Ivermectin in Singapore: Treatment Guide for Acne and Rosacea
- Nov 11, 2024
- 8 min read
Updated: Dec 4, 2025
Introduction
Ivermectin has emerged as a treatment option for inflammatory skin conditions, particularly acne and rosacea. Originally developed as an antiparasitic medication, research has explored its potential benefits for certain skin disorders through anti-inflammatory properties and effectiveness against Demodex mites—microscopic organisms that may contribute to skin inflammation. This guide provides evidence-based information about ivermectin's role in treating acne and rosacea in Singapore, including research findings, treatment approaches, safety considerations, and practical guidance for obtaining prescriptions.
Important Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medication. Individual responses to treatment vary, and outcomes cannot be guaranteed.
What is Ivermectin?
Ivermectin is a broad-spectrum antiparasitic medication belonging to the avermectin class of drugs. Discovered in the 1970s, it has been recognized by the World Health Organization as an Essential Medicine for treating parasitic infections.
How Ivermectin Works on Skin Conditions
For skin conditions, ivermectin offers two primary mechanisms that may benefit patients with acne and rosacea:
Targeting Demodex Mites
Demodex folliculorum and Demodex brevis are microscopic mites that naturally live in human hair follicles and sebaceous glands. In individuals with rosacea and certain types of acne, these mites can be present in elevated numbers. Ivermectin effectively reduces Demodex populations by interfering with their nerve and muscle function, leading to their elimination.
Anti-inflammatory Effects
Beyond its antiparasitic action, ivermectin demonstrates direct anti-inflammatory properties. It can help modulate immune responses in the skin, potentially reducing redness, swelling, and inflammatory lesions associated with acne and rosacea.
Regulatory Status in Singapore
The Health Sciences Authority (HSA) has approved ivermectin as a prescription-only medication for treating specific parasitic infections including onchocerciasis, strongyloidiasis, scabies, and head lice. For skin conditions like acne and rosacea, doctors may prescribe ivermectin off-label when clinically appropriate based on individual patient assessment and available scientific evidence. Off-label prescribing is a standard medical practice that allows physicians to utilize medications for conditions beyond their initially approved applications when medically justified.
Ivermectin and Rosacea Treatment
Rosacea is a chronic inflammatory skin condition characterized by facial redness, visible blood vessels, papules, pustules, and sometimes facial swelling. Multiple factors contribute to rosacea development, including vascular changes, immune system activity, and the presence of Demodex mites.
The Demodex-Rosacea Connection
Research has found that individuals with rosacea frequently have significantly higher Demodex mite densities compared to those without the condition. These mites can release substances that trigger immune responses, leading to inflammation in the skin. This inflammatory response contributes to the redness, papules, and pustules characteristic of rosacea. By reducing Demodex populations, ivermectin may help decrease inflammatory triggers and improve symptoms.
Research Evidence: What Studies Show
Clinical studies have investigated ivermectin's effectiveness for rosacea with encouraging findings:
Randomized controlled trials comparing 1% ivermectin cream to placebo have shown that patients using ivermectin experienced reductions in inflammatory lesions and facial redness
Comparative studies with metronidazole (a standard rosacea treatment) found that ivermectin demonstrated improvements in lesion counts
Long-term studies indicate that patients can maintain improvements with continued application and that the treatment is generally well-tolerated
Research suggests ivermectin may be particularly effective for papulopustular rosacea, the subtype characterized by persistent facial redness along with acne-like bumps and pimples.
Treatment Approach and Timeline
Treatment Phase | Timeframe | What to Expect |
Initial Application | Weeks 1-2 | Minimal visible change; possible temporary adjustment period |
Early Response | Weeks 3-4 | Beginning of lesion reduction; mild improvement in redness |
Optimal Results | Weeks 8-12 | Reduction in inflammatory lesions; decreased facial redness |
Maintenance | Ongoing | Some patients may need continued application to sustain improvements |
Application Method: Topical ivermectin (typically 1% cream) is applied once daily to affected facial areas after cleansing. A pea-sized amount covers the entire affected area. Avoid direct contact with eyes, lips, and mucous membranes.
Comparison with Other Rosacea Treatments
Treatment Option | How It Works | Typical Response Time | Key Considerations |
Ivermectin 1% cream | Anti-parasitic + anti-inflammatory | 2-4 weeks for initial response | May be effective for papulopustular rosacea |
Metronidazole gel/cream | Anti-inflammatory + antibacterial | 3-4 weeks | Established treatment option |
Azelaic acid | Anti-inflammatory + antimicrobial | 4-6 weeks | Multiple potential benefits |
Oral antibiotics | Anti-inflammatory + antibacterial | 2-3 weeks | Used for moderate to severe cases |
Laser/light therapies | Targets visible blood vessels | Multiple sessions needed | Addresses vascular symptoms |
Ivermectin and Acne Treatment
While ivermectin is more established for rosacea, research has explored its potential for certain types of inflammatory acne, particularly cases that have not responded adequately to conventional therapies.
