The world of dermatology is constantly evolving, brimming with treatments and discoveries that revolutionize the way we approach skin conditions. One such drug that has piqued the interest of dermatologists is ivermectin.

While it’s known for treating parasitic infections in animals and humans,¹ its potential in dermatological applications is proving to be both intriguing and promising. But what exactly makes ivermectin stand out when it comes to skin applications? What is the science behind how it works? And how does it fare in tackling some common and persistent skin conditions?

Let’s dive deep into the science of ivermectin, and take a closer look at its origins, mechanisms, and its relevance for our skin!

What is ivermectin?

Ivermectin is a pretty fascinating drug. It’s primarily known as a broad-spectrum antiparasitic agent. The story of its discovery goes back to the late 1960s when Satoshi Ōmura and William Campbell stumbled upon a unique soil bacteria.² This bacteria produced something called avermectin, and ivermectin is essentially a synthetic derivative of this component.

While its initial use was mainly focused on conditions caused by parasites, like nematodes and the Onchocerca volvulus (a parasite that causes river blindness),³ its application didn’t stop there. Dermatologists saw potential in it for treating skin conditions. It’s now used to treat conditions like rosacea and scabies.⁴

Some conditions require taking it orally, while others better benefit from a topical application. It all depends on the situation and what medical experts advise.⁵

There’s been some buzz about its potential use against COVID-19. It’s been considered for both treatment and prevention. But, as always with medical treatments, more research is pivotal.⁶

How is ivermectin used in dermatology?

From its widely recognized efficacy in treating rosacea to its potential in managing hookworms and scabies, ivermectin offers many benefits in the dermatological realm.

Let’s examine how it works and what conditions it can help treat.

Rosacea

Rosacea is a chronic skin condition characterized by facial redness, visible blood vessels, and sometimes acne-like bumps. One of the ways you can treat rosacea is by applying a 1% ivermectin cream.⁷

This cream is used once daily as a part of a rosacea treatment routine and helps to alleviate the symptoms of rosacea in two main ways:

Targeting skin mites: It’s believed that skin mites (called Demodex folliculorum), which are naturally present on human skin, might play a role in the development or exacerbation of rosacea.⁸ Ivermectin acts against these mites. Specifically, ivermectin sticks to specific channels in these parasites, effectively paralyzing and eliminating them.⁹

Reducing inflammation: Ivermectin helps in alleviating rosacea symptoms by interrupting a process in the body that typically leads to inflammation or redness. As a result, it helps diminish the red and swollen spots associated with the condition.¹⁰

So 1% Ivermectin cream, when applied topically, not only targets potential culprits like skin mites but also directly addresses the inflammatory aspect of rosacea, providing relief from its symptoms.

Perioral dermatitis

Perioral dermatitis is when small inflammatory papules and redness appear on the face, mainly around the mouth area.¹¹ Since ivermectin helps control inflammation, it’s beneficial for the treatment of this condition. A research study revealed that topical ivermectin was well tolerated and beneficial for the treatment of perioral dermatitis.¹²

Hookworms (Cutaneous larva migrans)

Hookworms can cause a condition known as cutaneous larva migrans, which is characterized by creeping eruptions on the skin.¹³ Ivermectin can be used as a treatment as it effectively targets the hookworms, leading to their elimination. In one study where a hookworm patient had a red, winding, and itchy rash on the sole of his foot, he found significant improvement after receiving just one dose of ivermectin. The patient was essentially better in just 3 days.¹⁴

Scabies

Scabies is a highly contagious skin infestation caused by the mite Sarcoptes scabiei, leading to intense itching and a rash.¹⁵ Oral ivermectin has proven to be an effective treatment for scabies infection. However, while ivermectin has been safely used for other parasitic diseases, the U.S. Food and Drug Administration has not approved its use specifically for scabies.¹⁶ Also, the safety of oral ivermectin for pregnant and lactating women and young children remains unestablished.¹⁷

Demodex folliculorum

As mentioned earlier, Demodex folliculorum are mites that naturally reside on human skin.¹⁸ While they’re typically harmless, they can sometimes play a role in various skin issues. These mites have been linked to conditions such as acne, rosacea, blepharitis, and eyelid inflammation. Ivermectin can help clear your skin by targeting and eliminating these mites.¹⁹

Lice (pediculosis)

Lice, or pediculosis, is a condition where tiny insects known as lice infest the scalp, body, or pubic area.²⁰ These parasites can cause itching and discomfort alongside a little embarrassment. Ivermectin is a treatment option for lice. It can be administered either orally or topically in the form of a shampoo.²¹ Recent research has shown that a single application of ivermectin shampoo successfully eradicated head lice in 86.2% of participants. And for those with a persistent lice infestation? A second shampoo application proved 100% effective in eliminating the lice!²²

Though the results look promising, seek advice from a dermatology provider before using any medication to ensure it’s safe and suitable for your specific needs.

How ivermectin works

Now that you know what conditions ivermectin can help treat, you may be wondering, how does it work?

