Soolantra
Soolantra
Product Description
Product overview
Soolantra by Galderma is an FDA-approved prescription cream containing 1% ivermectin, clinically proven to reduce the inflammatory bumps, pustules, and redness of papulopustular rosacea. Its dual antiparasitic and anti-inflammatory action targets Demodex mites and calms irritated skin in as little as two weeks.
Kills Demodex Mites
Targets the skin mites linked to inflammation in papulopustular rosacea.
Texture & feel
SENSORYKills Demodex Mites
Targets the skin mites linked to inflammation in papulopustular rosacea.
Calms Inflammation
Inhibits lipopolysaccharide-induced cytokine production for anti-inflammatory action.
83% Lesion Reduction
In head-to-head trials against metronidazole over 16 weeks of use.
Results from Week 2
Initial visible improvement can appear as early as two weeks of daily use.
Single Daily Dose
Convenient once-daily application vs. twice-daily for most alternatives.
Antibiotic-Free
No contribution to antibiotic resistance concerns with long-term topical use.
Safety & compatibility
SAFENot recommended. Animal studies showed embryofetal toxicity at high doses; safety in humans not established.
Contains oleyl alcohol, isopropyl palmitate, and cetyl/stearyl alcohols that may feed Malassezia yeast.
Skin may worsen in the first 1-2 weeks as Demodex mites die off. This typically resolves within 7 days.
For topical skin use only. Do not apply to lips, eyes, mouth, or intravaginal areas.
Peak plasma levels are extremely low (~2 ng/mL) with no expected cardiac or metabolic effects.
Safety demonstrated in 707 patients over 12 months with no serious adverse events reported.
Use caution with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) as plasma levels may rise.
Contains methyl/propylparaben and propylene glycol — may cause delayed allergic reaction in sensitive skin.
Ingredient breakdown
INGREDIENTSIvermectin 1%Proven
An antiparasitic agent from the avermectin family of macrocyclic lactones. In topical form, it targets Demodex folliculorum mites while exerting anti-inflammatory effects on the skin.
- FDA Approval: Approved December 23, 2014 for inflammatory lesions of rosacea
- Clinical Trial Data: Two Phase 3 studies in 1,371 patients showed superiority over vehicle at 12 weeks
- Head-to-Head: Outperformed metronidazole 0.75% — 83% vs. 73.7% lesion reduction at 16 weeks
- Mechanism: Binds glutamate-gated chloride channels in mites; inhibits inflammatory cytokine production
- Dosing: 10 mg of ivermectin per gram of cream (1% w/w)
Glycerin ~3%Proven
A classic humectant that draws moisture into the skin, helping to counter any drying effect from the cream base and supporting barrier recovery.
- Function: Hydration, skin conditioning
- Safety: Non-irritating, non-comedogenic, pregnancy-safe in cosmetic use
Dimethicone ~2%Proven
A silicone that forms a light, breathable film to reduce transepidermal water loss and give the cream a silky slip during application.
- Function: Occlusive, smoothing agent
- Safety: Considered non-comedogenic and hypoallergenic by most dermatologists
Cetyl & Stearyl Alcohol 3.5% + 2.5%Proven
Fatty alcohols that serve as emollients and emulsion stabilizers. They give the cream its rich, hydrating texture — unrelated to drying SD-type alcohols.
- Function: Emulsifier, thickener, skin softener
- Note: May contribute to Malassezia feeding in fungal-acne-prone skin
Propylene Glycol ~2%Proven
A penetration enhancer and humectant that helps deliver ivermectin into the pilosebaceous unit where Demodex mites reside.
- Function: Solvent, penetration enhancer, humectant
- Caution: Can cause contact dermatitis in approximately 2-3% of users
Phenoxyethanol + Parabens ≤1%Proven
Preservative system combining phenoxyethanol with methylparaben and propylparaben to protect the formula from microbial contamination over a 2-year shelf life.
