New indications for topical ivermectin 1% cream: a case series study

Introduction
Topical ivermectin is an effective treatment for inflammatory papulopustular rosacea in adults. Positive therapeutic effects of ivermectin due to its potential anti-inflammatory properties could be achieved in the other facial dermatoses.

Aim
To assess the efficacy of topical ivermectin 1% cream therapy in mild and moderate perioral dermatitis (PD), seborrheic dermatitis (SD) and acne vulgaris (AV).

Material and methods
The study comprising 20 patients diagnosed with PD (8), SD (8) and AV (4) was conducted between November 2016 and July 2017. Two scales were applied to establish efficacy of the treatment: Investigator Global Assessment score (IGA) and Patient Global Assessment of Treatment (PGA).

Results
All patients responded to the treatment with topical ivermectin very well with a gradual reduction in inflammatory skin lesions. Complete or almost complete clearance (IGA score 0–1) was achieved in 20 cases. Four patients with PD achieved IGA 0–1 after 4 weeks of treatment, 1 patient after 5 weeks, 2 patients after 6 weeks and 1 patient after 12 weeks. In the total group of 8 patients with SD, 4 presented IGA 0 after 4 weeks of therapy, while 4 patients demonstrated IGA 1 after 6 weeks. Patients with AV required 8 and 10 weeks to obtain IGA 1. Nineteen patients of the studied group reported “very good” or “excellent” response to the therapy, only one patient with AV assessed therapy with topical ivermectin as “good”. The adverse events were transient and manifested as mild-moderate desquamation, stinging and burning in 2 patients with PD.

Conclusions
Topical ivermectin was well tolerated and beneficial for treatment of mild and moderate PD, SD and AV.