Demodex Mites, Ivermectin (Stromectol) and its use in Dermatology

Written by on February 2, 2006 in Demodex Mites, Ivermectin with 7 Comments

How is Ivermectin used in dermatology ? This recently published paper is of interest because it mentions the possibility of treating rosacea with ivermectin (stromectol).

Sadly there is but a sole reference to treating rosacea with Ivermectin ; and whats more, this paper is not new to us. The research that this paper references was brought to our attention by Dr. Linda Sy in 2000 (see demodex mites ivermectin effective treatment ?). In her 2000 post Dr. Sy gave us the full text of that paper. Note that the cited 1999 paper refers to just one patient and there remains no published double blind study linking eradication of demodex by ivermectin to rosacea relief.

So this 2005 paper is interesting from the point of view of the general applicability of ivermectin to skin diseases, but doesn’t add to the rosacea/ivermectin story.

Another bit of history from the archives was the promotion of an anti-mite treatment called kwellada lotion that contains 5% permethrin. This was followed by several reports of bad reactions to this treatment.

The status of demodex folliculorum and its role in rosacea is still an open area of study. It has been difficult to prove that there is or isn’t a link between the mite and rosacea. In my mind, demodex mites remain as an innocent bystander.

Ivermectin: pharmacology and application in dermatology

International Journal of Dermatology, Volume 44 Page 981 – December 2005. Pharmacology and therapeutics, Assen L. Dourmishev, Lyubomir A. Dourmishev, and Robert A. Schwartz

Abstract: Ivermectin is a synthetic derivative of the antiparasitic class of compounds known as avermectins. It is a macrolide endectocide with activity against both endoparasites with cutaneous tropism (Strongyloides stercoralis, Ancylostoma braziliense, Cochliomyia hominivorax, Dermatobia hominis, Filaria bancrofti, Wucheria malayi, Onchocerca volvulus, Loa-loa) and ectoparasites such as Sarcoptes scabies, Pediculus humanus, Demodex folliculorum, and Cheyletiella sp. Ivermectin is of great interest in the treatment of patients with different forms of scabies, head lice, demodecidosis, cutaneous larva migrans, cutaneous larva currens, myiasis, and filariasis.


Ivermectin has a structure similar to that of macrolide antibiotics, but without antibacterial activity. It is used against a wide range of endoparasites (nematodes) and ectoparasites (insects, acarine) of animals and humans. The interest of dermatologists in ivermectin therapy grew when promising results were observed in the treatment of human ectoparasitoses such as scabies.

Mode of Application in Humans

Contraindications to ivermectin therapy are allergic sensitization, nervous system disorders, pregnancy, and lactation. Ivermectin therapy should not be recommended for children younger than 5 years or less than 15 kg in weight.

Application in Dermatology:
Ivermectin is used in dermatology against some parasitic infestations in humans with cutaneous tropism. The drug is of great interest in the treatment of patients with different forms of scabies, human body lice, head lice, demodecicosis, cutaneous larva migrans, cutaneous larva currens, myiasis, and filariasis.

Others diseases with probably parasitic origin

A patient with follicular, papulopustular rosacea-like eruption with a long history of unsuccessful treatment also responded to the ivermectin therapy.[75]

Safety and Adverse Reactions: The 20-year ivermectin history of effective control for millions of people suffering from microfilarial diseases indicates that it is an extremely safe drug. The results from several trials of ivermectin in the Onchocerciasis Control Programme in West Africa show a low prevalence of adverse reactions, most of which were mild and transient. Severe reactions were observed in only 1.83% of 50,929 treated patients. Transient and mild adverse reactions have been reported in 24% of filarial disease patients, with signs and symptoms including anorexia, asthenia, headache, arthralgia, myalgia, fever, and eosinophilia.

Conclusions: Oral ivermectin treatment offers several advantages over standard therapy of scabies, pediculosis, demodecidosis, larva migrans, myiasis, filariasis, and other parasitic infestations with cutaneous tropism. More studies are required to precisely define the optimal therapeutic uses for ivermectin in dermatology.

Further Reading

Related Articles

Read more about: Demodex Mites, Ivermectin

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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7 Reader Comments

  1. barry montgomery says:

    i have been treated many times for parasitic infestations over the past 4 years and used every thing i could find on the www! they do help some, it’s such a relief to not be infested! i need this treatment very bad!! this is my last chance at a real life again!!! please help me before i do something nuts!!!!!!!!!!!! HELP!!!!!

  2. barry's buddy says:

    I think that you should just go ahead and do something nuts. If you’re still alive afterwards, let us know how it went.

  3. monroe rupp says:

    I am saturated with the horrible demodex mites, from head to knees eyes hair, chest, back groin area and knees. Where can I get this new drug? ( ivermecton) I’ve had them for over a year, and they keep spreading, and I’m losing all my hair (falling hair follicles, loaded with mite eggs.

  4. macmite says:

    Hi monroe rupp,
    why do you think that all your hair follicles are filled with mite eggs. Was there a proper diagnose by a specialist?

  5. 1/27/15…I have had Demodex mites on face hairline…over a year and 6 months…Could not find a Dermo to prescribe the medication to kill the mites…called the University of Davis in California where I live and told them what my problem was …they contacted me with the information of a Doctor i skin disease in Century City, California. Meantime they also contacted this Doctor..his name was Stanley Bierman…Went to him in May of last year and he did scaling and so forth and started me with Ivermectin (Stromectol and Permethrin Cream 5%. Saw him once a week for 4 visits…and he informs me that he is giving up his practice of 58 years to retire. Asked him for referrals..gaveme 3 Doctors but when I called ..they had passed on…I have gone to 10 Dermos and none of them know about this treatment…trying for weeks to get my medicine from aboard…it would be to my benefit to find a Doctor here…but have had no luck. Is there anyone who could recommend a Skin Disease Orange County,Los Angeles Area or even San Diego? It is affecting my life and in this day and age can’t find a Doctor to prescribe the medications that were just helping by Dr, Stanley Bierman??? ..

  6. cate says:

    evelyn, i am seeing a dr paul smith in santa monica who is treating me for what he says is scabies with both permethrin and ivermectin. i feel it’s demodex, but it’s the same treatment just need more treatments in my opinion. i had the condition for years, always misdiagnosed, unitl it had become quite severe. mostly on my face but spread to my lower regions. it has been three weeks of pills and cream and i expect in another two weeks i should be clear of this. between the iver pills and permethrin i use nu-stock sulfur ointment. i wash everything daily, sleep without pillows and vacuum. good luck.all my sympathy!

  7. K says:

    Dr McNay a dermatologist in
    Pleasanton Ca just gave me a free sample of this. Sounds like she is closer to you good luck

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