WHAT IS ROSACEA?

Rosacea is a very common, chronic inflammatory  skin condition affecting over 16 million Americans.  This condition is characterized by facial redness, flushing, papules and pustules and thickening of the skin.

Research has shown high concentrations of the Demodex mite associated with the inflammatory response characteristic of rosacea.  Prescription Soolantra® (Ivermectin)cream is a safe and effective drug that kills the Demodex mite and ameliorates the signs and symptoms of Rosacea.

Rosacea affects both men and women and typically begins around age 30. Although rosacea is more commen in women, men are more severely affected.

First, this skin condition presents as redness on the cheeks, nose, chin or forehead. As Rosacea progresses. the redness intensifies and often pimples, bumps and pustules develop. Eventually, this can lead to a thickening of the nose called, rhinophyma.

In addition, in many Rosacea sufferers, the eyes are also affected.  At first, the eyes  appear bloodshot and feel irritated. But Ocular Rosacea can lead to loss of vision.  Therefore, individuals with Ocular Rosacea need close monitoring by your physician to prevent vision loss.

Rosacea varies in severity and it is characterized by flare-ups and remissions and can vary from individual to individual.  Rosacea always includes at least one of the PRIMARY SIGNS and may or may not include any of the Secondary Signs:

Primary Signs of Rosacea

• FLUSHING -the earliest sign of Rosacea is facial redness or flushing that comes and goes.
• PERSISTENT REDNESS – The most common sign of Rosacea in an individual is facial redness that looks like a sunburn that does not go away.
• BUMPS AND PIMPLES – Red solid bumps or pus-filled pimples often develop.  Although it looks like acne, there are no blackheads
• VISIBLE BLOOD VESSELS -small blood vessels become visible on the face

SECONDARY Signs of Rosacea

• EYE IRRITATION -The eyes look bloodshot and may be irritated and the eyelids may become red and swollen and styes are common. When the eyes are involved it is called OCULAR ROSACEA  and in severe cases corneal damage and vision loss can occur. Ocular Rosacea needs monitoring by an ophthalmologist.
• BURNING or STINGING -May feel itching, tightness and burning or stinging sensations of the face.
• DRY APPEARANCE – The facial skin may become rough and appear to be dry
• PLAQUES -May develop red patches or plaques
• SKIN THICKENING – As Rosacea progresses the skin can thicken and form extra tissue especially around the nose referred to as rhinophyma.
• SWELLING – Can develop facial swelling
• SIGNS BEYOND THE FACE – Sometimes Rosacea can also affect the neck, chest, scalp or ears.

Subtype 1: Facial Redness (Erythematotelangiectatic Rosacea)
Rosacea sufferers often experience flushing and persistent facial redness. Small blood vessels may also become visible in some patients, and stinging, burning, swelling and roughness or scaling may occur.

Subtype 2: Bumps and Pimples (Papulopustular Rosacea)
In addition to persistent redness, bumps (papules) and/or pimples (pustules) are common in many rosacea sufferers. Some patients may also experience raised red patches known as plaques.

Subtype 3: Enlargement of the Nose (Phymatous Rosacea)
Rosacea may be associated with enlargement of the nose from excess tissue, a condition known as rhinophyma. This may include thickening of the skin and irregular surface nodules, which in rare cases may also develop in areas other than the nose.

Subtype 4: Eye Irritation (Ocular Rosacea)
Rosacea affects the eyes in many patients, and may result in a watery or bloodshot appearance, irritation and burning or stinging. The eyelids may also become swollen, and styes are common.

TIPS FOR SURVIVING ROSACEA:

(From Rosacea.org)

Choose your cleanser with care according to your skin type. Keep in mind that unless your skin is oily, non-soap cleansers may be the best option — they contain less than 10% soap, rinse off easily, and have a neutral pH that’s closer to the natural pH of the skin.

Dry to normal or combination skin. A wide range of non-soap cleansers is available, including a number of options developed specifically for sensitive or redness-prone skin.

Very dry skin. A creamy, low-foaming, non-soap cleanser may be ideal for skin that’s very dry — these types of formulas often leave behind a thin film that helps skin hold moisture.

