Soolantra is a topical prescription cream that is primary used as a treatment for rosacea. Rosacea is a skin disease that causes redness on the face, and depending of the type of rosacea, often with pustules.
Soolantra contains ivermectin as active ingredient and a Cetaphil Moisturizing Cream as basis for ivermectin.

Oral ivermectin is usually used for skin problems when mites such as demodex or scabies are involved, because is able to kill them. Other medicines are also able to kill these mites, but some people see(/hope) topical ivermectin as an effective treatment.
Scabies mites are clearly parasitic and thus unwanted, they usually cause skin lesions and itch. In some countries such as the Fiji islands, it is estimated that a high percentage of 25% of the population is infested with scabies.
But demodex is usually not parasitic, and estimates are that 60% to 100% of the population is infested. Older people are more likely to have demodex than younger people. Most of these people don’t have skin problems that can be directly related to demodex, although there is a growing number of studies that show correlations and even causative effects between demodex and rosacea. Demodex is also often involved in blepharitis (eye lids problems), and case report studies also suggest a possible relation in some pustular skin lesions.

According to the Soolantra website, the exact mechanism of action of Soolantra is unknown. Soolantra has the following activities:

  • Antiparasitic
    • Antivermicidal
    • Demodex:
    • No direct data (not possible to culture Demodex).
    • Few supporting publications.
    • Published clinical case series: Demodicidosis, blepharitis, skin diseases.
  • Anti-inflamatory
  • Decreases cellular and humoral immune responses.
  • Parent compound avermectin has been shown to significantly regulate TNF-α, IL-1β and IL-10 in lipopolysaccharide-induced inflammation in in vitro studies.

Although only a small number of oozing yellow crusts suffers have reported to be using Soolantra (users: Tso, RecoverE, Anymnoo, Firstman), these users do report significant improvements. Assuming that there is no coincidence/placebo effect, than Soolantra is probably the most effect known treatment for the oozing yellow crusting lesions. But note that most of these users also used oral metronidazole and/or oral ivermectin while using Soolantra (topical ivermectin).

Soolantra is also easy to use: it just looks a cream without any odor, that has to be applied once per day on the face. While non-prescriptive topical anti parasite treatments often have a bad odor, such as sulfur, neem oil and/or leaf a clear colored layer on the face, making it unpleasant to use these in the presence of other people.


  • one gram of cream contains 10 mg of ivermectin
  • glycerol, isopropyl palmitate, carbomer copolymer, dimeticone, disodium edetate, citric acid monohydrate, cetyl alcohol, stearyl alcohol, macrogol cetostearyl ether, sorbitan stearate, methyl parahydroxybenzoate (E218), propyl parahydroxybenzoate (E216), phenoxyethanol, propylene glycol, oleyl alcohol, sodium hydroxide, purified water.

Although the Soolantra website and leaflet talk about ivermectin as active substance, the ingredient lists shows that it also contains dimeticone. According to Wikipedia:

a silicone oil, which coats and smothers the lice causing their death either by suffocation or dehydration. Most dimethicone lotions do not kill nits because the nits have only one breathing orifice, the operculum, so the dimethicone has less access there.

Soolantra is currently being rolled out in the Western world, so it isn’t widely available yet. It is probably available in the US, United Kingdom, Germany and Belgium.
Some people use ivermectin from non-prescriptive animal/horse drugs topically, where is it available for a while.

One of the concerns that I have with Soolantra is that the positive effects that I and other users have from it, is not caused by it killing demodex mites, but by it acting as an anti-inflammatory suppressor. I have used topical corticosteroids (triamcinolon) for this skin problem before, and that also was effective (but not recommended, because of the rebound effect and it being unhealthy for the skin, including the eyes).

Do you think I should go for it as well without waiting for a skin biopsy to be done?
It’s been months that I wait for one lesion to appear at the right moment but most of the case it occurs late in the afternoon, or in the evening/night. So it unfortunately hasn’t been done yet.
Can I get it without prescripiton or may I have to fix that with my derm?
Do I have to do this treatment alone or mixed with oral metronidazole and/or oral ivermectin ?
Last question : How long do I have to go for the treatment ?
Thanks, seems we’re getting closer and closer of the solutiont!

Not sure if I fully understand you. So you are basically waiting for the moment that you get a new lesion in the morning, and then go to a dermatologist the same day for a skin biopsy?

