Ivermectin Newbury: Uses, Dosage & Side Effects
A topical antiparasitic and anti-inflammatory cream (ivermectin 10 mg/g) used to treat the inflammatory papules and pustules of rosacea in adults
Ivermectin Newbury is a prescription topical cream containing ivermectin at a concentration of 10 mg/g (1%). It is specifically indicated for the treatment of inflammatory lesions of papulopustular rosacea in adults. Ivermectin exerts dual anti-inflammatory and antiparasitic effects on the skin, reducing the redness, papules, and pustules that characterize this chronic facial condition. The cream is applied once daily to the affected areas of the face and has been shown in large randomized controlled trials to be significantly more effective than vehicle (placebo) and at least as effective as metronidazole cream, with a favorable safety profile over extended treatment periods. Ivermectin Newbury is manufactured as a generic equivalent to the branded product Soolantra.
Quick Facts: Ivermectin Newbury
Key Takeaways
- Ivermectin Newbury (ivermectin 10 mg/g cream) is a once-daily topical treatment for the inflammatory papules and pustules of rosacea in adults, working through both anti-inflammatory and antiparasitic mechanisms.
- Clinical trials demonstrate significant reduction in inflammatory lesions within 12 weeks, with superiority over vehicle and non-inferiority to metronidazole 0.75% cream, plus continued improvement with long-term use up to 52 weeks.
- The cream has an excellent safety profile—the most common side effect is a mild burning sensation at the application site, occurring in only 1–2% of patients, with overall adverse event rates similar to placebo.
- Ivermectin targets Demodex folliculorum mites, which are found in significantly elevated numbers in rosacea-affected skin and are believed to contribute to the inflammatory process through innate immune activation.
- The cream is applied in a pea-sized amount to each of five facial areas (forehead, chin, nose, each cheek) once daily, with noticeable improvement typically seen from 4 weeks and optimal results after 3–4 months of consistent use.
What Is Ivermectin Newbury and What Is It Used For?
Ivermectin Newbury contains the active substance ivermectin, a macrocyclic lactone compound originally derived from the soil bacterium Streptomyces avermitilis. While oral ivermectin has been used for decades as a systemic antiparasitic agent to treat conditions such as river blindness (onchocerciasis) and strongyloidiasis, the topical formulation at 10 mg/g (1%) concentration has been specifically developed and approved for the treatment of inflammatory lesions of papulopustular rosacea. This represents a targeted repurposing of the molecule to exploit both its anti-inflammatory and antiparasitic properties at the skin surface.
Rosacea is a common chronic inflammatory skin condition affecting approximately 5–10% of the global population, with the highest prevalence in individuals of Northern European descent and fair-skinned populations. It predominantly affects adults between the ages of 30 and 60, and women are affected more frequently than men, although men tend to develop more severe disease. The condition primarily manifests on the central face—the cheeks, nose, chin, and forehead—and is characterized by persistent or recurrent episodes of facial redness (erythema), visible blood vessels (telangiectasia), and inflammatory papules and pustules that can be mistaken for acne.
Papulopustular rosacea (subtype II) is the specific form of the disease for which ivermectin cream is indicated. In this subtype, patients develop dome-shaped, red papules and pus-filled pustules superimposed on a background of facial redness. Unlike acne vulgaris, rosacea does not typically produce comedones (blackheads or whiteheads), and the distribution is characteristically centrofacial. The inflammatory lesions of rosacea can cause significant physical discomfort—including burning, stinging, and skin sensitivity—as well as substantial psychological distress and reduced quality of life.
How Ivermectin Works in Rosacea
The mechanism of action of topical ivermectin in rosacea involves two complementary pathways. First, ivermectin exerts potent anti-inflammatory effects by inhibiting the production of pro-inflammatory cytokines. Specifically, it suppresses lipopolysaccharide (LPS)-induced inflammatory pathways, reducing the production of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and other mediators that drive the inflammatory cascade in rosacea-affected skin. This direct anti-inflammatory action helps reduce the redness, swelling, and tenderness of inflammatory papules and pustules.
