Soolantra Ivermectin 1% (Rx)
✓ Reviewed against AAD & NRS guidanceLast reviewed June 25, 2026RosaceaClub Editorial TeamHow we review →
Educational only - not a substitute for professional medical advice.
Strong evidence for inflammatory papules and pustules.
Why it's graded A
This product's key ingredient is supported by clinical-guideline-level evidence (AAD/NRS/Cochrane) for rosacea.
How to use it
- Slot: Prescription in your routine.
- Introduce one new product at a time; patch-test for a few days first.
- Pair actives with a ceramide moisturizer and mineral SPF.
What is Soolantra?
Soolantra is a prescription cream containing 1% ivermectin. It is FDA-approved for the inflammatory lesions of rosacea - the bumps and pus-filled spots of papulopustular (Type 2) rosacea - and it is applied just once a day, which makes it easy to stick with.
Who is it for?
Soolantra suits people whose rosacea shows up mainly as inflammatory bumps and pustules. It is a strong first or second prescription choice for papulopustular rosacea, especially if you want a once-daily option. Like other inflammatory-lesion treatments, it does not target background flushing or visible vessels.
How does it work?
The FDA label states the exact mechanism in rosacea is unknown. In practice, ivermectin is thought to work in two ways: it calms inflammation, and it reduces Demodex mites, which live in higher numbers in rosacea-affected skin and are believed to contribute to the inflammation.
How well does it work?
Soolantra has high-quality evidence. In a head-to-head trial, once-daily ivermectin 1% reduced inflammatory lesions more than twice-daily metronidazole 0.75% (about an 83% reduction versus 74%), and a Cochrane review found it slightly more effective than metronidazole overall. That combination of strong results and once-daily dosing is why it is a go-to topical.
How to use it, and how long it takes
Apply a pea-sized amount of Soolantra once a day, spread thinly across the affected areas of clean, dry skin. In trials it began to outperform the vehicle cream by around 4 weeks, with benefit continuing to build through 12 weeks - so give it a couple of months of consistent use. Pair it with a gentle moisturiser and daily sunscreen.
Side effects
Soolantra is generally well tolerated. The side effects reported on the FDA label are local and uncommon (each in 1% or fewer of users): a skin burning sensation and skin irritation. As with any rosacea active, introduce it gently and check with your prescriber if irritation is sharp or persistent.
Pros and cons
| Pros | Cons |
|---|---|
| High-quality evidence; beat metronidazole head-to-head | Prescription only |
| Once-daily dosing - easy to keep up | Does not treat flushing or visible vessels |
| Generally very well tolerated | Branded product can be costlier than older topicals |
| Targets both inflammation and Demodex mites | Improvement takes weeks, not days |
Alternatives
Other FDA-approved topicals for inflammatory rosacea include azelaic acid 15% (Finacea) and metronidazole. If redness and flushing are your main concern rather than bumps, prescription brimonidine or oxymetazoline target that instead. A clinician can match the option to your pattern. Brimonidine can cause rebound redness worse than baseline in some users, so discuss it with your clinician.
Frequently asked questions
What is Soolantra approved to treat?
Soolantra (ivermectin 1% cream) is FDA-approved for the inflammatory lesions of rosacea - the bumps and pustules of papulopustular (Type 2) rosacea. It is used on-label, once daily, and is not indicated for background redness or visible vessels.
How does Soolantra work?
The FDA label says the exact mechanism is unknown. It is thought to combine an anti-inflammatory effect with activity against Demodex mites, which are present in higher numbers in rosacea-affected skin and are believed to contribute to inflammation.
Is Soolantra better than metronidazole?
In a head-to-head trial, once-daily ivermectin 1% reduced inflammatory lesions more than twice-daily metronidazole 0.75% (about 83% versus 74%), and a Cochrane review rated it slightly more effective overall. Both are reasonable options; the choice depends on your skin and your clinician's judgment.
How long does Soolantra take to work?
It began to outperform the vehicle cream by around 4 weeks in trials, with benefit continuing through 12 weeks. Give it a couple of months of once-daily use before judging the result.
What are the side effects of Soolantra?
It is generally well tolerated. The FDA label lists a skin burning sensation and skin irritation, each reported in 1% or fewer of users. Introduce it gently and check with your prescriber if irritation is sharp or lasting.
Sources
- Reviewed against clinical guidelines · www.accessdata.fda.gov
- Reference source · dermnetnz.org
- Peer-reviewed source · pubmed.ncbi.nlm.nih.gov
- Peer-reviewed source · pubmed.ncbi.nlm.nih.gov
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