Topical ivermectin is indicated for treating inflammatory lesions of rosacea and head lice infestations. It is also sometimes used off-label for other inflammatory skin conditions, such as perioral de... View MoreTopical ivermectin is indicated for treating inflammatory lesions of rosacea and head lice infestations. It is also sometimes used off-label for other inflammatory skin conditions, such as perioral dermatitis and scabies.
Rosacea
Indication: Topical ivermectin 1% cream, sold under brand names like Soolantra, is FDA-approved for treating inflammatory lesions (pimples and bumps) associated with papulopustular rosacea.
Mechanism: Ivermectin cream is thought to work through its anti-inflammatory effects and by reducing Demodex mites on the skin. A high number of these mites may contribute to the inflammation seen in rosacea.
Head lice
Indication: Topical ivermectin 0.5% lotion, sold under brand names like Sklice, is indicated for treating head lice in patients six months and older.
Mechanism: Ivermectin paralyzes and kills lice by binding to their nerve and muscle cells. A single 10-minute application is typically sufficient and does not require nit combing.
Off-label uses
Scabies: While not an FDA-approved indication for topical application, clinical studies have shown topical ivermectin to be effective for uncomplicated scabies, with comparable efficacy to permethrin cream. It may be used to treat refractory cases that do not respond to other topical treatments.
Other inflammatory dermatoses: Some small case studies suggest topical ivermectin may be beneficial for other skin conditions like perioral dermatitis, seborrheic dermatitis, and acne vulgaris. An emerging application is Spike protein associated skin condition arising after SARS-CoV-2 illness and or COVID-19 vaccination.
