Soolantra Review by Brady Barrows

[Guide]

Please note: This review was sometime back and you can see the dates of each post in this thread. My current regimen for rosacea can be viewed in my Rosacea Blog. However, in the spirit of 'everything rosacea' I have posted my experience using Soolantra for a number of months in this thread for your enjoyment and education. 

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Just got my prescription for Soolantra* today and applied it all over every red spot I have on my face and forehead just before bed. It took over eleven days for my insurance company to approve the prescription drug. I will be posting in this thread my experience using Soolantra. Hoping this works. 

*My insurance initially would not approve it. I called the insurance company and asked for a second review and after the eleven days of waiting it was approved. Walmart posts that the cost is $346.62 for 30 gram tube. 

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[Guide]

It has now been over one week since I started using Soolantra. I apply it in the evening just before bed. After the fourth day I had about four or five white capped papules appear on my cheeks which I removed. On the eighth day I have noticed an improvement.  I apply it over the red spots on my forehead and cheeks. Attached are photos on day eight. 

[Guide]

It has been one month. I apply Soolantra on all my red spots every night. I wash my face in the morning and apply absolutely nothing. I have tried to keep my diet going as best as I can. This past week I did have a couple of Longboard beers. Other than than those two beers, a very healthy high protein diet with some green veggies, lots of water, plenty of exercise (Walk 4.4 miles to the beach about four or five times a week). I haven't seen much improvement in my rosacea, but I will stay on this for three months to see what happens. Basically, after thirty days I am still breaking out with rosacea. I get those little white pustules and they turn into scabs after I remove them. I will stick it out 90 days to see if it improves. It is tough to go through this. Using sulphur creams works for me so to try this regimen isn't for sissies. Here are my photos: 

[MariaSt]

Hi, Brady. I think that you are doing just fine. I had a similar experience with a generic ivermectin cream,after an initial breakout with some red spots, which vanished fast, I didn't notice any significant improvement for the next 7 weeks and stopped the treatment, unfortunately. I understood my mistake a few days later, when my skin started deteriorating again. Anyway, there are some people who report improvement after many months of use, so be patient.

[Guide]

8 hours ago, MariaSt said:

Hi, Brady. I think that you are doing just fine. I had a similar experience with a generic ivermectin cream,after an initial breakout with some red spots, which vanished fast, I didn't notice any significant improvement for the next 7 weeks and stopped the treatment, unfortunately. I understood my mistake a few days later, when my skin started deteriorating again. Anyway, there are some people who report improvement after many months of use, so be patient.

Thanks MariaSt for the encouragement. Yes, from what I have read from other users it takes months to see improvement. I am willing to try 90 days and if there is improvement I will stick it out longer. But if I keep looking like this, I know how to control my rosacea with sulphur creams and diet. I also take probiotics. So what is your current regimen?

[MariaSt]

I have been using benzyl benzoate 10% on my eyelids and face for a month, it's too soon to tell about its effectiveness on my face, but according to my eye doctor, my blefaritis is much better. And of course, the diet. In between ivermectin and bb, I was using sulfur creams, (the zz cream was great for the p&p, I still keep it as a spot treatment), but they didn't help with my redness. And of course, I have to stick to the diet, to avoid breakouts. I tried probiotics in the past, but they caused me abdominal pain,so I stopped.

[Guide]

The Soolantra seems to be improving my skin after 45 days. Still some redness showing but it is definitely improving. Hope this keeps working. 

 

[MariaSt]

There is a huge difference between the "before" and the "during the treatment" photos. This is definitely working. You might have another die-off on week 6, but it shouldn't be as bad as the first one.

[Guide]

It has been two months now using Soolantra, every night at bedtime. There is some improvement after sixty days. I just got my third tube of Soolantra which lasts about a month and will give it one more month. 

[Rory]

Hi Brady

I see a nice improvement at day 45. The 2 month mark seems ok but still a fair improvement from baseline. I look forward to the 3 month finish line. But I don't think you should stop there. Remember the Soolantra extended study? 40% of patients were clear/almost clear at 12 weeks and a further 30%, who saw improvement at 12 weeks, were clear/almost clear at 52 weeks.

[Guide]

5 hours ago, Rory said:

Hi Brady

I see a nice improvement at day 45. The 2 month mark seems ok but still a fair improvement from baseline. I look forward to the 3 month finish line. But I don't think you should stop there. Remember the Soolantra extended study? 40% of patients were clear/almost clear at 12 weeks and a further 30%, who saw improvement at 12 weeks, were clear/almost clear at 52 weeks.

Rory, 

Thanks for the encouragement. I guess you are probably right. 90 days simply isn't enough time. I do see a little improvement but it is a tough regimen to go through. Breaking out with rosacea after using it isn't exactly my cup of tea, but I have read several other anecdotal reports that many go through similar flareups after applying Soolantra. One year is a long time to be patient for results. Did you go through all this with Soolantra?

[Rory]

Soolantra didnt help me. The study was 52 weeks but that doesn't mean it took that long for the entire 30% to clear. See how you feel about it next month. 

[Rory]

http://onlinelibrary.wiley.com/doi/10.1111/all.13118/full

Galderma have been studying the anti inflammatory effects of Soolantra. IMO this is what differentiates the 40% who cleared in 3 months and the 30% who cleared in 12 months. It now seems clear that the 30% were dealing with far more than just Demodex. After reading this new research, I sometimes wonder if it's such a good idea to wash one's face in the morning after applying Soolantra the night before. Particularly if you belong to the 30%. In effect, washing away the anti inflammatory effects at the start of a new day. 

Just a thought.

[Guide]

So how long were you on Soolantra total Rory?

