Anyone combined low-dose Accutane with Soolantra (1% ivermectin) for redness/flushing and papules?
I wanted to see if anyone else has experience combining very low-dose Accutane with prescription topicals like Soolantra, specifically for persistent redness/flushing and small papules alongside acne.
A bit of background:
A few years ago I completed a full Accutane course at 30mg/day. It cleared my skin really well overall, including cystic acne, but I also developed pretty significant redness and flushing while on it, which I honestly hated more than the dryness. After finishing the course, I later ended up using Soolantra (1% ivermectin cream) because my dermatologist suspected there was a demodex/rosacea component contributing to the redness and small bumps I was still getting.
The Soolantra actually worked extremely well for me. My skin calmed down a lot, the persistent redness improved noticeably, and the small uniform papules pretty much disappeared.
Unfortunately over time my acne slowly came back again, including cystic acne, which is why I’ve had to go back onto Accutane. This time though, the plan was to avoid the side effects I got during my first course, so my dermatologist started me on only 5mg/day instead of a more standard dose.
The issue is that even at 5mg/day, I still seem prone to the flushing/redness side effects that I experienced the first time around. The acne itself is improving, but my skin feels reactive again and I’m noticing increased redness/flushing, along with some small papules that almost seem more rosacea-like than acne-related.
I went back to my dermatologist about this and they suggested restarting Soolantra alongside the low-dose Accutane to target the redness and possible demodex inflammation again.
I’m curious if anyone else has done a combination like this:
- low-dose isotretinoin (5mg–10mg daily)
- combined with Soolantra/ivermectin
- especially if you had both acne and rosacea-like symptoms/redness
A few things I’m wondering:
- Did the ivermectin help with the flushing/redness, or mainly the papules?
- Did using Soolantra while on Accutane irritate your skin more?
- How long did it take before you noticed improvement?
- Did the flushing from low-dose Accutane eventually settle down over time?
- Anyone here dealing with a rosacea + acne + demodex overlap?
For reference, my skin used to be oily before Accutane but now leans more normal/sensitive, especially on low dose. I’m also keeping my skincare extremely minimal because my skin reacts pretty easily while on isotretinoin.
Would be interested to hear if anyone has gone through something similar because I don’t see many discussions around combining ultra low-dose Accutane with ivermectin/Soolantra specifically for redness and flushing while still treating acne.