Ivermectin in Dermatology

Ivermectin use in Dermatology 

I recently had a patient who treated her skin cancer with ivermectin cream because she was nervous about traditional therapies.  Honestly, it looked like it worked, for now.  While I like creativity and experimentation, it made me curious if there was any real science to support the use of ivermectin for treating skin cancer. If you don’t have time to read the rest of the article.  The answer is NO.

Ivermectin is trendy right now.  One thing that I find increasingly difficult is separating scientific facts from social media hype in our minds.  Unfortunately, everyone is an expert.  I would like to reassure my readers, that what I write on this blog may not be popular, but it is backed by real scientific facts.   

Since the 1970s, ivermectin was used to treat “worms” and other parasites, primarily in the farming industry, which is why it is available for off label use at farm supply stores.  It paralyzes and kills parasites through chloride ion channels.  It was approved for human use in 1987 to treat tropical diseases such as onchocerciasis, and it is widely used in third world countries for tropical disease prevention.

In dermatology, we have used small doses of oral Ivermectin to treat lice and scabies for many years.  In the office, it is my preferred treatment, because it is “foolproof” compared to complex at home regimens with creams.   

The other major use of ivermectin in dermatology has been in a rosacea cream branded Soolantra.  In rosacea, ivermectin primarily worked by killing Demodex mites that can live in the pores and aggravate rosacea. The name brand is no longer available because patent infringement issues with generic ivermectin.  While a few patients find success with the generic ivermectin cream, use of ivermectin for rosacea has fallen by the wayside.  

During the height of the COVID-19 pandemic, ivermectin was socially recommended as a COVID treatment.  Admittedly, we were all grabbing at straws during that difficult era.  There is some evidence that ivermectin does have some antiviral effects, but this is still under investigation.

When researching the impact of ivermectin on cancer, I found a great reference that thoroughly discusses the use of ivermectin to treat all kinds of cancer.  My summary is that there are lots of studies that show possible efficacy in vitro (cells in a Petri dish), but these have not been thoroughly extended and tested in humans.  In studies that found ivermectin to be effective, the concentration was much higher than anything previously show to be safe in humans.

In Vitro cell studies are how many scientific studies start.  If promising in a laboratory, the next step is to experiment in animals.  Then, if it is still promising, human studies are undertaken.  This process from In vitro to humans takes many, many years.  

Skin cancer treatment is a whole different ballgame.  Using ivermectin to treat skin cancer is definitely off label and not scientifically proven.  Plus, we have known effective therapies to treat skin cancers and precancers that have proven safety and efficacy.   

As a reminder, there are three main types of skin cancer.  Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma.  Actinic keratosis is the scientific name for precancerous lesions.  Scientific literature yielded ZERO articles of studies done with Basal Cell Carcinoma, Skin Squamous Cell Carcinoma and Actinic Keratoses.

While there have been some in vitro studies with melanoma, none of them have been extended to humans.  The main animal study highlighted using ivermectin to induce a metastatic melanoma like state in tadpoles.  

So, can I recommend ivermectin as a safe and effective therapy for skin cancer?  NO. 

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