Oily skin. For very oily skin, wash with a mild soap, taking care to avoid scrubbing. Aggressive rubbing or over-cleansing can irritate skin.

CLEANING TIPS

1. To minimize skin irritation, try this gentle, step-by-step cleansing routine developed by leading dermatologists for people with rosacea.
2. Using your fingertips, wash skin with a cleanser suitable for your skin type. Avoid using an abrasive washcloth or sponge, which may irritate.
3. Rinse away cleanser with lukewarm water. Hot or cold water may cause flushing or irritation. If your face is irritated by water at any temperature, try using a soothing cream cleanser you can simply tissue off.
4. Gently blot your face dry with a thick-pile cotton towel. Don’t rub skin, as this may cause irritation.
5. Since stinging most often occurs on damp skin, wait 30 minutes for the face to dry completely before applying any topical medication. Slowly reduce the drying time until you find the least amount of time your skin needs to avoid a stinging sensation.
6. After applying topical medication, wait five to 10 minutes more before applying moisturizer, sunscreen or makeup.
7. If you have ocular rosacea, be sure to follow your doctor’s directions for eyelid scrubbing and medication.

FOr Men: Shaving Tips for Skin with Rosacea

Shaving may pose a unique challenge for men with rosacea. Here’s what you can do to help get a closer shave without irritating skin.

• Shaving– Men with rosacea may prefer an electric razor to avoid the irritation of a dull razor blade.
• Lotion– Avoid any shaving creams or lotions that burn or sting your skin.
• After shave– Use a post-shave balm and/or moisturizer to help soothe the skin.

SOOLANTRA FAQ

WHAT IS ROSACEA and WHO IS SUSCEPTIBLE TO ROSACEA?

Rosacea is chronic inflammatory disease of the skin affecting mostly the face of both men and women.  Research has shown high concentrations of the Demodex mite associated with the inflammatory response characteristic of rosacea.  Although rosacea is more common in women, men are more severely affected.

HOW DOES ROSACEA DIFFER FROM ACNE?

Although rosacea may look like acne there is a major distinction. Moreover, there is essentially no association between acne as a teenager and developing rosacea as an adult. Acne is associated with plugging of the ducts of the oil glands resulting in comedones, blackheads and whiteheads.  Although rosacea papules and pustules may mimic acne, the main distinguishing difference of the lesions is that in rosacea there are no comedones, whiteheads and blackheads.  Rosacea is an inflammatory condition characterized by mid-facial flushing which is not seen in acne. Also, there is potential eyelid and eye involvement in rosacea which is never seen in acne.

WHAT IS SOOLANTRA® CREAM and is SOOLANTRA® CREAM SAFE?

Soolantra® (Ivermectin) cream, 1% is a white to pale yellow hydrophilic cream.   Each gram of  Soolantra® cream contains 10mg of ivermectin. It is for TOPICAL use only. Ivermectin is an anti-mite drug related to the macrolide antibiotics, and it belongs to a class of drugs known as antihelmintics. Ivermectin works by killing parasites by increasing cell permeability to chloride ions. Ivermectin kills the Demodex mite on the skin of Rosacea sufferers. The metabolic activity of the Demodex mite is associated with the inflammatory response seen in Rosacea. Ivermectin is also used to treat Scabies and lice. Ivermectin is safe and effective and Soolantra® cream is for topical use only (not to be used in eyes or intravaginally).

HOW DOES SOOLANTRA® CREAM WORK?

While the mechanism of action of Soolantra® cream is unknown, Ivermectin, the active ingredient, has anti-inflammatory and antiparasitic activity.  Ivermectin reduces or eliminates the Demodex folliculorum mite which is found in high concentrations on affected skin areas.  Killing the Demodex mite reduces the clinical signs and symptoms of rosacea which are primarily due to allergic and vasomotor inflammatory response of the body to the Demodex mite in susceptible individuals.

WHO QUALIFIES FOR AN ONLINE SOOLANTRA® CREAM CONSULTATION?