- Regulatory Status: All at safe concentrations per FDA & EU Cosmetic Regulation
- Note: Parabens are labeled E218/E216 and may trigger rare delayed allergic reactions
18 ingredients
Ivermectin 1% (Active), Water (Purified), Glycerin, Isopropyl Palmitate, Carbomer Copolymer Type B, Dimethicone, Disodium EDTA (Edetate Disodium), Citric Acid Monohydrate, Cetyl Alcohol, Stearyl Alcohol, PEG-4 Distearyl Ether (Polyoxyl 20 Cetostearyl Ether / Ceteareth-20), Sorbitan Stearate (Sorbitan Monostearate), Methylparaben, Propylparaben, Phenoxyethanol, Propylene Glycol, Oleyl Alcohol, Sodium Hydroxide.
Where it fits in your routine
ROUTINEApply Soolantra as the first leave-on product on clean, fully dry skin. Wait 15-20 minutes before moisturizer to allow the active to reach the follicle.
How to use
HOW TO USECleanse Gently
Wash your face with a mild, non-foaming cleanser. Pat completely dry — applying to damp skin increases irritation.
Take a Pea-Sized Amount
Dispense a pea-sized amount for each affected area: forehead, chin, nose, and each cheek. Five peas maximum per full-face application.
Apply a Thin Layer
Spread evenly in a thin layer over the affected zones. Avoid lips, eyes, and inside the nostrils.
Wash Your Hands
Wash your hands thoroughly after application to avoid transferring the cream to eyes or mucous membranes.
Wait, Then Moisturize
Allow 15-20 minutes for absorption, then follow with a gentle, barrier-supportive moisturizer.
Use Consistently for 12 Weeks
Apply once daily (typically at night). Continue for the full treatment course — courses can be repeated if needed.
Who is it for?
WHOPerfect for you if:
- You have papulopustular rosacea (bumps and pustules)
- Metronidazole or azelaic acid didn't fully clear your skin
- You want an antibiotic-free long-term option
- You prefer a once-daily routine over twice-daily gels
- You suspect Demodex involvement in your breakouts
- You need a prescription-strength dermatology treatment
Consider alternatives if:
- You are pregnant or breastfeeding
- You have erythematotelangiectatic rosacea (redness only, no bumps)
- You are prone to fungal acne (Malassezia folliculitis)
- You have a known allergy to parabens or propylene glycol
- You need an over-the-counter option
- You're looking for a moisturizing skincare product
Skin type compatibility
SKIN TYPESAbsorbs well without heaviness, though isopropyl palmitate may feel slightly occlusive for very oily skin.
Cream base with glycerin and fatty alcohols provides comfortable hydration alongside treatment.
Balanced formula works across different face zones without feeling too heavy or too light.
Specifically designed for rosacea skin; fragrance-free with anti-inflammatory action. Purge phase expected.
Best for rosacea-type bumps. Contains moderately comedogenic fatty alcohols — not ideal for pure acne sufferers.
Contains oleyl alcohol, isopropyl palmitate, and fatty alcohols that can feed Malassezia yeast.
Results timeline
ONGOINGInitial Purge / Die-Off
Many users report temporary worsening: new bumps, pustules, and tingling as Demodex mites die and release their bacterial load. Push through — this is expected.
~40% experience purgeFirst Improvements
Statistically significant reduction in inflammatory lesions begins. Early responders see calmer skin, fewer new pustules, and reduced burning sensation.
~30% see visible changeClear Progress
Significant lesion count reduction in clinical trials. Redness begins to fade, existing bumps flatten, and skin texture starts to smooth out.
~60% notice improvementFull Clinical Effect
Primary endpoint of Phase 3 trials. 38-40% of users rated "clear" or "almost clear" by investigators. Most users see 70-90% improvement.
80% show major improvementBest-in-Class Results
Head-to-head against metronidazole: 83% mean lesion reduction vs. 73.7%. Many users reach "clear" status and begin maintenance regimens.
83% lesion reductionMaintenance Phase
Treatment courses can be repeated as needed. Long-term data shows continued safety over 12 months with stable symptom control.
Sustained controlRatings by platform
545+ REVIEWSPros & cons
BALANCEDPraised
- Clinically superior to metronidazole for papulopustular rosacea
- Fragrance-free, once-daily convenience
- Dual action: anti-parasitic + anti-inflammatory
- Results visible as early as week 2
- No antibiotic resistance concerns
- Excellent long-term safety profile (12+ months studied)
- Suitable for most skin types including sensitive
Criticized
- Expensive — brand can exceed $500 per tube in the US
- Prescription-only; requires dermatologist visit
- Initial purge phase can be discouraging
- Not safe during pregnancy or breastfeeding
- Not suitable for fungal acne-prone skin
- Mainly targets bumps — less effective for pure redness
- Contains parabens and propylene glycol
Budget-friendly alternatives (dupes)
DUPESChemically identical active and nearly identical inactive ingredients. The most effective dupe by far, especially via Canadian or international pharmacies.
