Soolantra: What It Is, How It Works, and Who It’s For

Soolantra isn’t a cure, but for many people with rosacea, it’s the first thing that actually works. If you’ve tried cleansers, antibiotics, or over-the-counter creams that promised relief but left your skin red, burning, or covered in bumps, you’re not alone. Soolantra targets the root cause many doctors miss-not just surface inflammation, but the tiny mites living in your pores.

What exactly is Soolantra?

Soolantra is a topical cream with one active ingredient: ivermectin. It’s not an antibiotic. It’s not a steroid. It’s an antiparasitic-specifically designed to kill Demodex mites, which are microscopic creatures that live naturally in human hair follicles. For most people, these mites cause no harm. But in people with rosacea, especially the papulopustular type (the kind with red bumps and pus-filled spots), research shows these mites multiply out of control and trigger inflammation.

The cream comes in a 1% concentration and is applied once daily, usually at night. A pea-sized amount covers the entire face-forehead, cheeks, nose, and chin. It’s fragrance-free, non-comedogenic, and doesn’t sting like some other rosacea treatments. You don’t wash it off. You just leave it on.

How does Soolantra actually work?

For years, doctors thought rosacea was caused by blood vessel problems or diet. Then studies in the 2010s started pointing to Demodex mites. People with rosacea have 10 to 20 times more of these mites than people without it. The mites themselves aren’t the problem-it’s what happens when they die. Their bodies break down and release bacteria and toxins that make your skin angry.

Soolantra doesn’t just kill the mites. It reduces the inflammatory response they trigger. Clinical trials showed that after 12 weeks of daily use, over 40% of users saw their bumps and pimples clear up by 75% or more. That’s not a placebo effect. That’s measurable, visible improvement.

Unlike metronidazole or azelaic acid-which can take months to show results-some people notice less redness and fewer breakouts within 2 to 4 weeks. It’s not instant, but it’s faster than most alternatives.

Who is Soolantra for?

Soolantra is approved for adults with papulopustular rosacea. That means you have persistent redness on your central face, plus visible bumps and pimples that aren’t acne. It’s not for cystic acne, eczema, or perioral dermatitis. If your skin is just flushed or blushing easily without bumps, Soolantra probably won’t help.

It’s also not for kids. It’s only been tested and approved for people 18 and older. Pregnant or breastfeeding women should talk to their doctor first-there’s limited data, and while the cream is absorbed minimally, it’s not risk-free.

People with sensitive skin often tolerate it better than other rosacea treatments. I’ve seen patients who couldn’t use metronidazole because it burned like acid switch to Soolantra and finally sleep through the night without itching.

What are the side effects?

Most people have no side effects. In clinical trials, less than 5% of users reported mild irritation-like dryness, burning, or stinging-usually in the first week. That usually fades. If it doesn’t, you stop using it.

There’s no increased risk of skin thinning, like with steroid creams. No rebound flare-ups after stopping, like with some antibiotics. And unlike oral ivermectin (used for parasites like scabies), the topical version doesn’t enter your bloodstream in any meaningful amount. You’re not getting systemic effects.

One thing to watch: if you’ve never used a prescription rosacea treatment before, your skin might react at first. Don’t panic. Give it 3 weeks. If your skin looks worse after 6 weeks, it’s time to check in with your dermatologist.

How does it compare to other rosacea treatments?

Here’s how Soolantra stacks up against the most common options:

Soolantra stands out because it treats the likely cause-not just the symptoms. Metronidazole and azelaic acid help calm the skin. Brimonidine hides redness. Doxycycline wipes out bacteria but can disrupt your gut. Soolantra goes after the mites, which many experts now believe are the trigger.

How to use Soolantra correctly

Getting results isn’t about using more-it’s about using it right.

1. Wash your face with a gentle, fragrance-free cleanser. Pat dry-don’t rub.
2. Wait 15 minutes. Let your skin fully dry.
3. Squeeze a pea-sized amount onto your fingertip.
4. Dot it on your forehead, cheeks, nose, and chin.
5. Gently spread it in thin layers. Don’t rub it in hard.
6. Don’t apply makeup, sunscreen, or other creams for at least 15 minutes after.
7. Use it every night, even if your skin looks better.

Don’t use it on your eyelids, lips, or inside your nose. Don’t double up if you miss a dose. Just skip it and go back to your regular schedule.

What to expect over time

Week 1-2: Your skin might feel slightly dry or tingly. This is normal. Don’t stop.

Week 3-6: You’ll start to notice fewer bumps. Redness may begin to fade, especially around your nose and cheeks.

Week 8-12: Most people see the biggest improvement here. Many report their skin feels calmer, less reactive to heat, alcohol, or spicy food.

After 12 weeks: Your doctor might suggest continuing treatment. Unlike antibiotics, Soolantra doesn’t cause resistance. Long-term use is safe for most people. Some stay on it for years, using it 2-3 times a week to keep flare-ups away.

What doesn’t work with Soolantra

Soolantra won’t fix everything. If you’re still breaking out after 3 months, you might need a different approach. Here’s what it doesn’t help with:

• Visible blood vessels (telangiectasia)-you’d need laser or intense pulsed light for that.
• Thickened skin on the nose (rhinophyma)-that’s a surgical issue.
• Redness caused by menopause or stress-those need different strategies.
• Acne with blackheads or deep cysts-Soolantra isn’t an acne treatment.

Also, don’t combine it with harsh exfoliants, retinoids, or alcohol-based toners. They’ll make your skin more sensitive and defeat the purpose.

Where to get it and how much it costs

Soolantra is a prescription-only cream in the UK, the US, and most of Europe. You can’t buy it over the counter or online without a doctor’s note. Your GP or dermatologist can prescribe it. Some NHS clinics in the UK cover it if you’ve tried other treatments first.

A 30g tube usually costs between £60 and £90 without insurance. That lasts 2-3 months with daily use. Some private clinics offer subscription plans or patient support programs that lower the price.

Generic ivermectin creams exist in some countries, but they’re not FDA or EMA approved for rosacea. Stick with the branded version. It’s formulated specifically for facial use.

Real stories from real users

One woman in Leeds, 42, told her dermatologist she’d tried 11 different creams over 8 years. She’d given up on makeup, avoided social events, and felt like her skin was always on fire. After 8 weeks on Soolantra, she posted a photo on a rosacea forum: her cheeks were clear, no redness, no bumps. She wrote: ‘I didn’t think I’d ever feel normal again.’

A man in Manchester, 58, used to get flare-ups every time he drank wine. After Soolantra, he could have a glass without breaking out. He didn’t stop drinking-he just stopped fearing it.

These aren’t outliers. They’re the norm for people who’ve been stuck in the rosacea loop for years.

Final thoughts

Soolantra isn’t magic. It won’t erase rosacea forever. But it’s the first treatment in decades that targets what’s likely causing the problem-not just hiding it. If you’ve been told your rosacea is ‘just stress’ or ‘bad skin,’ know this: it’s a real, biological condition. And now, there’s a treatment that actually works on the root cause.

It’s not for everyone. But if you’ve got bumps, pimples, and persistent redness on your face-and nothing else has worked-it’s worth asking your doctor about. You don’t have to live with it anymore.

If you’ve been struggling with rosacea for years, you’re not alone-and you don’t have to keep guessing what’s wrong. Soolantra offers a real, science-backed option. Ask your doctor. Give it a fair shot. And don’t settle for creams that just cover up the problem.