Soolantra® cream is indicated for the treatment of inflammatory lesions of Rosacea. If you are 18 years or older, not pregnant or breast feeding, and have been diagnosed by a physician with Rosacea and do not have Ocular Rosacea, you are eligible for an online Soolantra® cream physician consultation.

IS THERE ANY TEST TO DIAGNOSE ROSACEA?

There are no histological or blood tests to diagnose rosacea. A physician must diagnose you with rosacea by physical exam and medical history one or more of the following signs and symptoms: facial redness, flushing, blushing, bumps, pustules, papules, swelling, burning, itching or stinging.

WHEN and HOW OFTEN DO I USE SOOLANTRA® CREAM?

Soolantra® cream is to be applied to the affected areas ONCE DAILY at bedtime.  Use a pea-size amount for each area of the face (forehead, chin, nose, each cheek).  Spread the cream as a thin layer avoiding eyes and lips.

CAN I USE SOOLANTRA® CREAM IF I’M PREGNANT OR BREAST FEEDING?

Ivermectin, the active ingredient in Soolantra® cream, is a FDA Pregnancy Category C drug and should NOT be used by pregnant women or women who are breast feeding. Ivermectin is distributed into breast milk. Do NOT use Soolantra® cream Ivermectin if pregnant or breast feeding.

HOW DO I CARE FOR MY SKIN IF I HAVE ROSACEA?

A rosacea facial care routine recommended by many dermatologists starts with a gentle and refreshing cleansing of the face each morning. Sufferers should use a mild soap or cleanser that is not grainy or abrasive, and spread it with their fingertips. A soft pad or washcloth can also be used, but avoid rough washcloths, loofahs, brushes or sponges. Next, rinse the face with lukewarm water several times and blot it dry with a thick cotton towel. Never pull, tug, scratch or treat the face harshly. Sufferers should let their face air dry for several minutes before applying a topical medication. Let the medication soak in for an additional five or 10 minutes before using any makeup or other skin care products.

WHAT KIND OF SKIN CARE PRODUCTS SHOULD I USE WITH ROSACEA?

The skin of many rosacea sufferers may be sensitive and easily irritated. Patients should avoid using any products that burn, sting or irritate their skin. In a National Rosacea Society survey, many individuals with rosacea identified alcohol, witch hazel, fragrance, menthol, peppermint, eucalyptus oil, clove oil and salicylic acid as ingredients that irritated their individual cases, and many also avoided astringents and exfoliating agents. A useful rule of thumb may be to select products that contain no irritating or unnecessary ingredients.

Sunscreens or sunblocks effective against the full spectrum of ultraviolet A and B radiation can be especially important for rosacea patients, whose facial skin may be particularly susceptible to sun damage and consequent rosacea flare-ups. An SPF of 15 or higher is recommended, and physical blocks utilizing zinc or titanium dioxide may be effective if chemical sunscreens cause irritation.

WHAT FACTORS TRIGGER OR EXACERBATE ROSACEA FLARE-UPS?

According to a National Rosacea Society survey, some of the most common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, heavy exercise, hot baths, heated beverages and certain skin-care products and see if your acne improves.

HOW DO I USE SOOLANTRA® CREAM?

Read and follow the steps below so that you use Soolantra® cream correctly:

Soolantra® cream (ivermectin) 1% is for use on the face only.
Do not use Soolantra® cream in your eyes, mouth or vagina.

1. Open the tube of Soolantra® cream by gently pressing down on the child resistant cap and twist in the direction of the arrow (counterclockwise) as shown below. See Figures A and B. To avoid spilling, do not squeeze the tube while opening or closing.

Figure A

Figure B

2. To apply Soolantra® cream to your face, squeeze a pea-sized amount of Soolantra® cream from the tube onto your fingertip. See Figure C.

Figure C

3. Apply Soolantra ® cream to the affected areas of your face once a day. Use a pea-sized amount of Soolantra® cream for each area of your face (forehead, chin, nose, each cheek) that is affected. Spread the cream smoothly and evenly in a thin layer. Avoid contact with your eyes and lips.

4. To close Soolantra® cream, gently press down on the child resistant cap and twist to the right (clockwise). See Figure D.

