Soolantra: How to Get the Best from Your Treatment

Q: What if my skin gets worse on Soolantra?

An initial worsening is common in the first few weeks and is often attributed to die-off. This is different from a genuine allergic reaction, which may involve swelling, hives, or severe burning. If you are unsure, contact your prescriber for guidance.

Soolantra is a prescription ivermectin 1% cream used to treat papulopustular rosacea. It works by targeting Demodex mites - microscopic organisms that live in the skin and are believed to contribute to rosacea flare-ups in some people.

Soolantra - How to Get the Best from Your Treatment

One of the most common things I see is people being prescribed Soolantra with very little guidance on how best to use it.

Occasionally Soolantra can appear to make the skin worse before it gets better. This is often referred to as "die off" the ivermectin within the cream targets Demodex mites. So it's believed toxins are released causing little pinprick spots or additional reddening.

As new mites hatch, the cycle continues, which is why consistency matters so much.

1. Gently cleanse and pat the skin dry before application.

2. Apply Soolantra in the evening, as Demodex mites are more active.

3. I use the 8 dot technique - take one large pea sized amount, separate into two dots on each cheek & forehead, one on the nose & chin - then gently smooth it over the skin rather than heavily rubbing it in.

4. Smooth into areas such as around the ears, slightly behind the ears and the upper neck.

5. I found Soolantra worked best when used completely on its own at night without layering lots of other creams over the top.

6. Stay consistent, people stop too early because their skin might become red, itchy, dry or bumpy in the first few weeks. Unless you are having a genuine allergic reaction, this does not always mean the treatment is failing.

Soolantra is commonly prescribed for a minimum of 12 weeks - sometimes longer. It will not work for everyone, but with its anti-inflammatory properties I still think it's one of the best treatment options available when used correctly and consistently.

Frequently Asked Questions

What is the die-off effect with Soolantra?

When ivermectin kills Demodex mites living in the skin, their breakdown is thought to release toxins that temporarily trigger small pinprick spots, extra redness, or itchiness. This reaction typically settles within the first few weeks of consistent use. It is not necessarily a sign that the treatment is failing - for many people it is part of the process.

How long does Soolantra take to work?

Soolantra is prescribed for a minimum of 12 weeks. Some people notice improvement earlier, but the Demodex life cycle means results build over time. Consistency is the single biggest factor in getting a good outcome.

Can I use Soolantra with other skincare?

The best results often come from using Soolantra alone at night without layering other creams on top. Keep your morning routine gentle - a simple moisturiser and sunscreen are usually enough. Avoid actives like retinoids or acids in the evening while using Soolantra unless your prescriber says otherwise.

What if my skin gets worse on Soolantra?

An initial worsening - more spots, redness, dryness, or itchiness - is common in the first few weeks and is often attributed to die-off. This is different from a genuine allergic reaction, which may involve swelling, hives, or severe burning. If you are unsure whether your reaction is normal, contact your prescriber for guidance.

Take Control of Your Rosacea Journey

Tracking how your skin responds to treatments like Soolantra can help you spot patterns and share useful information with your prescriber. Create a free Nosacea account to start logging symptoms, tracking triggers, and building routines that work for your skin.