Different mechanism (antibiotic) but addresses the same condition. Clinically less effective by ~10% in head-to-head trials but a fraction of the cost.
The Ordinary Azelaic Acid 10% is an OTC alternative at ~$8. Works on both redness and bumps with anti-inflammatory and keratinocyte-normalizing action.
OTC sulfur has mild anti-Demodex activity and is used off-label for rosacea. Less effective than ivermectin but cheap and widely available.
Comparison with competitors
SIDE-BY-SIDE
MetroGel 1% (Galderma)
Mirvaso 0.33% Gel (Galderma)
Storage & shelf life
24 MONTHS24 months (unopened). Typically 6-12 months after opening for topical prescription creams.
Store at 20°C to 25°C (68°F to 77°F). Excursions permitted between 15°C and 30°C. Do not freeze.
Laminated aluminum tube with child-resistant cap. Available in 30g, 45g, and 60g sizes.
Yes — all tube sizes are well under 100ml and TSA carry-on compliant. Keep in original packaging.
Frequently asked questions
FAQNo. Soolantra is not recommended during pregnancy or breastfeeding. Although topical absorption is low, animal studies at high oral doses have shown embryofetal toxicity, and it is not known whether ivermectin passes into breast milk. It was previously classified as FDA pregnancy category C. If you are pregnant, planning pregnancy, or nursing, speak with your dermatologist about alternatives such as azelaic acid, which has a more favorable pregnancy profile.
No. Soolantra contains several ingredients that can feed Malassezia yeast, including oleyl alcohol, isopropyl palmitate, cetyl alcohol, and stearyl alcohol. If you have fungal acne (pityrosporum folliculitis), these ingredients may worsen your condition. However, if your breakouts are truly papulopustular rosacea (Demodex-driven), the antiparasitic action of ivermectin typically outweighs the fungal-acne concern. A dermatologist can help distinguish the two.
With caution. Combining Soolantra with strong actives can significantly increase irritation, especially during the first few weeks. A common approach is to use Soolantra at night and a gentle vitamin C in the morning, or to alternate nights with retinol once your skin has adjusted (typically after week 4-6). Avoid AHA/BHA exfoliants during the purge phase. Always wait at least 20-30 minutes between products and prioritize barrier-supportive moisturizers.
Soolantra is best for adults with papulopustular rosacea — characterized by persistent redness combined with acne-like bumps and pustules on the central face. It is excellent for sensitive, dry, and combination skin types with rosacea. It is less ideal for fungal-acne-prone skin or for people whose primary concern is diffuse flushing or visible blood vessels (erythematotelangiectatic rosacea), for which Mirvaso, Rhofade, or laser therapy may be more appropriate.
In Phase 3 clinical trials, statistically significant improvement was observed as early as week 2. Most users see clear progress by weeks 4-6, with full results at 12-16 weeks of daily use. Be prepared for an initial purge (worsening) in the first 1-2 weeks as Demodex mites die off and release bacterial content — this is normal and expected. Push through: the majority of users who persist achieve 70-90% lesion clearance by week 12.
Apply Soolantra to completely clean, dry skin as the first leave-on product — after cleansing, before moisturizer. Use a pea-sized amount per affected zone (forehead, chin, nose, each cheek) and spread in a thin layer. Wait 15-20 minutes for the cream to absorb and reach the follicle, then apply your moisturizer. In the morning, always finish with a mineral-based SPF, as rosacea skin is highly sun-sensitive.
Mildly comedogenic — rated approximately 3/5. The formula contains isopropyl palmitate (4/5) and fatty alcohols (2/5) that can contribute to pore-clogging in very acne-prone skin. However, for its target audience (rosacea sufferers), the anti-inflammatory and antiparasitic benefits far outweigh the comedogenic concern. If you have combination acne-rosacea, monitor for comedonal breakouts and consider pairing with a non-comedogenic moisturizer.
