Rosacea Treatment Comparison Tool
Use this interactive tool to compare key features of different rosacea treatments. Select a treatment below to see detailed information about its mechanism, onset time, side effects, and average monthly cost.
Select a treatment option above to view details
| Treatment | Mechanism | Onset Time | Side Effects | Monthly Cost (UK) |
|---|---|---|---|---|
| Soolantra (Ivermectin) | Mite-kill + anti-inflammatory | 4-6 weeks | Mild burning, dry skin | £45-£55 (NHS prescription) |
| Metronidazole | Anti-bacterial, anti-inflammatory | 6-8 weeks | Stinging, dryness | £20-£30 |
| Azelaic Acid | Keratinisation regulator, antimicrobial | 4-8 weeks | Tingling, mild erythema | £15-£25 (OTC) |
| Doxycycline (low-dose) | Anti-inflammatory (sub-antimicrobial) | 2-4 weeks | Gastro-intestinal upset, photosensitivity | £10-£18 |
| Brimonidine | Vasoconstriction | Minutes (peak at 1-2 h) | Rebound redness, irritation | £30-£40 |
| Isotretinoin | Sebum suppression, keratin normalisation | 1-3 months (steady improvement) | Dry lips, teratogenic risk, liver enzyme changes | £80-£120 (specialist prescription) |
When tackling Soolantra is a topical 1% ivermectin cream prescribed for rosacea, many wonder how it stacks up against other options. This guide walks through a side‑by‑side Soolantra comparison of the most common alternatives, so you can pick the one that fits your skin, budget and lifestyle.
Quick Takeaways
- Soolantra works by killing the Demodex mites that often aggravate papulopustular rosacea.
- Metronidazole remains the cheapest topical, but takes longer to clear inflammation.
- Azelaic acid is a good over‑the‑counter (OTC) choice for mild‑moderate cases and also brightens pigmentation.
- Oral doxycycline offers rapid reduction of redness, but systemic side effects require monitoring.
- Brimonidine provides instant flushing relief but does not treat the underlying inflammation.
- Isotretinoin is reserved for severe, refractory rosacea and needs strict medical supervision.
What Is Soolantra?
Soolantra is a prescription‑only, 1% ivermectin cream approved by the MHRA for the treatment of papulopustular rosacea. The gel‑like formulation is applied once daily to the affected facial areas.
Clinical trials in the UK showed that after 12 weeks, 52% of users achieved clear or almost clear skin, compared with 32% on placebo. The drug is particularly effective when a high density of Demodex mites is present, a factor often confirmed by dermatologist skin‑scraping.
How Does ivermectin Work?
Ivermectin binds to glutamate‑gated chloride channels in the nerve and muscle cells of the mite, causing paralysis and death. In addition, it exhibits anti‑inflammatory properties by reducing cytokine release from skin‑resident immune cells. This dual action tackles both the microbial trigger and the inflammatory cascade that fuels rosacea flare‑ups.
Top Alternatives to Consider
Below is a quick rundown of the most widely used rosacea therapies, each with its own sweet spot.
- Metronidazole - a nitroimidazole cream (0.75%‑1%) that interferes with bacterial colonisation and reduces inflammation. It’s the historic workhorse and often the first prescription.
- Azelaic Acid - a naturally occurring dicarboxylic acid (15%‑20% cream or gel) that kills acne‑causing bacteria, reduces keratinisation and fades post‑inflammatory hyperpigmentation. Available OTC in the UK.
- Doxycycline - a low‑dose (40mg) oral tetracycline taken daily for 8‑12 weeks, targeting the inflammatory component without strong antibacterial pressure.
- Brimonidine - a topical alpha‑2 adrenergic agonist (0.33% gel) that constricts superficial blood vessels, giving an almost immediate reduction in facial redness.
- Isotretinoin - an oral retinoid (often 0.5mg/kg) reserved for severe, refractory cases; it shrinks sebaceous glands and normalises keratinisation.
