Topical ivermectin modulates the skin microbiome and improves symptoms of rosacea

Rosacea is a chronic inflammatory skin condition that affects 16 million people in the United States, with worldwide prevalence reported as high as 5%. The pathophysiology of rosacea involves an abnormal innate immune response that may include a response to dysbiosis of the skin microbiome, a condition that contributes to inappropriate inflammation in several disease states. Here, we hypothesized that the clinical improvement in rosacea symptoms with topical ivermectin is due not only to a decrease in the Demodex mite population, but also to a change in the population of commensal skin microbes such as coagulase-negative Staphylococcus (CoNS) that contribute to skin health.