Second, ivermectin has antiparasitic activity against Demodex folliculorum and Demodex brevis, microscopic mites that naturally inhabit human hair follicles and sebaceous glands. In healthy individuals, Demodex mites are present in relatively low numbers and cause no symptoms. However, research has consistently demonstrated that patients with papulopustular rosacea harbor significantly higher densities of Demodex mites—often 5 to 10 times the normal population. This overpopulation is believed to trigger and sustain the inflammatory process through several mechanisms: the mites physically damage the follicular epithelium, their excretory products provoke innate immune responses, and bacterial endosymbionts (Bacillus oleronius) carried within the mites release antigens that activate Toll-like receptor 2 (TLR2) signaling pathways in the skin.
By killing Demodex mites, ivermectin reduces this parasitic burden and its associated inflammatory stimulus. The combined anti-inflammatory and acaricidal effects provide a dual therapeutic approach that addresses two of the key pathogenic factors in papulopustular rosacea. This unique mechanism of action differentiates ivermectin from other topical rosacea treatments such as metronidazole (which is primarily antibacterial and anti-inflammatory) and azelaic acid (which is anti-inflammatory and antikeratinizing).
Clinical Evidence
The efficacy of topical ivermectin 1% cream was established in two pivotal phase III randomized, double-blind, vehicle-controlled clinical trials (PIVOTAL 1 and PIVOTAL 2) involving a total of 1,371 patients with moderate to severe papulopustular rosacea. In both studies, ivermectin cream applied once daily for 12 weeks was significantly superior to vehicle cream in reducing inflammatory lesion counts and in achieving treatment success as measured by the Investigator’s Global Assessment (IGA) score of 0 (clear) or 1 (almost clear). At week 12, approximately 38–40% of patients treated with ivermectin achieved IGA success compared with 11–19% in the vehicle group.
A subsequent head-to-head comparative trial demonstrated that ivermectin 1% cream applied once daily was superior to metronidazole 0.75% cream applied twice daily in reducing inflammatory lesion counts over a 16-week treatment period, with the difference becoming statistically significant from week 3 onward. Extended treatment studies have shown that the therapeutic benefits of ivermectin cream are maintained over 52 weeks of continuous use, with a low relapse rate after treatment discontinuation.
Rosacea is a chronic condition that requires ongoing management. While ivermectin cream effectively reduces inflammatory lesions, it does not cure rosacea. Many patients benefit from long-term maintenance therapy. Your dermatologist will create an individualized treatment plan that may include ivermectin cream alone or in combination with other therapies, along with guidance on identifying and avoiding personal triggers such as sun exposure, extreme temperatures, spicy foods, alcohol, and stress.
What Should You Know Before Using Ivermectin Newbury?
Contraindications
Ivermectin Newbury cream must not be used if you have a known allergy (hypersensitivity) to ivermectin or to any of the other ingredients in the formulation. The inactive ingredients include cetyl alcohol, stearyl alcohol, citric acid monohydrate, dimethicone, disodium edetate, glycerol, isopropyl palmitate, carbomer, macrogol cetostearyl ether, methyl parahydroxybenzoate (E218), propyl parahydroxybenzoate (E216), oleyl alcohol, phenoxyethanol, polysorbate, propylene glycol, purified water, sodium hydroxide, and sorbitan stearate. If you have previously experienced an allergic reaction to any topical product containing parabens, cetyl alcohol, or stearyl alcohol, inform your dermatologist before starting Ivermectin Newbury.
The cream is formulated exclusively for external topical application to the facial skin. It must not be ingested, applied to the eyes, lips, mouth, nostrils, or any mucous membranes. It should not be applied to broken, abraded, or otherwise compromised skin. If accidental eye contact occurs, rinse the affected eye immediately and thoroughly with water.
Warnings and Precautions
Before starting Ivermectin Newbury, discuss the following with your doctor or pharmacist:
- Hepatic impairment: Ivermectin is metabolized in the liver, primarily through the cytochrome P450 3A4 (CYP3A4) enzyme pathway. Although systemic absorption from topical application is minimal, patients with severe liver disease should be monitored, as impaired hepatic metabolism could theoretically lead to increased plasma levels of ivermectin.
