Scalp Rosacea Treated with Topical Ivermectin

Abstract

Introduction: Scalp rosacea is often misdiagnosed or overlooked, and few reports deal with this peculiar localization. Furthermore, the pharmacological approach to scalp rosacea remains a therapeutic challenge, as no topical and/or systemic drugs have been approved for this specific area so far.

Case presentation: A series of 5 adult patients affected by inflammatory rosacea and concurrent scalp involvement, confirmed by dermoscopy and histopathology with negative microbiologic swabs, and effectively treated with ivermectin 1% cream once daily for 12 weeks is presented.

Conclusion: Our experience, although limited, suggests that evaluation of rosacea subjects should also include the scalp and that the treatment with ivermectin 1% cream may be effective on scalp rosacea.

Keywords: Ivermectin 1% cream for scalp rosacea; Scalp rosacea; Scalp rosacea clinical monitoring.

Fig. 1.

a Patient with mild/moderate inflammatory rosacea and rhinophyma, showing multiple scattered pustules in the right temporal region with sparing of bald scalp areas. b Clinical resolution after once daily of IVM 1% cream for 12 weeks. It should be noted that the inflamed rhinophyma also improved after treatment. In the black circle is the scar of the skin biopsy. We received a signed patient consent form to publish all photographic materials.

Fig. 2.

a Patient with moderate inflammatory facial rosacea (insert), showing on the scalp, in a diffusely erythematous background, several pustules that caused intense burning and located both inside and outside the AGA area. b Clinical resolution of facial (insert) and scalp rosacea after once daily delete IVM 1% cream for 12 weeks. We received a signed patient consent form to publish all photographic materials.