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Best Proven Topical Treatments for Rosacea with Ivermectin and Brimonidine

Rosacea is a dermatological condition that affects 40% of the world’s population. It has a chronic nature and about 40 million of the world population is affected by Rosacea. Many people suffer from this, not only medically and also psychologically. Because of social embarrassment and many other related factors. But new studies related to Rosacea identified Ivermectin and Brimonidine cream has great results in controlling the disease. And the other satisfying thing is the application of Ivermectin and Brimonidine has very low side effects compared with other known medications.

The condition is characterized by inflammatory lesion and erythema largely located to the central face. The incidence of Rosacea is increased with age, most arise within the age of 30. It has an equal gender distribution with slight female predominance according to recent studies. Although this condition has no targeted skin type, most cases are reported in fair-skinned people. The United States health sector reports that about 16 million of Americans have symptoms of Rosacea.

The treatment of Rosacea is somewhat challenging because the causative factor is difficult to determine. Scientists have identified that Rosacea can cause,

  • Immunological dysregulations
  • Vascular abnormalities
  • Neurogenic abnormalities
  • UV radiation
  • Skin barrier damage
  • Presence of cutaneous microorganisms

So new treatment modalities are targeted on controlling these etiological factors.

Ivermectin and Brimonidine both are scientifically proven for treatment due to they can improve the quality of life in patients, reduce the lesion count, lower the disease severity and low side effect profile. Both of these products can be purchase online via OKDERMO Dermatological Skin Store:

  1. Ivrea – Ivermectin Cream and Shampoo (Soolantra alternative)
  2. Erythego – Brimonidine Gel (Mirvaso alternative)
  3. Metrogyl – Metronidazole Gel

How Ivermectin acts ?

As previously mentioned presence of cutaneous microorganisms is a provoking factor for Rosacea. Demodox Folliculorum is a well known causative mite that lives in pilosebacous glands (the sweat secreting gland located near by hair follicles). These mites destroy the epidermis of the skin and the proteins on their surfaces produce a hypersensitivity reaction. By that lymphocytes, the immune cells in our body activates to produce an inflammatory reactions.

Although up to 50% of Rosacea patient’s identified as infected with Demodox mites, there are some cluster of population that even not causing any reactions for the mite. This was all depended with individual factors that specific for a person.

Ivermectin cream is well known for its anti parasitic action against multiple organisms. Onchocerciasis, strongyloidiasis and Scabies are commonest parasites that can effectively treated with Ivermectin. Researches have shown that Demodox mite also able to include in to this list. In addition from treating Demodox mite infection, Ivermectin can reduce the inflammation around the site. It can reduce the migration of neutrophils to the affected site, and reduce the formation of cytokines as a response for mites.

Topical application of Ivermectin cream is effective from 10 hours after application. It is completely metabolized by liver and excreted via urine. So there is less harmful side effects like skin irritations noted on therapeutic trials.  A study performed for 12 weeks with Rosacea patients shows that this is an excellent product for long term use. As well as it has less side effects and more effectiveness compared with previous treatment methods like Metronidazole cream.

Using Ivermectin 1% topical application

Before using Ivermectin cream you should consider about the allergies. If you have any known allergic reactions with foods, drugs or animal related conditions, it’s better to get advice from your healthcare provider before using the product. Ivermectin is categorized as category C for pregnancy. Which means animal studies showed that pregnancy is contraindicated but not tested in human. So better avoid Ivermectin during pregnancy.

The application of Ivermectin should be advised by a doctor. A pea sized amount of cream applying only the each affected areas is generally known dose. For adults its once a day application but for children don’t use without proper medical attention.

How Brimonidine 0.33% acts ?

Brimonidine is one of the well known topical application for Rosacea. It comes as Brimonidine tartrate. It is identified as alpha 2 agonist. Alpha 2 receptors are mainly located in peripheral vessels. Therefore Brimonidine action cause peripheral vasoconstriction.

The erythema and redness in Rosacea caused due to vasodilatation of the affected skin as a response to lymphocytic action and cytokines. Therefore Brimonidine is very effective against reducing the erythema over the affected skins.

The side effects profile of Brimonidine is very low. Most patients who used Brimonidine for long period of time and successfully controlled their condition informed that this medication is easy to use and gives less side effects. Currently most of these people are able perform well in their normal lives, without having social embarrassment like earlier.

Studies have shown that within 12 hours after application, reducing erythema occurs. Most of the patients had a reasonable recovery from the condition after using for 2 to 3 months.

Using Brimonidine 0.33% topical application

Since this medication affects your blood vessels, there are much more things to consider than Ivermectin before using the drug. There are conditions which needs special attention like Scleroderma ( disease with tight skin ), Raynaud’s phenomena ( a bluish discoloration of fingers after exposing to cold environments ), orthostatic hypotension ( a low blood pressure which occur with sitting position ), other autoimmune condition like Sjogren’s syndrome, previous events of strokes and heart attacks. Therefore take a proper medical advice before using this application.

FDA categorized Brimonidine as category B which is not known side effect for pregnancy in animal studies. But there is still no proper human studies are performed. Although there are no noted side effects in pregnancy and breastfeeding up to now.

A pea sized amount is advisable to apply daily. However it’s better to follow the instructions given by manufacturers before using the drug. The drug should be stored within room temperature by avoiding heat, direct sunlight and moisture.

The best thing in both products are safe side effect profile. Since Rosacea is a chronic condition, there should be significant period of time to use for have better results. Although there are other products with good effectiveness as Ivermectin and Brimonidine, most have full of side effects. Because most of other drugs have failed to provide good quality of life for patients due to failed compliance of the drugs. Therefore these two drugs give better user experience and satisfaction than others.


1. New developments in the treatment of rosacea – role of once-daily ivermectin cream (!po=50.000)
2. Spotlight on brimonidine topical gel 0.33% for facial erythema of rosacea: safety, efficacy, and patient acceptability (
3. The role of brimonidine tartrate gel in the treatment of rosacea (
4. Brimonidine (Topical Application Route) ( )
5. Ivermectin (Topical Application Route) ( )