[Rory]

I tried it on 2 occasions and I think the max I lasted was about 6 or 7 weeks. I may even try It a third time. 

[Guide]

Update today 92 days on Soolantra. Just a little improvement from a month ago. I will stay the course for one more month. 

[Rory]

Looks good Brady. I'm curious. How would you compare compare your results so far with Soolantra to years of using ZZ cream? 

I started Soolantra again 2 weeks ago. 

[Guide]

On 2/2/2017 at 11:27 PM, Rory said:

Looks good Brady. I'm curious. How would you compare compare your results so far with Soolantra to years of using ZZ cream? 

I started Soolantra again 2 weeks ago. 

I would say the ZZ cream works better. However, the ZZ cream is more expensive than Soolantra since my insurance pays for it. 

[Rory]

What I find odd are the ups and downs you're experiencing with Soolantra. I have read many stories of people having these ups and downs with ZZ cream which is believed to be a purge or Demodex die-off. But since you were using ZZ for years before starting Soolantra, I would have thought the purge or die-off or whatever the ups and downs really are, were well behind you. Did you suffer flares when you started ZZ cream years ago?

[Guide]

7 hours ago, Rory said:

What I find odd are the ups and downs you're experiencing with Soolantra. I have read many stories of people having these ups and downs with ZZ cream which is believed to be a purge or Demodex die-off. But since you were using ZZ for years before starting Soolantra, I would have thought the purge or die-off or whatever the ups and downs really are, were well behind you. Did you suffer flares when you started ZZ cream years ago?

Rory, 

Basically I controlled my rosacea with my Rosacea Diet and the ZZ cream all those years. This didn't cure it, but it works to control it. If I went off my diet I would get a zit or two or even more depending on how far I strayed from my diet. My rosacea really shows up quickly after I eat sugar/carbohydrate whether on the ZZ cream or Soolantra. For the past year I was using the Sulphur Butter to save some money and see if it works, which it does but not as good as the ZZ cream since my skin is oily and I prefer the way the ZZ cream dries up my skin. 

I read all those incredible results of those who say Soolantra works for them and simply wanted to try it. Today Soolantra seems to be improving my skin so I am hoping after four months it works. Most reports from users say they have to keep using it on a maintenance basis dabbing it on a flareup to keep it under control. With my insurance Soolantra is cheaper than the Sulphur Butter. 

My understanding is that if demodex is the culprit, demodex simply keep coming back, hence, the need to keep using Soolantra. 

The only way to know if a rosacea treatment works is to try it. And we know that it takes time, usually months, to know for sure. 

[MariaSt]

Brady, do you think you have demodex folliculorum or brevis?

[Rory]

I noticed where some people reported being able to eat anything after treatment with Soolantra. But i can see that you haven't been that lucky. There was no mention of any kind of diet used in the Soolantra studies.But maybe the 30% who failed to see any improvement could have benefited from restricting carbs. From what I understand so far about you, neither ZZ cream nor Soolantra would help if you didn't adhere to a low carb diet. If that's the case then Its somewhat disappointing because it shows that you still haven't got to the route cause of your particular type of Rosacea. 

[Guide]

19 hours ago, MariaSt said:

Brady, do you think you have demodex folliculorum or brevis?

Not sure, but most reports say demodex folliculorum is the culprit. Never have tested for demodex. 

[Guide]

On 2/6/2017 at 3:22 PM, Rory said:

I noticed where some people reported being able to eat anything after treatment with Soolantra. But i can see that you haven't been that lucky. There was no mention of any kind of diet used in the Soolantra studies.But maybe the 30% who failed to see any improvement could have benefited from restricting carbs. From what I understand so far about you, neither ZZ cream nor Soolantra would help if you didn't adhere to a low carb diet. If that's the case then Its somewhat disappointing because it shows that you still haven't got to the route cause of your particular type of Rosacea. 

Rory,

It has never been proven whether killing the mites improves the rosacea or if the density count is different when using Soolantra. Do the numbers actually go down after using Soolantra? We really don't know for sure. There are no studies done on this. 

A paper published by the American Journal of Clinical Dermatology in April 2015 succinctly clarifies the controversy:

 “According to Rothman’s model of causality, Demodex mites are probably a non-necessary and non-sufficient cause of rosacea.”

[Note added 2/23/2021 that one week after this post there is now evidence that reducing the mite count improves rosacea. Read this post, Decreasing Demodex Density Count Improves Rosacea]

What we do know is that Soolantra use with improvement of rosacea implies that treating for demodectic rosacea is warranted. In other words, if it works for some then it is a valid treatment. 

As for sugar/carbohydrate avoidance, you will note that physicians rarely if ever mention this as a rosacea trigger. Only the RRDi recognizes sugar/carbohydrate as a rosacea trigger. There are few, if any, clinical papers on this subject. I do agree with you that if those who use Soolantra also avoided sugar/carbohydrate they would notice better improvement. 

[Rory]

Sorry Brady but I didn't say that those using Soolantra would notice a better improvement with a low carb diet. I was referring to the 30% of participants in the Soolantra study who failed to see any improvement. 70% of participants were clear/almost clear without any mention of a diet. Also, I have no idea what most of your last post has to do with my previous post. What exactly Soolantra does for Rosacea may very well still be a little up in the air. My previous post was specifically looking at your case, where it seems that Soolantra or ZZ cream will treat your secondary symptoms, and diet addresses the primary cause. Or maybe it's the other way round. I was hoping that Soolantra could have treated both aspects of your Rosacea, but that doesn't seem to be the case so far. 

Like I've said, there have been some people on the Soolantra thread who have reported being able to eat and drink whatever they want while using Soolantra. But I guess this may not apply to all of us.