- Previous allergic reactions: If you have experienced allergic reactions to other avermectin-class compounds (such as abamectin, doramectin, or selamectin, commonly used in veterinary medicine), inform your doctor. Cross-reactivity between avermectins is possible.
- Skin irritation: If you experience significant skin irritation, burning, or worsening of rosacea symptoms during treatment, discontinue use temporarily and consult your healthcare provider. A temporary initial worsening of rosacea symptoms may occasionally occur as Demodex mites are killed and their contents are released into the skin, triggering a transient inflammatory response.
- Exacerbation of rosacea: In rare cases, ivermectin cream may initially worsen rosacea symptoms before improvement occurs. This phenomenon is thought to be related to the release of inflammatory material from dying Demodex mites and typically resolves within the first few weeks of treatment.
- Other skin conditions: Ivermectin Newbury is specifically approved for papulopustular rosacea and should not be used for other skin conditions such as acne vulgaris, dermatitis, or eczema unless specifically directed by your dermatologist.
Pregnancy and Breastfeeding
As a precautionary measure, Ivermectin Newbury is not recommended during pregnancy. There are no adequate, well-controlled studies of topical ivermectin use in pregnant women. Animal reproductive toxicity studies with oral ivermectin (at doses producing systemic exposure far exceeding topical application) have shown teratogenic effects in some species at high doses. However, the systemic exposure from topical application at the recommended dose is very low. If you discover you are pregnant while using Ivermectin Newbury, discontinue treatment and consult your doctor.
Ivermectin is excreted in human breast milk at low concentrations following oral administration. While the amount transferred via breast milk after topical facial application is expected to be negligible, a risk to the nursing infant cannot be entirely excluded. Your doctor will assess whether to discontinue breastfeeding or to discontinue Ivermectin Newbury therapy, taking into account the benefit of breastfeeding for the child and the benefit of therapy for the mother.
Driving and Operating Machinery
Ivermectin Newbury cream has no or negligible influence on the ability to drive and use machines. As a topical preparation with minimal systemic absorption, it does not cause drowsiness, dizziness, or any cognitive effects that would impair your ability to safely drive or operate machinery.
Apply Ivermectin Newbury only to the affected areas of the face. Avoid contact with the eyes, lips, inside of the nose, and mouth. If the cream accidentally gets into the eyes, wash immediately with plenty of water. Do not cover the treated area with bandages or occlusive dressings. Wash your hands thoroughly after applying the cream.
How Does Ivermectin Newbury Interact with Other Drugs?
Topical ivermectin 10 mg/g cream has very low systemic bioavailability. Following once-daily application to the entire face, steady-state plasma concentrations of ivermectin are reached after approximately 2 weeks, with a mean maximum concentration (Cmax) of approximately 2.1 ± 1.0 ng/mL. These plasma levels are substantially lower than those achieved with oral ivermectin dosing (typically 30–50 ng/mL) and are well below the threshold for systemic pharmacological activity. Because of this minimal systemic exposure, the potential for clinically significant drug-drug interactions is very low.
No formal clinical drug interaction studies have been conducted specifically with topical ivermectin 1% cream. However, based on the pharmacokinetic profile and known metabolism of ivermectin, the following theoretical interactions and practical precautions merit consideration:
| Interacting Drug/Class | Type | Clinical Significance | Recommendation |
|---|---|---|---|
| Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir) | Pharmacokinetic | May theoretically increase ivermectin plasma levels by inhibiting hepatic metabolism, although clinical significance is unlikely given low systemic absorption | No dose adjustment needed. Monitor for increased skin irritation if using potent CYP3A4 inhibitors concurrently. |
| Topical corticosteroids applied to the face | Pharmacodynamic | May mask rosacea symptoms temporarily but can worsen rosacea upon withdrawal (steroid-induced rosacea). Does not directly interact with ivermectin. | Avoid concurrent topical corticosteroid use on the face. Taper off steroids before starting ivermectin if applicable. |
| Other topical rosacea treatments (metronidazole, azelaic acid, brimonidine) | Physical/Pharmacokinetic | Applying multiple topical products simultaneously may alter absorption or cause increased irritation | If combination therapy is prescribed, apply products at different times of day (e.g., ivermectin in the morning, another product at night). Consult your dermatologist. |
| Oral doxycycline (anti-inflammatory dose, 40 mg) | No interaction | No known interaction. These are often used together in clinical practice for moderate-to-severe rosacea. | Safe to combine. Commonly prescribed together for rosacea management during flare-ups. |
| Warfarin and other anticoagulants | Theoretical | Oral ivermectin has been reported to enhance anticoagulant effects in rare cases, but topical use is unlikely to cause this interaction given minimal systemic absorption | No special precautions needed with topical use. Inform your doctor of all medications you take. |
Practical Considerations for Combination Therapy
In clinical practice, many patients with rosacea use multiple products as part of their skincare and treatment routine. When using Ivermectin Newbury alongside other facial products, it is generally recommended to apply the ivermectin cream first, allow it to be absorbed for several minutes, and then apply other products such as moisturizers or sunscreen on top. If you are prescribed another topical medication for rosacea (such as brimonidine gel for persistent redness), your dermatologist will advise on the optimal timing and order of application to maximize the effectiveness of both treatments.