Tiny mites or parasites cause many skin issues like rosacea, scabies, or even lice. These little critters might be microscopic, but they can wreak havoc on our skin. That’s where ivermectin steps in. It goes after the nervous system of these parasites, leaving them paralyzed. It can help against skin inflammation as well, which is another reason it’s a great treatment for conditions like rosacea.²³

Whether you’re taking it orally or applying it topically depends on what skin condition you’re trying to treat, how severe it is, and, of course, which form of ivermectin you’re using. So, before you try it out, always consult a healthcare provider. They’ll steer you right and ensure you’re on the best path to clear, happy skin.

Is ivermectin safe to use?

Ivermectin has been around for over 25 years and has been shown to be generally safe, even when given in high doses.²⁴ Fun fact: when it’s used as a lotion for head lice, the amount entering your bloodstream is minimal.

Some animals have exhibited adverse reactions like vomiting or difficulty walking with very high doses.²⁵ However, those doses are way beyond what humans typically take. Plus, ivermectin doesn’t easily penetrate the brain, which is good news because it minimizes the risk of severe side effects.²⁶

A small percentage of people might experience some side effects like low blood pressure (with oral ivermectin) or minor irritation with topical ivermectin. However, these reactions are typically short-lived.²⁷ Be sure to consult your healthcare provider if you experience any adverse effects.

So, ivermectin is usually a safe bet. But, as always, get approval from a healthcare professional before jumping into any treatment. Safety first!

Ivermectin in a nutshell

Ivermectin is an anti-parasitic medication that’s very useful in the world of dermatology. Whether you’re dealing with rosacea or parasites causing skin issues, ivermectin can help. When you use ivermectin as a lotion for skin problems, very little of it goes into your bloodstream. This is great because it’s generally safe, and the chance of experiencing side effects is low.

Ivermectin is considered safe and useful in dermatology. But like all things health-related, it’s best to get a thumbs-up and prescription from your dermatologist before diving in.

Curology offers rosacea treatment

If you’re dealing with rosacea, it’s essential to have a solution that works effectively. Curology combines the expertise of licensed dermatology professionals with the convenience of personalized skincare, resulting in a unique formula designed just for your concerns.

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Get your personalized skincare routine with Curology

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Ready to start your journey to clearer skin? Explore our rosacea treatment that may contain ivermectin (if right for you) today!*

P.S. We did the homework so you don’t have to:

1. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. (2021, July 14).

2. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

3. DPDx - Laboratory Identification of Parasites of Public Health Concern. Onchocerciasis. Centers for Disease Control and Prevention. (2017, December 14).

4. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

5. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

6. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

7. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

8. Woo, Y.R., et al. Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition. Int J Mol Sci. (2016, September 15).

9. Woo, Y.R., et al. Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition. Int J Mol Sci. Ibid.

10. Woo, Y.R., et al. Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition. Int J Mol Sci. Ibid.

11. Tolaymat, L. and Hall, M.R. Perioral Dermatitis. StatPearls. (2023, April 17).

12. Barańska-Rybak, W. and Kowalska-Olędzka, E. New indications for topical ivermectin 1% cream: a case series study. Postepy Dermatol Alergol. (February 2019).

13. Maxfield, L., and Crane, J.S. Cutaneous Larva Migrans. StatPearls. (2023, June 28).

14. Harrison, I.S., et al. Cutaneous Larvae Migrans Treated with a Single Dose of Ivermectin. Case Rep Med. (2022, November 16).

15. Murray R.L., and Crane J.S. Scabies. StatPearls [Internet]. (January 2024).

16. Mathachan, S. R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatology Online Journal. (July - August 2021).

17. Fawcett, R.S. Ivermectin use in scabies. Am Fam Physician. (2003, September 15).

18. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

19. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

20. Bragg, B.N. and Wills, C. Pediculosis. StatPearls. (2023, March 14).

21. Karthikeyan, K., et al. Effectiveness of Topical 0.5% Ivermectin Shampoo in the Treatment of Pediculosis Capitis among School-going Female Children. Int J Trichology. (March 2022).

22. Karthikeyan, K., et al. Effectiveness of Topical 0.5% Ivermectin Shampoo in the Treatment of Pediculosis Capitis among School-going Female Children. Int J Trichology. Ibid.

23. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

24. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

25. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

26. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

27. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

28. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

29. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

30. Barańska-Rybak, W. and Kowalska-Olędzka, E. New indications for topical ivermectin 1% cream: a case series study. Postepy Dermatol Alergol. Ibid.

31. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

32. Mathachan, S.R., et al. Current Use of Ivermectin in Dermatology, Tropical Medicine, and COVID-19: An Update on Pharmacology, Uses, Proven and Varied Proposed Mechanistic Action. Indian Dermatol Online J. Ibid.

Elise Griffin is a certified physician assistant at Curology. She received her Master of Medical Science in physician assistant studies from Nova Southeastern University in Jacksonville, FL.

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Written by

Curology Team

Medically reviewed by

Elise Griffin, PA-C