Soolantra has an unopened shelf life of 24 months when stored between 20-25°C (68-77°F). Once opened, it should generally be used within 6-12 months, though the FDA-approved prescribing information does not specify a separate post-opening expiry. Always check the printed expiration date on the tube, avoid extreme heat, do not freeze, and discard if the cream changes color, texture, or odor.
Verdict: Soolantra is the gold-standard topical prescription for papulopustular rosacea, and for good reason. Its unique dual action — killing Demodex mites while calming inflammation — delivers clinically superior results to metronidazole and azelaic acid in head-to-head trials. The once-daily, antibiotic-free, fragrance-free formula is gentle enough for long-term use and has a strong safety record over 12+ months. The initial purge phase and high brand-name cost are real drawbacks, and it is not suitable for pregnancy, breastfeeding, or fungal-acne-prone skin. But for the right patient, few rosacea treatments are as life-changing. Worth every penny if your dermatologist confirms Demodex-driven rosacea.
Product Overview
What are Quick Product Notes?
Quick product notes are a great way to check if a product is free from commonly avoided ingredients by skincare enthusiasts. These preferences come about for different reasons depending on the ingredient such as personal experiences, sensitivities, health preferences & etc.
Pro Tip Alert!
Just because a product is not free from a common preference does not mean it's a bad product! You can make a personal decision whether or not you want to use a product that contains these ingredients or not - click the labels of the preference to read more about them.
Quick Product Notes
Paraben-Free
Paraben-Free
Understanding Parabens
Parabens are a large group of preservatives which are used to prevent bacteria growing in cosmetic formulations. There has been some healthy controversy surrounding them due to a few studies finding paraben presence in breast tumours and breast tissue. However, the majority of the scientific community have deemed these findings non-conclusive due to the limitations of these studies. There's still a lot of support for avoiding parabens following the better safe than sorry route. If you do we completely support you! If you are concerned about the health safety of parabens, then feel free to avoid them by looking out for the Paraben-Free icon. If not, don't worry about it - they do have had one of the longest safety records as preservatives!
Which Ingredients are classified as Paraben?
A product will be paraben-free if it does not contain any of the following parabens:
- Sodium Isobutylparaben
- Sodium Ethylparaben
- Sodium Butylparaben
- Propylparaben
- Isopropylparaben
- Isobutylparaben
- Sodium Propylparaben
- Butylparaben
- Ethylparaben
- Sodium Methylparaben
- Methylparaben
Sulfate-Free
Sulfate-Free
Understanding Sulfates
Sulfates are a large group of ingredients which act as cleansing agents in Cosmetics. They help loosen up the dirt and grime from your skin and hair to allow for water to wash it away with ease. However some sulfates are so good at their job, they can wash off your skin’s own natural oils that keep it moisturised and protected which can lead to dryness and irritation. Most people will find no issues with sulfate, however if you find your skin doesn't like sulfates then free feel to avoid them by looking out for the sulfate-free icon on Skincarisma.
Which ingredients are classified as sulfates?
We've taken the Sulfates which are considered more harsh for our Sulfate-Free status. A product will be Sulfate-Free if it does not contain any of the following Sulfates:
- TEA-Dodecylbenzenesulfonate
- Ammonium Laureth Sulfate
- Sodium Lauryl Sulfate
- PEG-15 Cocamine
- Sodium Laureth Sulfate
- Sodium Cocoyl Sarcosinate
- Sodium C14-16 Olefin Sulfonate
- Dioctyl Sodium Sulfosuccinate
- Ammonium Xylenesulfonate
- Ammonium Lauryl Sulfate
- Sodium Xylenesulfonate
- Sodium Myreth Sulfate
- Sodium Lauryl Sulfoacetate
Alcohol-Free
Alcohol-Free
Understanding Simple Alcohols
Alcohol ingredients are widely used in cosmetics and come in different types. For the most part alcohols are not problematic at all. However one type of alcohols, simple alcohols can be quite drying to the skin because it evaporates very quickly. This can cause irritation which can also lead to other skin complications. These alcohols should never be used alone on your skin, but combined with other cosmetic ingredients, they are normally without issue. However, for some people with sensitive and easily irritable skin, avoiding products with these simple alcohols may be beneficial. If you find your skin doesn't like these simple alcohols, then free feel to avoid them by looking out for the Alcohol-Free icon.