Sunscreen use is strongly encouraged for all rosacea patients, regardless of treatment. Topical ivermectin does not interact with sunscreen products, and daily sun protection is an essential component of rosacea management. Apply a broad-spectrum sunscreen with SPF 30 or higher after your ivermectin cream has been absorbed, typically 5–10 minutes after application.
What Is the Correct Dosage of Ivermectin Newbury?
Adults
Standard Adult Dosage
Apply once daily to the affected areas of the face. Use a pea-sized amount (approximately 0.5 g per application) for each of the five facial zones: forehead, chin, nose, right cheek, and left cheek. The maximum recommended total daily dose is approximately 1 gram of cream (containing 10 mg of ivermectin). Spread the cream as a thin, uniform layer over the entire affected area.
Ivermectin Newbury should be applied once daily, ideally at the same time each day, to help establish a consistent treatment routine. The cream can be applied in the morning or evening, depending on your preference and skincare routine. Many patients prefer morning application so they can apply moisturizer and sunscreen on top. The duration of treatment depends on clinical response, but the standard recommendation is up to 4 months (16 weeks) for the initial treatment course. Your dermatologist will assess your response and decide whether to continue, modify, or discontinue treatment.
Step-by-step application instructions:
- Cleanse your face gently with a mild, non-irritating cleanser and pat dry with a soft towel. Avoid harsh scrubs or exfoliants that may aggravate rosacea.
- Squeeze a pea-sized amount of Ivermectin Newbury cream onto your fingertip for each area of the face.
- Apply a small dot to the forehead, chin, nose, right cheek, and left cheek.
- Gently spread the cream as a thin, even layer across each area, avoiding the eyes, eyelids, lips, inside of the nose, and mouth.
- Wash your hands thoroughly after application.
- Wait several minutes for the cream to absorb before applying moisturizer, sunscreen, or makeup.
Children and Adolescents
Pediatric Use
Ivermectin Newbury is not recommended for use in children and adolescents below 18 years of age. The safety and efficacy of topical ivermectin 10 mg/g cream have not been established in the pediatric population. Rosacea is rare in children, and any suspected rosacea-like condition in a child should be evaluated by a pediatric dermatologist.
Elderly Patients
Elderly Dosage
No dose adjustment is necessary for elderly patients. Clinical trials included patients up to 86 years of age, and no significant differences in safety or efficacy were observed between older and younger patients. The standard once-daily application to the face applies equally to all adult age groups.
Patients with Hepatic or Renal Impairment
No specific studies have been conducted with topical ivermectin in patients with hepatic or renal impairment. Given the minimal systemic absorption (steady-state plasma levels of approximately 2 ng/mL with standard dosing), significant accumulation is unlikely. However, patients with severe liver disease should inform their doctor, as ivermectin is primarily metabolized by hepatic CYP3A4 enzymes. No dose adjustment is anticipated for renal impairment.
