Soolantra is not a steroid. It contains ivermectin, a compound that belongs to a completely different drug family called macrocyclic lactones. The FDA approved Soolantra in December 2014 specifically for treating the inflammatory bumps and pimples caused by rosacea, and its prescribing information contains no steroid classification of any kind.
What Soolantra Actually Is
Soolantra is a 1% ivermectin cream. Ivermectin is a semi-synthetic compound originally derived from a soil bacterium called Streptomyces avermitilis. It was first developed as an anti-parasitic medication and has been used in oral form since 1996 to treat conditions caused by mites, roundworms, and other parasites. The topical cream version was developed later as a targeted treatment for rosacea.
Steroids used on the skin, known as topical corticosteroids, work by broadly suppressing the immune response and reducing inflammation. Ivermectin works through a different pathway entirely. It has both anti-parasitic properties (it can kill Demodex mites, which are thought to play a role in rosacea flare-ups) and anti-inflammatory effects that reduce redness and swelling without the immune suppression that steroids cause.
Why the Distinction Matters
This isn’t just a technicality. Topical steroids come with a well-known set of risks when used on the face, especially over long periods. They can thin the skin, cause visible blood vessels, trigger rebound flares when stopped, and even cause a condition called steroid-induced rosacea, where the skin develops rosacea-like symptoms as a direct result of steroid use. These risks are why dermatologists generally avoid prescribing topical steroids for facial rosacea.
Soolantra does not carry these risks. Its most common side effects are mild: skin burning sensation (reported in 1% to 10% of users), skin irritation, itching, and dry skin (each reported in fewer than 1% of users). Skin thinning is not listed among its adverse effects. This makes it a much safer option for long-term use on the face compared to any topical steroid.
How Well It Works for Rosacea
In the two pivotal clinical trials that led to FDA approval, Soolantra reduced inflammatory lesion counts by about 65% over 12 weeks. In comparison, patients using a plain moisturizer (vehicle cream) saw reductions of roughly 42% to 43%. That gap is meaningful, and it’s achieved without any of the steroid-related complications that can make facial skin conditions worse over time.
Soolantra is applied once daily to the affected areas of the face. A pea-sized amount is typically enough for each area (forehead, chin, nose, each cheek). Results generally become noticeable after several weeks of consistent use, with the full benefit appearing around the 12-week mark.
If You’ve Been Using Steroids on Your Face
Many people searching this question are already dealing with the consequences of topical steroid use on their face, or they’ve been prescribed Soolantra and want to make sure they’re not getting another steroid. If you’ve been using a topical steroid for rosacea or a rosacea-like condition, switching to Soolantra is a fundamentally different treatment approach. You’re moving from a drug that suppresses your skin’s immune response (and can make things worse when stopped) to one that targets the underlying triggers of rosacea without those risks.
The transition can still involve a temporary flare, particularly if your skin has become dependent on the steroid. That flare is a withdrawal effect from the steroid, not a reaction to the ivermectin. It typically settles as the skin adjusts.