About the question whether you should wait for a biopsy or start with Soolantra without biopsy: from a scientific point of view, a biopsy would be very interesting, not just for yourself, but also for us (the other oozers). Because even if demodex is involved (what we currently think), it is likely that bacteria also play a role (carried by demodex as a vector). Only a well performed biopsy followed by good pathology will be able to tell the exact cause and the possible microorganisms involved or whether demodex (or it’s bacteria) is causing some kind of allergic reaction.
TV show “The Dr’s” discuss women with chronic, untreated skin condition shows a woman with skin problems in which a biopsy showed what was going on.
But I’m not sure if there is a risk of scars with a biopsy, so it’s difficult to give advice on this part.

Soolantra is likely only available on prescription. If you want to get it, you could try the following:

  1. Confirm at your pharmacy whether they have Soolantra available, otherwise your derm won’t be able to prescribe it.
  2. Not all dermatologists belief/know about demodex being able to cause problems. (This point of view will probably change now that Galderma has released Soolantra for the treatment of rosacea, which is primarily targeting demodex.) Some dermatologists may not know yet about Soolantra. In that case, you may have to convince your derm by showing scientific research and the existance of Soolantra. You could try by handing some studies from Demodex studies to your derm, one of them should be [Demodex] Papulopustular rosacea, skin immunity and Demodex: pityriasis folliculorum as a missing link from the dermatologist from Brussels.

Taking oral metronidazole and/or ivermectin should in theory make the treatment more efficient. Although both may cause side effects when taken orally. (I haven’t used them, but the others on Soolantra have.)

I think you have to take it at least 1 to 3 months, but hard to say.

I have been suffering with these for about 9 years, im 27 now. It got really bad a couple of months ago where most of my face was covered. I went to derm and got given impitigo cream, they died down after 7-days but they always have tended to do that by themselves. Im now at a stage where im back to my baseline and getting 1 new one every day, closer to the mouth the worse they are because the skin is constantly being stretched.

I have decided to give Soolantra a go and combine it with metrinidzole, im unsure on how much is used over a period of 2months (more than 2 30g tubes?).

I will update with my findings every week to help other people out on here. It’s reassuring to know i’m not alone!

Welcome pcal1,
I use about one 30g tube per 2 months., unless I also apply it to the scalp. Usually I apply it after washing my face, while the face is still a bit damp. On a dry skin, I would probably use a bit more, because then it’s more difficult to spread over the face.

Few questions:

  1. Are you using oral or topical metronidazole?
  2. (If oral) How much mg per day?
  3. (if oral) For how many days will you take it?
  4. When did you start with Soolantra and metronidazole?
  5. What were the findings of your dermatologist? Did they perform a skin biopsy or swabs?
  6. Have you tried oral anti-biotics and other oral medication?
  7. The impetigo cream is fusidic acid? Or mupirocin (Bactroban)? I never had any results with fusidic acid.


oral metro im taking 2x 400mg daily for up to 6 weeks (i only plan 2 weeks but derm offered 6) I have literally just started my course this afternoon and im only really looking for results in end of jan /feb.

In the past ive used : antibiotics - oxytetracycline, lymacycline, fluaxicillin. Topicals - bactroban (that seems to stop them from weeping as much by sealing them up), Rosex, metrogel and isotrex.

The derm did my first swabs ever this month when it was really bad, they all came back negative for any growth.Then moved on to HSV test which also came back negative. Then i came to him with this research and he agreed it as the next option.

I would say that if you live in UK this Soolantra is expensive on a private prescription so id try to get your regular GP to give you an NHS prescription if possible. Ill be doing that if this works for me in the future.

[quote=“pcal1, post:7, topic:64”]
The derm did my first swabs ever this month when it was really bad, they all came back negative for any growth.Then moved on to HSV test which also came back negative.[/quote]
Was the first swab taken from an active lesions or from staph carrier sites (nose, throat, armpits or perineum)?

Active lesion, but then my partner took some from all those places (shes a microbiologist) and only the inside of my nose grew anything… which isn’t surprising since all people carry bacteria there and the growth was very minimal

So… I have been using Soolantra for 28 days and i haven’t had one of the spots since day 4. WOW. Normally i would be getting a new one appearing every day.

I did started the course of antibiotics but had to stop after 1 day because i had some side affects i wasn’t happy with, im glad i did because it seems the cream is enough to do the job on its own anyway!