Missed Dose
If you forget to apply Ivermectin Newbury at your usual time, apply it as soon as you remember, provided it is still the same day. If you miss an entire day, simply resume your normal once-daily application the next day. Do not apply a double amount to make up for a missed dose. Missing an occasional dose will not significantly affect your overall treatment outcome, but consistent daily application is important for optimal results.
Overdose
Topical overdose with Ivermectin Newbury cream is unlikely to cause significant toxicity due to the very low systemic absorption from cutaneous application. If an excessive amount is applied to the skin, the affected area should be washed with water. In the unlikely event of accidental ingestion, symptomatic and supportive care should be provided. Contact a poison control center or seek emergency medical attention if a large quantity is accidentally swallowed, particularly by a child. No specific antidote for ivermectin exists; treatment of oral overdose is supportive, focusing on gastrointestinal decontamination and symptomatic management.
Consistency is key with Ivermectin Newbury. Apply the cream every day at approximately the same time. Most patients notice initial improvement within 4 weeks, but the full therapeutic benefit may not be apparent until 8–12 weeks of treatment. Do not discontinue treatment prematurely if you do not see immediate results. Use gentle, fragrance-free skincare products alongside your treatment to minimize irritation.
What Are the Side Effects of Ivermectin Newbury?
Like all medicines, Ivermectin Newbury cream can cause side effects, although not everybody gets them. In the pivotal clinical trials, topical ivermectin 1% cream demonstrated an excellent safety profile. The overall incidence of treatment-related adverse events was low, and the rates of adverse events in the ivermectin group were comparable to those in the vehicle (placebo) group. Most side effects, when they occur, are localized to the application site and are mild and transient in nature.
The following side effects have been reported in clinical trials and post-marketing surveillance:
Common
May affect up to 1 in 10 people
- Burning sensation at the application site
- Skin irritation
- Pruritus (itching) of the skin
- Dry skin (xerosis) at the application site
Uncommon
May affect up to 1 in 100 people
- Contact dermatitis
- Worsening of rosacea (transient)
- Skin discomfort
- Erythema (redness) at the application site
- Papular rash (initial flare)
Rare
May affect up to 1 in 1,000 people
- Allergic skin reactions (urticaria, angioedema)
- Swelling of the face (not related to rosacea)
- Peripheral edema
Frequency Not Known
Cannot be estimated from available data
- Elevated liver enzymes (transaminases)
Understanding Initial Worsening
Some patients may experience a transient worsening of rosacea symptoms during the first few weeks of treatment with Ivermectin Newbury. This phenomenon is thought to be related to the die-off of Demodex mites in the skin. As the mites are killed by ivermectin, their decomposing bodies and the release of their internal contents (including bacterial endosymbionts) can trigger a temporary inflammatory reaction. This initial flare typically manifests as a temporary increase in papules, pustules, or redness and usually subsides within 2–4 weeks as the Demodex population decreases and the inflammatory stimulus is removed.
If the initial worsening is mild to moderate, treatment can usually be continued. However, if symptoms are severe or particularly distressing, your doctor may recommend temporarily interrupting treatment or applying the cream less frequently (e.g., every other day) until the reaction subsides, before resuming daily application.
Long-Term Safety
Extended studies evaluating the safety of topical ivermectin 1% cream over 52 weeks (one year) have confirmed its long-term tolerability. No new safety signals emerged with prolonged use, and the incidence of adverse events did not increase over time. Ivermectin does not thin the skin (unlike topical corticosteroids), does not cause perioral dermatitis, and does not lead to antibiotic resistance (unlike topical antibiotics). These characteristics make it well suited for the long-term management of a chronic condition such as rosacea.
Contact your doctor immediately if you experience signs of a serious allergic reaction including severe swelling of the face, lips, tongue, or throat; difficulty breathing or swallowing; hives or widespread skin rash; or severe dizziness. While such reactions are extremely rare with topical ivermectin, they require immediate medical evaluation. Also consult your doctor if skin irritation becomes severe or if your rosacea significantly worsens during treatment.
How Should You Store Ivermectin Newbury?
Proper storage of your medication ensures that it remains effective and safe throughout the treatment period. Ivermectin Newbury cream should be stored at room temperature, not exceeding 30°C (86°F). Store the tube in its original packaging to protect it from light. Do not refrigerate or freeze the cream, as extreme temperatures can alter the consistency and stability of the formulation.