Which Ingredients are classified as Alcohol?
A product will be alcohol-free if it does not contain any of the following alcohol ingredients:
- SD Alcohol
- Alcohol Denat
- Isopropyl Alcohol
- Alcohol
Silicone-Free
Silicone-Free
Understanding Silicones
If you've ever used a skincare, makeup or beauty product that's made your skin look and feel smoother tempoarily - it's likely contained Silicone. They are a popular class of ingredients found in cosmetics due to their smooth, soft, easy-to-spread and smooth properties that help creates an artificial layer/barrier on top of skin or hair (commonly found in conditioners).
For the same reasons they are popularly used, they are also commonly avoided. Anecdotally, many individuals have reported that Silicones cause/excerbate breakouts, irritation, cause a feeling of skin being unable to breathe, cause clumping of cosmetic products and find it difficult to wash off. As a result, those who find them problematic are avoiding them and increasingly, cosmetic companies are avoiding them as well.
If you have had bad experiences with Silicones in the past, or suspect they are problematic then look out for the tick on the Silicone-free label.
Disclaimer
The Silicone-free label only includes the most common Silicone ingredients that have indentified been reported by individuals that could potentially cause issues.
These include: Amodimethicone, Behenoxy Dimethicone, Bis-Aminopropyl Dimethicone, Cetearyl Methicone, Cetyl Dimethicone, Cyclomethicone, Cyclopentasiloxane, Dimethicone, Dimethicone Copolyol, Dimethiconol, Methicone, Phenyl Trimethicone, Phenyl Trimethicone, Stearoxy Dimethicone, Stearyl Dimethicone, Trimethylsilylamodimethicone.
Note, that this does not include all ingredients part of the Silicone class of ingredients.
EU Allergen-Free
EU Allergen-Free
Understanding the Identified Contact Allergens
The EU's Scientific Committee on Consumer Safety (SCCS) has identified and established 26 cosmetic ingredients that are likely contact allergens (potential to cause skin allergies) as demonstrated in clinical or epidemiological studies. The EU's SCCS have recommend cosmetic companies to disclose them on the labels if used and in cases where the concentration exceeds 0.001% in leave-on products and 0.01% in rinse-off products, then they must be labelled.
Look out for the tick on the EU-Allergen free label to know your cosmetic is free from any of the 26 identified cosmetic ingredients.
For more information regarding the EU's Scientific Committee on Consumer Safety, please visit their official website.
Disclaimer
The EU Allergen Free label is for the 26 ingredients identified by the EU SCCS and products will be only flagged if a suspected ingredient is on it's ingredient list. It is possible for cosmetics to contain one of the suspect ingredients without it appearing on the ingredient list due to it not reaching the concentration threshold to disclose it and cosmetic manufacturers choice to not disclose it.
Also note, the EU Allergen Free label is not personalized for your own allergies you may have and it does not constitute as medical advice. For your specific case, always consult your medical professiona such as dermatologist, physician, pharmacist, or health care provider - please read our medical disclaimer for more information.
Fungal Acne (Molassezia) Safe
Fungal Acne (Molassezia) Safe
Understanding Fungal Acne (Pityrosporum Folliculitis/Malassezia Folliculitis)
Pityrosporum Folliculitis/Malassezia folliculitis or simply known as Fungal Acne is a persistent acne-like condition that commonly responds poorly to traditional acne-treating methods. Unlike most cases of Acne where bacteria is the culprit, Fungi is the culprit of Fungal Acne (Hence the name!). There are certain classes & groups of ingredients that have been shown to promote and feed the growth of the Fungal Acne, Fungi such as fatty acids, oils, esters, polysorbates and fermented ingredients.
For more information regarding Fungal Acne, please visit Simple Skincare Science (f.c) - #3 of our Recommend Skincare Resources for an amazing comprehensive guide!
Please Read: How to use the Fungal Acne (Malassezia) Label
At SkinCarisma, we've done our best to identify as many ingredients as possible but note the fungal-free label may not be 100% accurate due to the complexconditions and combination of ingredients that malezzeria can thrive on.
Additionally, products that may contain ingredients that have shown to feed Malassezia may not neccessarily exacerbate the condition due to concentration of ingredient used in the product, this information is simply not available on the products.