At the moment im unsure whether its something i can continue using or if i should stop after 6 weeks or 2months. I feel like this is a continuing problem for me and if i stop using this cream they will come back but i guess there’s only one way to find out.

One other note is that when i had my initial really bad outbreak that spurred me to go to the derm i used a product called PROSACEA. I am CERTAIN this caused the massive outbreak of them so avoid it !!

Good to hear that it is working for you.
It’s difficult to say when you can stop with it and whether it will come back when only using Soolantra. There isn’t a single clear/reliable user report on this for our problem. Although based on my own experience, it doesn’t seem to come back immediately, but if it does, then probably slowly. (My results are unreliable because shortly after stopping with Soolantra, I got a bad throat infection and oral antibiotics (Amoxicillin/Clavulanic acid) to treat it. This antibiotic had a positive effect on my skin.)

Which side effect did you got from the antibiotic (oral metronidazole)?

Soolantra question. My primary prescribed it to me because I can’t get in to see my dermatologist for a few weeks. I wanted to know if you guys use it together with your usual moisturizer. For example, I usually use coconut oil as my only moisturizer, so I’m applying Soolantra, and then putting on the coconut oil. What are your methods?

You finally have Soolantra :slightly_smiling:

I didn’t use a moisturizer while using it, because it contains Cetaphil moisturizer as its base. I did use a moisturizer before it.
I stopped using Soolantra since December (so that the lesions would came back so that my derm can look at it), since then, I didn’t use a moisturizer at all. Currently my skin is very good since at least two weeks. No signs oozing lesions at all. Currently I’m only using a povidone-iodine soap as a face wash. It does dry out my face a bit, but since it’s very good at the moment, I’ll continue. (I attribute the good skin at the moment to: Soolantra followed by a oral antibiotic amoxicillin/clavulanic acid and povidone-iodine soap.)

Do you wash it off at night? I’m trying to figure out what to do until I can go to a dermatologist and find out the correct way to apply it.

When I woke up this morning after keeping it on my face overnight, it was all dried up and peeling off my face. I think maybe I’ll wash it off at night and apply coconut oil as moisturizer, then reapply Soolantra in the AM. Don’t know what is working for everyone else as far as application methods.

Did you take too much? Only take a pea size amount for each part of the face (forehead, nose,each side of face). And clean your face before applying the lotion. See more in the attached explanation sheet that comes with the cream.

Some doctors recommend to take it overnight as demodex are only active and come out when its dark. The worked very well for me.

Give it two weeks, that’s when I was realized that it’s working!

If you skin becomes dry the next day you can take some lotion the next morning.

My Soolantra usage patterns depend on whether I’m working at home. (I currently don’t use Soolantra.)
I don’t like using Soolantra when going outside, because I have an oily skin and Soolantra makes it more oily. So in that case, I apply it at night and was it off in the morning or use a dry clean towel and pad my face dry.

There was a period in which I did use Soolantra with a separate moisturizer, in this case I first applied Soolantra, then waited a couple of minutes, then applied the moisturizer.

As Anymnoo said, I also read about the recommendation about applying it at night, but I was also thinking that when applied at night, more Soolantra is absorbed by the pillow. (But don’t know if that is really the case.)
There was a period in which I applied it in the morning, and a period in which I used it before bedtime. I haven’t noticed a clear difference in these usage patterns.

I also used it as described in the explanation sheet.

Thanks. That gives me the insights I needed :relaxed:

I passed the 1 month mark of being outbreak free for the first time in 20+ years thanks to Soolantra. For the first two weeks, I put it on nightly. Then I went to putting it on every other night, letting it absorb, and then putting on extra virgin coconut oil as moisturizer and nothing else. I’m very pleased with the product. Over this past month, I did get an occasional red, inflamed patch but no oozing. Now I don’t get the red, inflamed patches even. From the amount I’ve used of the tube so far, I feel like I can get three months out of each tube using it every other night. But honestly, this stuff is a miracle cream. I tried fixing this yellow ooze problem the natural way, but that doesn’t work for everyone; it didn’t work for me. Soolantra worked for me. No side effects whatsoever except for feeling pretty awesome.

Really happy to read that!

Some questions:
Are you still using Soolantra? Any plans on stopping the treatment? To what extent is it solving the lesion problem, completely zero lesions or smaller and lower frequency?