestation on my face. I was told by my dermatologist there will be a cycling initially as the mites die off and cause inflammation. Then eventually it will stop due to their life cycle.
Perhaps that is what is happening on your forehead, they are dying off and causing a bit of a flare. I honestly didn’t think it would work for me but it is AMAZING. I have experienced no side effects.
Mandy
Tx
Same effects here. It is wonderful. Changed my life!
Marge D
Wisconsin, USA
I have struggled for years with Rosacea. I tried a number of prescription creams but none of them were effective. MOM & Selsun Blue made my skin worse. I am currently taking 2000mg of L-Lysine twice a day and applying Neutrogena Ageless Intensives Deep Wrinkle Moisturizer, also twice a day. The redness & the pimples have been retreating!
Frances
North Carolina
Totally agree. What a pharmaceutical farce! Disgusting.
tom
Cleveland
When I turned 30 my rosacea started and I did not know what it was till I was 40 and for the next 25 years nothing worked. Hot shower in the morning, a beer, a ride on my bike, or hot food and BOOOM…I don’t know if I had another change of life or what but after less than two weeks it cleared up too almost gone, even if I use only every few days. Amazing. Now I drink all I want LOLOL.
Birdmom
Florida
After trying everything else I got samples of Soolantra and it cleared up my rosacea in two weeks. HOWEVER when I took a regular prescription to the pharmacist I learned it would be $400!!! I’m retired and can’t afford that OUTRAGEOUS price. Fear now it will return since I’m no long on Soolantra. My dr contacted the mf but they wouldn’t do anything for me.
Liz
San Diego, CA
Hi, I have suffered from Rosacea but have never done anything about it. My doctor just prescribed soolantra so we’ll see how it goes. What moisturizers, sunscreen and mAke up work best for you? My doctor told me to continue using neutrogena’s hydro boost. Most sunscreens give me a flare up. Thx for any suggestions.
Linda
Orlando, Florida
I started using Soolantra about a month ago. I was previously using Metrogel and antibiotics to control my Rosacea. Since I’ve been using Soolantra, my skin has cleared up drasticallyand it feels nice and smooth with no side effects. I am off the antibiotics which were not a good thing to be on for such a long time. I recommend Soolantra to anyone who has Rosacea. You will be glad you tried it.
A
Cincinnati
I just started a course of soolantra. I have high hopes for it. My question is are you still having success with it and are you still using it? Since there don’t seem to be any long term studies yet, I’m concerned with how long is too long to use this.
Rachel
Ocean Springs, MS
Finacea was wonderful but it now cost $888 in Biloxi, MS. In July it cost $275.00. Such a huge price increase. I just started my first day of soolantra. Hope it works. It was $300.00.
Peter
Florida
Fun, sun and Soolantra. This product has worked wonderfully for me. I have had Rosacea for 20 years and have tried everything you can think of to treat this embarrassing issue. Nothing else has come anywhere close to the ease of use and effectiveness of Soolantra. Galderma finally got something right!
Sophia
Ontario
I recently started using Soolantra approx. 6 days ago and it has worked wonders so far for me. It cleared my pimples and postules – not completely – but a marked improvement.
I still am getting postules but overall, my face is manageable. No burning, mild redness, a few red bumps.
I will keep putting it on and see how everything goes 3 months from now.
Crossing my fingers and hoping this cures my issue !!!
Val
nyc
I have tried everything under the sun for my rosacea, both pharmaceutical and neutraceutical, and Soolantra finally worked for me!! My regimen is Soolantra in the AM and a prescription sulphur cream at night. I use Origins Mushroom line for my skincare. Although not thrilled I determined my rosacea is mite-driven, I’m so happy this came to market!!
Jenn
Miami, Florida
I just want to share opinions about rosacea tx. Thanks in advance.
Courteney
Texas
I was prescribed Soolantra for my rosacea by a dermatologist. Within about 3-4 days my skin started hurting when you touched it and became very red and inflamed. By about the 5th day I had tiny hive-like bumps everywhere I had been using the cream. Once it was bad enough I quit applying the cream but the next couple of days the hives did not go away and my lips and tongue started to swell. My PCP gave me a steroid shot and I took Prednisone for a week to make it clear up. This medicine seems extreme to me, considering Ivermectin is a cream to treat mostly severe parasitic infestations like scabies. I had a horrible experience and I wish I would’ve stopped using the cream sooner than I did.
