Ivermectin (Topical)

By killing the head lice which attach themselves to a person's head, ivermectin helps eliminate the unhealthy condition of an infestation of these small bugs.


Ivermectin kills head lice effectively, and that is its most common medical usage. Children who are treated must be at least six months of age, and adults of any age are acceptable users for this medication. One of the forms it comes in is that of a topical ointment, and this is applied directly to the hair and scalp in order to eradicate the unwanted lice.

This medication can also be used in the treatment of a skin condition known as rosacea, which is typically characterized by redness on the skin, along with the possible appearance of acne and some degree of swelling. For this usage, ivermectin would be applied directly to the facial area, using only a very small amount, and administering a thin layer of the cream over all affected areas of the face. This cream is used only once per day, and should not be used more often unless a doctor has given such instructions.

Ivermectin should not be used in larger amounts than your doctor's instructions call for, nor should it be used any more frequently, because this will not help clear up your medical condition any more quickly. The only real effect that excessive usage might have is to worsen any side effects that you will experience, and possibly prolong the period that you will be subject to these side effects.

Condition Treated

  • Head lice, Rosacea

Type Of Medicine

  • Anthelmintics

Side Effects

Along with the expected medical benefits, there is a possibility that ivermectin will also deliver some unwanted side effects for patients being treated with this topical. While many patients will experience no side effects whatsoever or very mild ones, there is at least a possibility that some moderate or severe side effects can occur in some patients. One such severe side effect is an allergic reaction, and if you should observe the signs of an allergic reaction after being treated with ivermectin, you should seek medical attention as soon as possible. There is a possibility for an allergic reaction to become serious enough to be life-threatening, so that it endangers the welfare of the patient. These are the side effects characteristic of someone undergoing an allergic reaction:

  • Hives and or rashes appearing on skin surfaces
  • Difficulty with breathing, very often accompanied by a severe tightening in the chest
  • Extreme itchiness at various locations around the body
  • Lightheadedness or dizziness, as though you are about to faint
  • Pronounced swelling or puffiness in the eyelids or on the tongue, lips, or throat.

While allergic reactions are extremely rare for people who are being treated with ivermectin, there are some much more common side effects that are possible. For instance, since this is a topical medication applied directly to the skin, there's a chance that you may experience some kind of skin irritation at any of the sites which receive treatment. You may notice a burning sensation or a stinging sensation when the medication is applied, and there may be some redness at the site for a while after application. While these are generally mild in nature, if you should experience them to a more severe degree and it makes you uncomfortable, you should contact your doctor for medical advice.

There is also a possibility that your eyes may be affected after an application of ivermectin. You may notice that they become swollen, itchy, teary, red, or irritated in other ways shortly after ivermectin has been applied topically. As with other side effects related to this medication, this is a generally mild condition that usually fades away within a few hours. If it does not, and it causes you more than a little discomfort, make sure to contact your doctor for consultation.

In the event that some family member accidentally ingests ivermectin so that it is taken internally, you should call the poison control center immediately and take the family member to the nearest emergency room clinic right away. The symptoms to look for in a person who has swallowed ivermectin and has overdosed on it, are the following:

  • A sudden severe looking rash
  • Hives
  • Swollen skin
  • Extreme difficulty with breathing
  • Headaches
  • Dizziness
  • Weakness
  • Nausea and/or vomiting
  • Diarrhea
  • Extreme pains or cramping in the stomach
  • Abdominal pains or cramping
  • Seizures or convulsions
  • Burning or tingling sensation experienced either in the feet, the hands, or both
  • Sudden swelling of the feet, lower legs ankles, or hands
  • Sudden difficulty with coordination and movements.


There are two different treatment programs associated with ivermectin, depending on which condition is being treated. When treating a patient with head lice, the topical lotion known as Sklice should be used and applied only on the hair and scalp. Patients must be very careful to keep the medicine away from nose, mouth, eyes and vagina, and if some amount of cream does reach one of these areas, it should be immediately flushed out with water.

Make sure to wash your hands before and after applying this medicine, and when you do apply it, use an entire tube directly on your dry hair, completely covering your whole head, and leaving the medicine in place for about 10 minutes. After this time has expired, you should rinse with warm water and comb your hair with a fine-toothed comb that will bring out any lice eggs or shells. Within seven days, you should not have any more live lice on the hair or scalp.