Side‑by‑Side Comparison
| Medication | Mechanism | Typical Onset | Common Side Effects | Average Cost (per month) |
|---|---|---|---|---|
| Soolantra (ivermectin) | Mite‑kill + anti‑inflammatory | 4‑6 weeks | Mild burning, dry skin | £45‑£55 (NHS prescription) |
| Metronidazole | Anti‑bacterial, anti‑inflammatory | 6‑8 weeks | Stinging, dryness | £20‑£30 |
| Azelaic Acid | Keratinisation regulator, antimicrobial | 4‑8 weeks | Tingling, mild erythema | £15‑£25 (OTC) |
| Doxycycline (low‑dose) | Anti‑inflammatory (sub‑antimicrobial) | 2‑4 weeks | Gastro‑intestinal upset, photosensitivity | £10‑£18 |
| Brimonidine | Vasoconstriction | Minutes (peak at 1‑2h) | Rebound redness, irritation | £30‑£40 |
| Isotretinoin | Sebum suppression, keratin normalisation | 1‑3 months (steady improvement) | Dry lips, teratogenic risk, liver enzyme changes | £80‑£120 (specialist prescription) |
How to Choose the Right Option for You
Think of the decision as a simple checklist. Ask yourself:
- What’s my rosacea subtype? Papulopustular flare‑ups often respond best to Soolantra or metronidazole, while persistent facial erythema may benefit from brimonidine.
- Do I need a quick cosmetic fix? If you need redness gone for a special event, brimonidine gives results within minutes, whereas topical or oral anti‑inflammatories need weeks.
- Am I comfortable with a prescription? OTC options like azelaic acid avoid doctor visits but may be less potent for severe pustules.
- What’s my budget? Low‑dose doxycycline and azelaic acid are the cheapest long‑term solutions; Soolantra sits in the mid‑range.
- Any contraindications? Pregnant or nursing patients should avoid isotretinoin and doxycycline; those with sensitive skin may experience irritation from metronidazole.
Once you rank these factors, the table above makes the trade‑offs crystal clear. For most adults with moderate papulopustular rosacea, starting with Soolantra offers a balanced mix of efficacy, safety and convenience.
Practical Tips for Getting & Using Your Treatment
- Prescription pathway: In the UK, Soolantra, metronidazole, doxycycline and isotretinoin require a GP or dermatologist script. Many online pharmacies now offer a tele‑consultation that can issue a private prescription within 48hours.
- Application routine: Cleanse with a gentle, pH‑balanced cleanser, pat dry, then apply a pea‑sized amount of cream to each affected area. Avoid the eye zone.
- Sun protection: All rosacea meds increase photosensitivity. Use a broad‑spectrum SPF30+ mineral sunscreen daily.
- Monitoring: For oral doxycycline or isotretinoin, schedule liver function tests after the first month. Report any severe dryness or worsening redness immediately.
- Combining treatments: You can layer a non‑comedogenic moisturizer under Soolantra, but avoid mixing two topical anti‑inflammatories (e.g., Soolantra + metronidazole) unless advised.
Frequently Asked Questions
Is Soolantra safe for long‑term use?
Clinical data up to three years show no cumulative toxicity. The most common long‑term issue is mild skin dryness, which can be managed with a fragrance‑free moisturizer.
Can I use Soolantra and azelaic acid together?
Yes, if you apply azelaic acid in the morning and Soolantra at night. Both are gentle, but start with alternate days to see how your skin reacts.
Why does my doctor suggest doxycycline over a cream?
Oral low‑dose doxycycline reaches deeper skin layers and reduces inflammatory lesions faster than most topicals, making it ideal for moderate‑to‑severe papules.
Is brimonidine suitable for daily use?
It can be used daily, but some patients experience rebound redness when they stop. Use it only when you need an immediate cosmetic fix, not as a primary anti‑inflammatory.
What are the risks of isotretinoin for rosacea?