Demodex Mites and Acne
Demodex mites inhabit hair follicles throughout the body, including facial skin. While their presence is typically harmless, overgrowth can potentially trigger inflammatory responses in susceptible individuals. Some research suggests a possible connection between elevated Demodex populations and inflammatory acne, especially in presentations resembling papulopustular rosacea. The immune response to these mites may contribute to follicular inflammation, manifesting as papules and pustules.
Available Research Findings
Studies examining ivermectin for acne treatment remain more limited compared to rosacea research. Available evidence includes:
Clinical investigations have explored topical ivermectin cream for inflammatory acne, with some studies reporting reductions in lesion counts after 8-12 weeks
Research suggests potential benefits particularly for patients with moderate inflammatory acne that has proven resistant to traditional therapies
The medication is generally not considered a first-line acne treatment and is typically reserved for cases where conventional approaches have been insufficient
Treatment Approach
Formulations: Ivermectin for acne is primarily administered topically as a cream or lotion. Oral ivermectin is less commonly used and typically reserved for specific situations.
Application: Specific dosage and frequency should be determined by a doctor based on acne severity and individual characteristics. Topical formulations are generally applied once daily to affected areas after cleansing, with treatment duration typically ranging from 8-16 weeks.
Combination Approaches: Ivermectin may be used alongside other acne treatments such as topical retinoids, benzoyl peroxide, or other prescribed medications. Discuss all current treatments with your healthcare provider to ensure compatibility.
Comparison with Other Acne Treatments
Treatment Type | Best Suited For | Typical Duration | Primary Benefits |
Topical retinoids | Comedonal and inflammatory acne | 12+ weeks | Prevents pore blockage; multiple skin benefits |
Benzoyl peroxide | Inflammatory acne | 4-8 weeks | Antibacterial effects; widely available |
Topical antibiotics | Inflammatory acne | 6-12 weeks | Reduces bacteria; typically combined with other treatments |
Oral antibiotics | Moderate to severe inflammatory acne | 3-6 months | Systemic effects; resistance concerns |
Ivermectin (off-label) | Treatment-resistant inflammatory acne | 8-16 weeks | Alternative mechanism when standard treatments are insufficient |
Isotretinoin | Severe or treatment-resistant acne | 4-6 months | Highly effective; requires careful monitoring |
Safety Information and Side Effects
Ivermectin is generally well-tolerated when used as prescribed. Understanding potential side effects helps patients recognize normal responses versus situations requiring medical attention.
Common Side Effects
With topical ivermectin, mild side effects may include:
Skin irritation at application site (burning, stinging, or itching)
Mild redness or dryness
Temporary skin sensitivity during initial treatment
Skin peeling or flaking
These effects are typically mild and transient. If irritation persists or becomes concerning, consult your healthcare provider.
With oral ivermectin (used at higher doses for parasitic infections), additional side effects may include dizziness, nausea, diarrhea, or mild headache.
When to Seek Medical Attention
Contact your healthcare provider immediately if you experience:
Severe allergic reactions (difficulty breathing, facial swelling, severe rash)
Neurological symptoms (severe confusion, seizures, difficulty walking)
Vision changes
Signs of liver problems (yellowing of skin or eyes, dark urine, severe abdominal pain)
Drug Interactions
Inform your healthcare provider about all medications, supplements, and herbal products you are taking. Important interactions include:
Blood thinners (warfarin): May increase bleeding risk
Medications affecting liver function: May alter ivermectin metabolism
Other topical skin treatments: May cause increased skin irritation
Special Considerations
Pregnancy and Breastfeeding: Ivermectin crosses the placental barrier and is excreted in breast milk. Discuss risks and benefits thoroughly with your healthcare provider if you are pregnant or breastfeeding.
Pediatric Application: Safety and efficacy in children have not been as extensively studied. Pediatric cases should be evaluated by a qualified pediatrician.
How to Obtain Ivermectin in Singapore
Prescription Requirements
Ivermectin is a prescription-only medication in Singapore regulated by the Health Sciences Authority (HSA). It cannot be purchased over the counter. For skin conditions like acne and rosacea, doctors may prescribe it off-label when deemed clinically appropriate.