As a result, please note this is only an experimental label that can be best used to possible identify problematic products you have used in the past. It is in no way a perfect identifier nor a predictor in whether or not it will exacerbate or cause fungal acne. It will continue to be worked on as more information and research comes to light.
If you find any ingredients you believe should be included, please email us at snails@skincarisma.com.
Disclaimer
Due to the lack of substantial research into this area it is very likely there are other ingredients and class/groups of ingredients that could feed Fungal Acne which have not been indentified.
The Fungal-Safe label does not constitute as medical advice. For your specific case, always consult your medical professiona such as dermatologist, physician, pharmacist, or health care provider - please read our medical disclaimer for more information.
What are Notable Effects & Ingredients?
Ever used a product that promised a certain effect but provided no results? It might not have contained any notable ingredients that could have been responsible for that promised effect. It doesn't matter what the marketing or packaging «promises» it can do, if it doesn't contain anything that can help - then the likelihood of it helping is low.
We help you identify key notable ingredients that have been shown to help with effects such as acne-fighting, brightening, UV-protection, wound healing & anti-aging to help you achieve your skincare goals smarter. Please note that different notable ingredients have varying levels of research behind them, some are extremely well proven yet some have mixed research in their efficacy.
Pro Tip Alert!
Just because a product doesn't contain any notable ingredients doesn't mean it's bad. And a product with notable ingredients (or even many) doesn't necessarily guarantee the efficacy of the product performing these effects either. There are other factors such as ingredient quality, concentration and formulation that will ultimately determine this.
Be smart and use this as just a starting point for you to make more informed and smarter choices and compare it with reviews to see if the product is right for you
Notable Effects & Ingredients
Anti-Aging from 1 ingredient(s):
Brightening from 2 ingredient(s):
Promotes Wound Healing from 2 ingredient(s):
What are Ingredients Related to Skin Type?
Why are some products great for some people and horrible for others? Well everyone has different skin types and different reactions to the same ingredients.
We've identified a range of ingredients that are commonly regarded as potentially good or bad for those with Dry, Oily/Acne-Prone or Sensitive skin.
Pro Tip Alert!
A product that contains good or bad ingredients for your skin type doesn't always flat out make the entire product good or bad for your skin. There are other factors such as ingredient quality, concentration and formulation that will ultimately determine your skins reaction.
One of the best ways to use this section is to troubleshoot products you've had bad experiences with in the past. Check if it contains any of the marked ingredients to point out suspect ingredients to avoid in the future!
Ingredients Related to Skin Types
Dry Skin
Oily/Acne-Prone Skin
Sensitive Skin
What is the Ingredient Safety Breakdown?
Ingredient Safety Breakdown refers to the percentage % of ingredients in different risk categories as classified by EWG (Environment Working Group) if they are available. There are almost endless cosmetic ingredients and they are one of the few organisations globally that have assigned ratings to a lot of the more commonly used ingredients which is why we reference them.
Pro Tip Alert!
EWG is seen by many to be more on the alarmist side in their assignment of health ratings resulting in rating ingredients as riskier than they actually are. We recommend using this a reference point rather than a strict guide of ingredient safety and to always do further research if into ingredients that you may find suspect.
Ingredient Safety Breakdown
Product ingredient list
| EWG | CIR | Ingredient Name & Cosmetic Functions | Notes |
|---|---|---|---|
| 1 |
Carbomer
Viscosity Controlling, Viscosity Increasing Agent, Emulsion Stabilising, Gel Forming
|
|
|
| 1 |
Cetyl Alcohol
Emulsion Stabilising, Fragrance, Opacifying, Emulsifying, Surfactant, Foam Boosting, Viscosity Increasing Agent, Emollient, Masking, Viscosity Controlling
|
|
|
| 2 |
Citric Acid
Masking, Fragrance, Chelating Agent, Ph Adjuster, Buffering Agent
|
Brightening
Anti-Aging
Promotes Wound Healing
Texture
Pores
|
|
| 3 |
Dimethicone
Skin Conditioning, Emollient, Antifoaming Agent, Skin Protecting
|
|
|
| 1 |
Disodium EDTA
Viscosity Controlling, Chelating Agent
|
|