Keep the tube tightly closed after each use to prevent the cream from drying out or becoming contaminated. Do not transfer the cream to another container. Store the medication out of the sight and reach of children. If a child accidentally ingests the cream, contact your doctor or poison control center immediately.
Do not use Ivermectin Newbury after the expiry date stated on the tube and outer carton. The expiry date refers to the last day of that month. Once opened, the cream should be used within the timeframe specified by the manufacturer—typically within 6 months of first opening, although this may vary by formulation. If the cream changes color, develops an unusual odor, or appears to have separated, do not use it and obtain a new supply.
Do not dispose of medications via wastewater or household waste. Ask your pharmacist about how to properly dispose of medicines you no longer use. Following proper disposal guidelines helps protect the environment.
What Does Ivermectin Newbury Contain?
The active substance in Ivermectin Newbury is ivermectin. Each gram of cream contains 10 mg of ivermectin (equivalent to a 1% w/w concentration). Ivermectin is a semi-synthetic derivative of avermectin B1, a macrocyclic lactone produced by the fermentation of Streptomyces avermitilis. It is a mixture of two homologues: ivermectin B1a (at least 80%) and ivermectin B1b (not more than 20%).
The other ingredients (excipients) that make up the cream base are:
- Cetyl alcohol – emollient and emulsion stabilizer
- Stearyl alcohol – emollient and consistency agent
- Citric acid monohydrate – pH adjuster
- Dimethicone – skin protectant and emollient
- Disodium edetate – chelating agent (preservative enhancer)
- Glycerol – humectant and moisturizer
- Isopropyl palmitate – emollient and skin penetration enhancer
- Carbomer – gelling agent
- Macrogol cetostearyl ether – emulsifier
- Methyl parahydroxybenzoate (E218) – preservative (may cause allergic reactions)
- Propyl parahydroxybenzoate (E216) – preservative (may cause allergic reactions)
- Oleyl alcohol – emollient
- Phenoxyethanol – preservative
- Polysorbate 80 – emulsifier
- Propylene glycol – solvent and humectant
- Purified water – vehicle
- Sodium hydroxide – pH adjuster
- Sorbitan stearate – emulsifier
Ivermectin Newbury cream is a white to pale yellow, smooth, homogeneous cream. It is available in tubes of 15 g, 30 g, and 45 g, although not all pack sizes may be marketed in every country. The cream has a faint characteristic odor.
Ivermectin Newbury contains methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216), which may cause allergic reactions (possibly delayed). It also contains cetyl alcohol and stearyl alcohol, which may cause local skin reactions (contact dermatitis). Propylene glycol may cause skin irritation in sensitive individuals. If you have known sensitivities to any of these excipients, discuss with your doctor before starting treatment.
Frequently Asked Questions About Ivermectin Newbury
Ivermectin Newbury and Soolantra contain the same active ingredient (ivermectin) at the same concentration (10 mg/g or 1%) and are both used to treat the inflammatory lesions of rosacea. Soolantra is the original branded product, while Ivermectin Newbury is a generic equivalent manufactured by a different company. Generic medicines must meet the same strict quality, safety, and efficacy standards as the original brand. The main differences may be in the inactive ingredients (excipients) used in the cream base, the packaging, and the price. Your pharmacist may substitute one for the other depending on availability and local prescribing policies.
The standard initial treatment course is up to 4 months (16 weeks) of once-daily application. Your dermatologist will assess your response and determine whether to continue treatment. Clinical studies have shown that ivermectin cream is safe and effective for use up to 52 weeks (one year). Since rosacea is a chronic condition, many patients benefit from long-term or intermittent maintenance therapy. Some dermatologists recommend using the cream continuously, while others suggest treatment cycles with breaks. Follow your doctor’s individual recommendation.
Yes, you can apply makeup after Ivermectin Newbury has been absorbed into the skin. Wait at least 5–10 minutes after applying the cream before applying moisturizer, sunscreen, or makeup. Choose non-comedogenic, fragrance-free cosmetics designed for sensitive skin. Mineral-based makeup products are often well tolerated by rosacea patients and can provide additional sun protection. Green-tinted primers or color-correcting products can help camouflage residual redness.