Getting a Prescription: Step-by-Step
Schedule a consultation with a doctor, preferably one specializing in skin conditions
Clinical evaluation including medical history, skin examination, and discussion of previous treatments
Receive prescription if ivermectin is deemed suitable for your condition
Fill prescription at any registered pharmacy in Singapore
Important: Avoid Illegal Sources
Never purchase ivermectin from:
Unregulated online vendors
Overseas websites without proper licensing
Sources offering "prescription-free" access
Veterinary supply sources (animal formulations are not suitable for human application)
These sources pose risks including counterfeit products, incorrect dosages, contamination, and legal consequences.
Cost Considerations
Pricing varies by formulation (topical vs. oral), brand (generic vs. branded), and pharmacy. Generic formulations are typically more affordable. Insurance coverage may vary, particularly for off-label applications—check with your insurance provider regarding coverage policies.
Maximizing Treatment Success
Proper Application Technique
For Topical Ivermectin:
Cleanse face gently with mild cleanser
Pat skin completely dry; wait 5-10 minutes
Apply thin layer to entire affected area
Avoid eyes, lips, and mucous membranes
Allow absorption before applying other products
Apply once daily, preferably evening
For Oral Ivermectin:
Take on empty stomach with full glass of water
Ideally 1 hour before or 2 hours after meals
Follow prescribed dosing schedule exactly
Complete full course even if symptoms improve
Complementary Skincare Practices
Supporting ivermectin treatment with appropriate skincare may enhance results:
Use gentle, fragrance-free cleansers and moisturizers
Apply broad-spectrum sunscreen daily
Avoid harsh exfoliants during treatment
Maintain consistent routines
Stay adequately hydrated
Lifestyle Factors
For Rosacea:
Identify and avoid personal triggers (spicy foods, hot beverages, alcohol, temperature extremes)
Manage stress
Protect skin from wind and extreme weather
For Acne:
Maintain balanced diet
Avoid touching or picking lesions
Use non-comedogenic products
Clean items that contact face regularly
Frequently Asked Questions
How long should I use ivermectin for my skin condition?
Treatment duration varies by individual response and condition severity. Most patients use topical ivermectin for at least 8-12 weeks. Your healthcare provider will assess progress and determine appropriate duration.
Can I use ivermectin with my other skin medications?
In many cases, yes, but this must be discussed with your healthcare provider. They can advise on proper timing, sequencing, and compatibility to maximize benefits while minimizing irritation.
Will my insurance cover ivermectin for acne or rosacea?
Coverage for off-label prescriptions varies by insurance provider and policy. Contact your insurance company to inquire about specific coverage. Generic formulations may offer more affordable options if coverage is not available.
What should I do if I experience skin irritation?
Mild irritation during initial treatment is not uncommon and often resolves as skin adjusts. If irritation persists or worsens, contact your healthcare provider for guidance on adjusting your regimen.
Can ivermectin permanently resolve my rosacea or acne?
Ivermectin can help manage and improve symptoms, but rosacea and acne are chronic conditions that may require ongoing management. Many patients experience improvement, though some may need maintenance therapy to sustain results.
Is ivermectin more effective than other treatments?
Studies suggest ivermectin can be effective for papulopustular rosacea and may help when standard treatments are insufficient. Effectiveness depends on individual factors including specific condition type, previous treatment responses, and patient characteristics. Your healthcare provider can help determine the most appropriate treatment for your situation.
Conclusion
Ivermectin represents a treatment option for patients with rosacea and certain types of inflammatory acne, particularly when conventional therapies have been insufficient. Research supports its potential effectiveness, especially for papulopustular rosacea, with many patients experiencing improvement in their condition.
In Singapore, obtaining ivermectin requires consultation with a qualified healthcare provider who can assess your specific condition and determine whether ivermectin therapy is appropriate. While prescribed off-label for skin conditions, this practice is supported by clinical evidence when used under proper medical supervision.
Successful treatment requires consistent application, realistic expectations regarding timelines, and open communication with healthcare providers. Combined with appropriate skincare practices and lifestyle considerations, ivermectin may help patients achieve improvement in their skin condition.
Seeking Professional Guidance
At Skin Medical Clinic, our experienced medical professionals specialize in treating acne and rosacea using evidence-based approaches. We provide comprehensive evaluations, personalized treatment plans tailored to your specific condition, and ongoing support throughout your treatment journey.
For personalized medical advice regarding ivermectin or other treatment options for acne and rosacea, please schedule a consultation where we can discuss your individual needs and develop an effective treatment strategy.
Please see below for treatment details.
Note: This article is for educational purposes only and does not constitute medical advice. Individual treatment plans should be developed in consultation with qualified healthcare professionals. Treatment outcomes vary from person to person, and no guarantee of results is intended or implied. All professional treatments mentioned should be performed by licensed medical practitioners in Singapore, using HSA-approved products, devices, and techniques, as applicable.