When using ivermectin as a topical cream for the treatment of rosacea, the commercial product Soolantra is indicated. This medicine should only be applied to the skin, and should never be applied anywhere near the eyes, mouth, or vagina, nor should it be used on any skin surfaces which have open cuts. Using only a pea-sized amount of medication, administer the lotion to the entire facial area without getting near eyes or lips.

  • For the topical dosage in cream form, treating rosacea, ivermectin should be applied to the face once each day, for a period to be determined by your doctor
  • For the topical dosage in lotion form, treating head lice, the entire head should be covered with ivermectin for adults, teenagers, and children who are at least of six months age, once daily. It should only be necessary to continue this treatment for a period of seven days before all head lice have been eradicated. If treatment for seven consecutive days does not completely eliminate the lice population on your scalp, contact your doctor immediately, so that alternative approaches can be considered.


Since this medicine is applied topically, there is less danger for it to interact with other drugs than there might be for a drug which is taken internally. Still, there is a possibility that some drug interactions may occur, so it is advisable to avoid that possibility by taking a few simple precautions.

Before using ivermectin, prepare a list of all medications which you are currently using, including all the over-the-counter drugs, prescription medications, herbal supplements, and vitamins, as well as all the dosages of these. Your doctor can review this list and make a determination on whether or not any of them have the potential for interacting with ivermectin.

You can also use this list if you happen to make an unscheduled trip to the emergency room for treatment. Any doctor there will be able to review your medication list and avoid the potential for drug interactions, by prescribing medication for your treatment which will not impact any other drug you are taking.

This is the best and safest procedure to take to avoid the possibility of worsening any side effects which you might experience from taking ivermectin, or for diminishing the effectiveness of ivermectin or any other drug you are currently taking.


As with most medications, there are a few precautions and/or warnings which you should observe, so that you can safely take this medicine without incurring any greater risk than necessary. For patients who are using Sklice, the head lice form of this medicine, you should be aware that head lice can easily spread from person-to-person when there is direct contact through any of the following mechanisms:

  • Scarves
  • Bandannas
  • Clothes
  • Hair brushes
  • Combs
  • Hats
  • Towels
  • Sheets
  • Blankets
  • Washcloths
  • Ribbons
  • Helmets
  • Hairbands
  • Actual hair.

If anyone in your household has been infected with head lice, it is strongly urged that all members of the house should be checked for the presence of head lice, and receive the same treatment if they turn out to be infected. To discourage the spread of head lice, all personal items such as clothes, bedding, and all the items referenced above, should be washed frequently in very hot, soapy water. Ivermectin for head lice should not be used to treat any other problem with the scalp, unless you have discussed this with your doctor and it is been approved.

For patients using the form of ivermectin intended for rosacea treatment, known as Soolantra, you should carefully monitor the condition of your skin every day, looking for improvement. If you don't see improvement within a few days, or if your condition becomes noticeably worse, you should contact your doctor immediately for advice. Soolantra should not be used for any kind of skin condition which has not been pre-authorized by your doctor.


This medication should be kept in the container which it came in, and well out of the reach of children. It should be stored at room temperature, in a location which is not subject to any extremes of heat, cold, direct lighting, or moisture. For this reason, bathrooms are generally not a good location for this to be stored.

Since this medication can be swallowed and become toxic in small children, it is extremely important that the medication be kept somewhere that children can't possibly reach, even with assistance. If you have unused portions of ivermectin, you should dispose of it according to procedures recommended by your doctor or pharmacist. If you lack this information, you can also look it up on the website maintained by the FDA for the safe disposal of medicines.


Ivermectin is a medicine which is used either in the treatment of head lice, or for a skin condition called rosacea. In either case, it is applied topically, and must be kept out of the eyes, nose, or mouth. When treating head lice, it should take no more than seven days to eliminate the lice problem, and when treating rosacea, your skin should improve within a few days.

Head lice ivermectin is marketed commercially under the brand name of Sklice, while rosacea ivermectin is marketed under the brand name of Soolantra.