Ivermectin Newbury is primarily designed to treat the inflammatory bumps (papules and pustules) of rosacea rather than the persistent background redness (erythema) or visible blood vessels (telangiectasia). However, by reducing the inflammatory component, many patients do notice some improvement in overall facial redness as well. If persistent redness is a primary concern, your dermatologist may prescribe additional treatments such as topical brimonidine gel (which directly reduces redness) or recommend procedures such as laser or intense pulsed light (IPL) therapy for visible blood vessels.
No. Ivermectin Newbury is a topical cream containing 10 mg/g of ivermectin, applied to the skin of the face for the treatment of rosacea. It has very low systemic absorption. Oral ivermectin is a tablet or liquid formulation used at much higher doses for systemic parasitic infections such as river blindness and strongyloidiasis, and is also used in some countries for other parasitic conditions. The two formulations have different indications, dosing regimens, and safety profiles. Ivermectin Newbury should be used only as directed by your prescribing physician for rosacea.
An initial temporary worsening is not uncommon and is thought to result from the die-off of Demodex mites in the skin, which can cause a brief inflammatory flare. This typically resolves within 2–4 weeks. If the worsening is mild, it is usually safe to continue treatment. However, if symptoms are severe, widespread, or very uncomfortable, contact your dermatologist. They may recommend applying the cream every other day temporarily, or pausing treatment briefly before resuming. Do not discontinue treatment without consulting your doctor, as premature cessation means you may miss the therapeutic benefit that typically appears after 4–8 weeks.
References
- European Medicines Agency (EMA). Ivermectin 10 mg/g cream – Summary of Product Characteristics. Last updated 2025. Available at: www.ema.europa.eu
- U.S. Food and Drug Administration (FDA). Soolantra (ivermectin) cream, 1% – Prescribing Information. Reference ID: 4959473. Available at: www.accessdata.fda.gov
- Stein Gold L, Kircik L, Fowler J, et al. Efficacy and safety of ivermectin 1% cream in treatment of papulopustular rosacea: results of two randomized, double-blind, vehicle-controlled pivotal studies. J Drugs Dermatol. 2014;13(3):316–323.
- Taieb A, Ortonne JP, Ruzicka T, et al. Superiority of ivermectin 1% cream over metronidazole 0.75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial. Br J Dermatol. 2015;172(4):1103–1110.
- Schaller M, Gonser L, Röschl K, et al. Concomitant use of ivermectin 1% cream and doxycycline 40 mg modified-release capsules for the treatment of severe rosacea. J Dtsch Dermatol Ges. 2020;18(11):1288–1297.
- Two AM, Wu W, Gallo RL, Hata TR. Rosacea: Part I. Introduction, categorization, histology, pathogenesis, and risk factors. J Am Acad Dermatol. 2015;72(5):749–758.
- Forton FMN, De Maertelaer V. Two consecutive standardized skin surface biopsies: an improved sampling method to evaluate Demodex density as a diagnostic tool for rosacea and demodicosis. Acta Derm Venereol. 2017;97(2):242–248.
- van Zuuren EJ, Fedorowicz Z, Carter B, et al. Interventions for rosacea. Cochrane Database Syst Rev. 2015;(4):CD003262.
- British Association of Dermatologists (BAD). Guidelines for the management of rosacea. 2021. Available at: www.bad.org.uk
- National Rosacea Society Expert Committee. Standard management options for rosacea: updated recommendations. J Am Acad Dermatol. 2017;76(1):91–100.
Medical Editorial Team
All content on iMedic is written and reviewed by qualified medical professionals following the GRADE evidence framework and international clinical guidelines.
Dermatology Specialist
Board-certified dermatologist with expertise in inflammatory skin conditions, rosacea management, and topical pharmacotherapy. Member of the European Academy of Dermatology and Venereology (EADV).
Clinical Pharmacologist
Licensed pharmacologist specializing in dermatological therapeutics, drug safety, pharmacokinetics, and evidence-based prescribing. Experienced in regulatory medicine and drug information.
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