Besides the well‑known teratogenicity, isotretinoin can cause severe dryness, liver enzyme elevation, and mood changes. It’s reserved for patients who have failed all other therapies.
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Gina Lola
2/Oct/2025Yo, the Soolantra mechanism is basically a dual‑action kill‑and‑calm combo – it knocks out Demodex mites while dialing down the cytokine cascade, so you get that anti‑inflammatory boost without the classic antibiotic resistance worries.
Leah Hawthorne
2/Oct/2025The table you posted is spot on; the onset time for doxycycline is indeed the fastest among oral options, but keep an eye on photosensitivity, especially during summer months.
Jolanda Julyan
2/Oct/2025Soolantra is the champion for papulopustular rosacea.
It attacks the mites that make the skin red.
No other cream does that.
Metronidazole just masks the problem.
Azelaic acid is good for mild cases but not for big breakouts.
Doxycycline works but it is a pill and can upset your tummy.
Brimonidine hides the red for a short time only.
Isotretinoin is risky and needs a specialist.
The cost of Soolantra is worth it for real results.
Patients who stick to the regimen see clear skin in weeks.
The side effects are mild, just some dryness you can manage.
Doctors should put Soolantra first on the list.
Insurance often covers it, so budget is not a big issue.
Stop wasting money on creams that do nothing.
If you have severe flare‑ups, combine Soolantra with a gentle moisturizer.
Bottom line: pick Soolantra unless you have a specific allergy.
Kevin Huston
2/Oct/2025I’m all about that ivermectin power.
Amanda Hamlet
2/Oct/2025Honestly, u cant bLindly trust that cheap azelaic acid, it’s just a gimmick and u’ll be stuck with red skin forever if u don’t switch to a proper prescriotion.
Nolan Jones
2/Oct/2025Pro tip: Apply Soolantra at night after a quick splash of water‑free cleanser, then lock in moisture with a fragrance‑free lotion – that’ll keep the dryness down.
Jada Singleton
2/Oct/2025The comparison table omits a critical factor: patient adherence. Even the most efficacious drug fails if the regimen isn’t followed, so real‑world studies should be highlighted.
Emily Rossiter
2/Oct/2025Great rundown! For anyone feeling overwhelmed, start with the cheapest option that matches your symptoms and step up only if needed.
Renee van Baar
2/Oct/2025Remember that rosacea affects a diverse group of people; skin tone can influence how redness appears, so choosing a treatment that also addresses post‑inflammatory hyperpigmentation can be beneficial.
Mithun Paul
2/Oct/2025It is incumbent upon the practitioner to evaluate the pharmacoeconomic implications of each therapeutic modality, thereby ensuring that the prescribed regimen aligns with both clinical efficacy and patient affordability.
Sandy Martin
2/Oct/2025While ivermectin’s rapid action is appealing, clinicians should also consider its long‑term safety profile, especially in patients with compromised barrier function.
Steve Smilie
2/Oct/2025Dearest interlocutor, your assertion betrays a lamentable paucity of dermatological insight; the nuanced interplay between mite eradication and inflammatory modulation renders Soolantra a paragon of therapeutic elegance.
Josie McManus
2/Oct/2025i see u r super pumped bout soolantra, but dont forget u need to be consistent and maybe pair it w/ a gentle moisturizer so the skin dont get too dry.
Justin Durden
2/Oct/2025nice observation, leah – just add that some folks cant afford doxy, so they might need a tiered approach with metronidazole first.
Sally Murray
2/Oct/2025Your concise delineation of Soolantra’s dual mechanism is commendable; nevertheless, an exploration of the underlying immunological pathways would enrich the discourse.
Adam Shooter
2/Oct/2025jada, your point about adherence is valid, yet the literature demonstrates that once‑daily regimens like Soolantra markedly improve compliance versus multi‑dose protocols.
Shanmughasundhar Sengeni
2/Oct/2025yeah, emily, i kinda feel the guide is decent but kinda generic, need more real‑life anecdotes to make it pop.