Jenny
I started an ivermectin cream 3 days ago and this exact thing is happening to me. My rosacea is worse. I have hive like bumps all over my face. Did your doctor explain why this happened? I’ll need to go in asap
Pat
Maryland
I have been using Soolantra for the last 3 weeks and I’m thrilled with the results. First, let me say that I don’t have rosacea very bad. It started a few years ago when I turned 60. I only get small red pimples on my nose and the sides of my nostrils. I had tried almost all the prescriptions creams, gels, and oral antibiotics and nothing worked. I use one small drop of cream at night on my nose and have tried using Vitamin E cream as a moisturizer during the day as suggested by others. I am 90% better. I saw a difference within days of using the Soolantra. It works for me!
duffy s.
New Orleans
Started using soolantra three weeks ago.. It is the most painful stuff I have ever put on my face.. My face has never been this red and flaky before.. The flakes fall into my eyes and burn like fire.. This sad little dr I was going to, didn’t want to hear I didn’t like soolantra .. I never had this kind of red, flaky skin before using this soolantra stuff.. Going back to vitamin e products..
Sharon
NC
The cost of a tube of Soolantra is $300 in my area as of July 2015 according to GoodRX. That is the same price as a tube of Finacea, another rosacea topical medicine. The coupon from Galderma is only good if you have insurance. You can’t use the coupon if you have Medicare, either. Looks like I will be trying milk of magnesia.
Phyllis
Houston
I have had great results treating my rosacea with CleocinT (clindomycin) lotion, used twice daily. It also acts as a moisturizer.
Nancy
Sun City Center
My husband has Rosacea but, it is (so far) limited to the nose. His doctor prescribed some of the aforementioned medications and none of them worked. Quite by accident, I told him to try the Vitamin E cream that I use on my face. Overnight, it cleared his flare up. Every time he gets a flare now, he just uses the cream and it does the trick. It’s 25,00 iu’s. I don’t know if that makes a difference…
I hope this can help others!
Nancy
That was supposed to be 25,000 iu’s. So sorry.
Sophia
Mismi
rosacea
Kat
Florida
My rosacea presented in large, hard pimple-like blemishes that never came to a head. I would even get these on my head because I didn’t understand that sun was a trigger for me and I have fine, thin hair ( we have lived in Las Vegas, Hawaii, and now Florida). I had this for years and saw many doctors/dermatologists with no success.. When I was finally correctly diagnosed I started on Metrogel, which helped with the small red patches I also sometimes got, but not the bumps. Next we tried Finacea (topical cream) which was a godsend. That got rid of the bumps, but I also have to be careful with my daily skin regimen. Sun and heat are my two biggest triggers, but because I live in Florida, it’s hard to completely keep away from them. I use a good facial sunscreen, plus my make-up has sunscreen in it. If I am going to be outside for an extended length of time I wear a wide-brimmed hat. I have never had any problem with the topical creams I use, but I understand we are not all alike. Most tourists have a better tan than I do (I am very fair). I’m 66.
lise
United States
Often rosacea is caused by h.pylori. That happened to me.
Smitty
How did you treat your h.pylori?
Becky Farnham
Pilot, VA
Long story short, I think Zyflamend by New Chapter has cured my Rosacea. Used metro gel for years. Started taking Zyflamend, stopped metro gel. No more rosacea! It has been many years.
MdV
Va
re. rosacea: milk of magnesia was effective in getting rid of rosacea for me (in 2/3 days after application I could see an impact). I tried metrogel, it was largely ineffective.
DianeRene
CO.
Hi – I was unable to read how you would apply Milk of Magnesia to your rosacea and I would like to try this. Would you send me an e-mail and tell me what to do? Thank you in advance. I have tried so many different things and most dry my already dry skin out more. Look forward to hearing from you.
Jan Shelden
Roanoke, VA
Please do Not use Metrogel without reading side effects. I took that stuff for a year, causing Terrible cold sores that lasted 3 weeks and another would start. I’m on L-Lysine that does keep them away but a hospital stay with none, caused such a big one on my lower lip, it left a scar. I am on Metronidazole 2 x a day. My dad’s left cheek had cancer from Rosacea but mine is not bad (I’m 78). Good luck!
Sherry Reiver
28173
There are side effects to topicals and I am very concerned that people won’t realize this or will not connect the dots that the ointment they are using for their rosacea will create other health issues. Please read the inserts carefully and know that the 1% the inserts speak of is indeed much higher than reported.
Christina
Danmark
Hi, i just Bought the cream and I’m scared to use it cause of the side effects. It doesn’t say in the note inside. I’m trying to find it but I can’t . Do you know the side effects?
I’m from Denmark and I rather have Rosacea the cancer. I’m 42
Thanks
lm
Yay for us with rosacea. Sadly, the sulfa based medication I use to use is now hard to come by. It worked really well. We have been using ivermectin for years in veterinary medicine. It’s dirt cheap. Cheap. Once again, thank you drug companies.