Figure D 

HOW SHOULD I STORE SOOLANTRA® CREAM?

Store Soolantra® cream at room temperature between 68°F to 77°F (20°C to 25°C). Keep Soolantra® cream out of the reach of children.

WHAT ARE THE SIDE EFFECTS OF SOOLANTRA® CREAM?

Soolantra® cream (Ivermectin) is a very safe drug and has minimal side effects. The only side effects reported from topical  Soolantra® cream were skin burning sensation and skin irritation in less than 1%. Ivermectin, the active ingredient in Soolantra® cream, has no major Central Nervous System (CNS) side effects as Ivermectin does not cross the blood-brain barrier in humans. Headache, dizziness, muscle pain, nausea or diarrhea may rarely occur. To reduce dizziness upon standing, get up slowly when rising from a sitting or lying position. Allergic reactions are very rare. However if you notice any symptoms of a serious allergic reaction such as rash, itching/swelling, trouble breathing seek immediate medical attention.

WHO SHOULD NOT USE SOOLANTRA® CREAM?

Soolantra®  (Ivermectin) should NOT be used by pregnant women, women attempting to become pregnant or women who are breast feeding.

If you have Ocular Rosacea, you should not use Soolantra®. You need close, direct physician monitoring to prevent loss of vision

Soolantra® cream is NOT to be used in children or anyone under the age of 18.

Before Proceeding to the Medical Consultation Form  please read
CONTRAINDICATIONS, PRECAUTIONS and WARNINGS
and accept the Waiver of Liability

CONTRAINDICATIONS

Soolantra Cream (Ivermectin) is CONTRAINDICATED and must NOT be used in anyone with the following conditions:

• Do NOT use Soolantra® cream if you are pregnant or attempting to become pregnant.
• Do NOT use Soolantra® cream if you are breast feeding. Ivermectin is distributed in breast milk.
• Do NOT use Soolantra® cream if you are allergic  or sensitive to Ivermectin
• Be cautious using Soolantra® cream if you have bronchial asthma, occasionally worsening of bronchial asthma has been reported.
• Soolantra® cream is contraindicated to be administered without direct ophthalmologist supervision if you have severe case of Ocular Rosacea.  Ocular Rosacea can lead to loss of vision.
• Do not use Soolantra® cream if you have a sensitivity to Ivermectin, the active ingredient, or you are sensitive to any of the inactive ingredients: carbomer copolymer type B, cetyl alcohol, citric acid monohydrate, dimethicone, edetate, disodium, glycerin, isopropyl palmitate, methylparaben, oleyl alcohol, phenoxyethanol, polyoxyl20 cetostearyl ether, propylene glycol, propylparaben, purified water, sodium hyroxide, sorbitan monostearate, and stearyl alcohol
• We do NOT prescribe Soolantra® cream to anyone under the age of 18. Studies of Ivermectin safety have NOT been performed in children under 15 kg.
• Soolantra® cream is not to be used in the eyes, orally or intravaginally.

IMPORTANT PRECAUTIONS and WARNINGS

• Soolantra® cream is NOT for oral, ophthalmic or intravaginal use.
• Ivermectin may cause dizziness.   Use caution upon standing.  Get up slowly when rising from a sitting or lying position.
• Serious side effects are very rarely reported.  But if you have any rare serious side effect or allergic reaction such as rash, itching/swelling, severe dizziness or trouble breathing seek immediate medical attention.

ADVERSE REACTIONS

SIDE EFFECTS:

Clinical trials have been conducted in 2047 subjects with inflammatory rosacea lesions:  1555 subjects were treated once daily for more than 12 weeks, and 519 were treated for approximately one year.

Adverse reactions, reported in less than 1% of subjects treated with Soolantra® cream for at least 3 months, included skin burning sensation and skin irritation.

• The majority of patients using Soolantra® report no side effects.
• Rarely there have been reports of mild side effects such as headaches, dizziness, muscle pain, nausea or diarrhea when taking Oral Ivermectin. But Soolantra® cream is NEVER to be taken orally.
• There are NO systemic CNS toxicity as Ivermectin does not cross the blood-brain barrier.