Rosacea is chronic inflammatory disease of the skin affecting mostly the face of both men and women most commonly beginning around age 30. Rosacea is characterized by facial redness, flushing, papules and pustules and thickening of this skin. Rosacea can also involve the eyes leading to loss of vision.  Ocular Rosacea individuals need close monitoring by a physician to prevent loss of vision. Research has shown high concentrations of the Demodex mite in Rosacea sufferers which is associated with the inflammatory response characteristic of Rosacea.  Although Rosacea is more common in women, men are more severely affected. 

Although rosacea may look like acne there is a major distinction and there is essentially no association between acne as a teenager and developing rosacea as an adult. Acne is associated with plugging of the ducts of the oil glands resulting in comedones, blackheads and whiteheads.  Rosacea most commonly occurs in adults between ages 30-50 and although the papules and pustules may mimic acne, the main distinguishing difference of the lesions is that in rosacea there are no comedones, whiteheads and blackheads.  Rosacea is an inflammatory condition characterized by mid-facial flushing which is not seen in acne.  Also there is potential eyelid and eye involvement in rosacea which is never seen in acne. 

Soolantra® (Ivermectin) cream, 1% is a white to pale yellow hydrophilic cream.   Each gram of  Soolantra® cream contains 10mg of ivermectin.  It is for TOPICAL use only. Ivermectin is an anti-mite drug related to the macrolide antibiotics, and it belongs to a class of drugs known as antihelmintics . Ivermectin works by killing parasites by increasing cell permeability to chloride ions.  Ivermectin kills the Demodex mite on the skin of Rosacea sufferers.  The metabolic activity of the Demodex mite is associated with the inflammatory response seen in Rosacea.  Ivermectin is also used to treat Scabies and lice. Ivermectin is safe and effective and Soolantra® cream is for topical use only (not to be used in eyes or intravaginally).

While the mechanism of action of Soolantra® cream is unknown, Ivermectin, the active ingredient, has anti-inflammatory and antiparasitic activity.  Ivermectin reduces or eliminates the Demodex folliculorum mite which is found in high concentrations on affected skin areas.  Killing the Demodex mite reduces the clinical signs and symptoms of rosacea which are primarily due to allergic and vasomotor inflammatory response of the body to the Demodex mite in susceptible individuals. 

Soolantra® cream is indicated for the treatment of inflammatory lesions of Rosacea. If you are 18 years or older, not pregnant or breast feeding, and have been diagnosed by a physician with Rosacea, you are eligible for an online Soolantra® cream physician consultation.

There are no histological or blood tests to diagnose rosacea.  A physician must diagnose you with rosacea by physical exam and medical history one or more of the following signs and symptoms: facial redness, flushing, blushing, bumps, pustules, papules, swelling, burning, itching or stinging.

Soolantra® cream is to be applied to the affected areas ONCE DAILY at bedtime.  Use a pea-size amount for each area of the face (forehead, chin, nose, each cheek).  Spread the cream as a thin layer avoiding eyes and lips.

Soolantra® cream (Ivermectin) is a very safe drug and has minimal side effects. The only side effects reported from topical  Soolantra® cream were skin burning sensation and skin irritation in less than 1%.  Ivermectin, the active ingredient in Soolantra® cream, has no major Central Nervous System (CNS) side effects as Ivermectin does not cross the blood-brain barrier in humans.  Headache, dizziness, muscle pain, nausea or diarrhea may rarely occur.   To reduce dizziness upon standing, get up slowly when rising from a sitting or lying position.  Allergic reactions are very rare.   However if you notice any symptoms of a serious allergic reaction such as rash, itching/swelling, trouble breathing seek immediate medical attention.

Ivermectin, the active ingredient in Soolantra® cream, is a FDA Pregnancy Category C drug and should NOT be used by pregnant women or women who are breast feeding.  Ivermectin is distributed into breast milk.   Do NOT use Soolantra® cream Ivermectin if pregnant or breast feeding.

Do not use Soolantra® cream if you have a sensitivity to Ivermectin, the active ingredient, or you are sensitive to any of the inactive ingredients: carbomer copolymer type B, cetyl alcohol, citric acid monohydrate, dimethicone, edetate, disodium, glycerin, isopropyl palmitate, methylparaben, oleyl alcohol, phenoxyethanol, polyoxyl20 cetostearyl ether, propylene glycol, propylparaben, purified water, sodium hyroxide, sorbitan monostearate, and stearyl alcohol.   Be cautious if you have bronchial asthma, worsening of bronchial asthma has occasionally been reported with oral ivermectin.  If you have Ocular Rosacea you need to be followed closely and monitored by your physician because Ocular Rosacea can lead to loss of vision.

A rosacea facial care routine recommended by many dermatologists starts with a gentle and refreshing cleansing of the face each morning. Sufferers should use a mild soap or cleanser that is not grainy or abrasive, and spread it with their fingertips. A soft pad or washcloth can also be used, but avoid rough washcloths, loofahs, brushes or sponges.

Next, rinse the face with lukewarm water several times and blot it dry with a thick cotton towel. Never pull, tug, scratch or treat the face harshly. Sufferers should let their face air dry for several minutes before applying a topical medication. Let the medication soak in for an additional five or 10 minutes before using any makeup or other skin care products.

The skin of many rosacea sufferers may be sensitive and easily irritated. Patients should avoid using any products that burn, sting or irritate their skin. In a National Rosacea Society survey, many individuals with rosacea identified alcohol, witch hazel, fragrance, menthol, peppermint, eucalyptus oil, clove oil and salicylic acid as ingredients that irritated their individual cases, and many also avoided astringents and exfoliating agents. A useful rule of thumb may be to select products that contain no irritating or unnecessary ingredients.

Sunscreens or sunblocks effective against the full spectrum of ultraviolet A and B radiation can be especially important for rosacea patients, whose facial skin may be particularly susceptible to sun damage and consequent rosacea flare-ups. An SPF of 15 or higher is recommended, and physical blocks utilizing zinc or titanium dioxide may be effective if chemical sunscreens cause irritation.

According to a National Rosacea Society survey, some of the most common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, heavy exercise, hot baths, heated beverages and certain skin-care products and see if your acne improves.

Soolantra® cream (ivermectin) 1% is for use on the face only. 
Do not use Soolantra® cream in your eyes, mouth or vagina.

1. Open the tube of Soolantra® cream by gently pressing down on the child resistant cap and twist in the direction of the arrow (counterclockwise) as shown below. See Figures A and B. To avoid spilling, do not squeeze the tube while opening or closing.

Figure A             Figure B

2. To apply Soolantra® cream to your face, squeeze a pea-sized amount of Soolantra® cream from the tube onto your fingertip. See Figure C.

Figure C

3. Apply Soolantra ® cream to the affected areas of your face once a day. Use a pea-sized amount of Soolantra® cream for each area of your face (forehead, chin, nose, each cheek) that is affected. Spread the cream smoothly and evenly in a thin layer. Avoid contact with your eyes and lips.

4. To close Soolantra® cream, gently press down on the child resistant cap and twist to the right (clockwise). See Figure D.

Figure D

Store Soolantra® cream at room temperature between 68°F to 77°F (20°C to 25°C).

Keep Soolantra® cream out of the reach of children