Topical Ivermectin With Melatonin for Dry Eye

My dry eye specialist posted a video explaining a new treatment for dry eyes, specifically for meibomian gland dysfunction, blepharitis, and demodex mite overgrowth. The treatment is a topical ivermectin with melatonin compound. He calls it Ivermectin Plus.

What is Ivermectin Plus?

When I saw the video, the only thing that I really knew about ivermectin is that it has been used as a treatment for COVID-19 and that it is used on animals as a dewormer. A quick internet search showed me that it’s also used for parasitic diseases, as well as some skin conditions like rosacea. I quickly remembered that a link between rosacea and dry eye exists as I have been diagnosed with both.

My doctor explained in the video that demodex mites come out at night to feed off of sebum and dead skin cells. They know when it is night because they read the amount of melatonin on a person’s skin. During the day, they bury themselves in pores and in follicles, causing inflammation, and getting them out of their trenches proves difficult.

My doctor explained that determining which comes first, demodex or meibomian gland dysfunction, is hard to conclude. Once a person gets meibomian gland dysfunction, he or she stops having normal tear production, which includes production of lysosomes that kill bacteria and demodex. The cycle then becomes vicious.

Intense pulsed light treatment, which I have been using, kills demodex, but keeping the demodex away between treatments is difficult. Also, IPL won’t kill demodex that are buried in follicles. Neither will the Quantum blue light device, which I use at home. Between IPL treatments, my doctor recommends his patients use Soothe wipes, which contain a hyaluronic complex, on the lids and face. This wipe decreases the sebum and dead skin cells that demodex feed on.

Ivermectin Plus is his newest treatment for demodex, and he says that it has shown to be effective in killing the mites. Melatonin is added to draw the demodex out of their trenches. He uses two formulas, one for the lids and one for the face. The one for the face has a higher concentration of ivermectin, and the one for the lids has a lower concentration. This is because the skin on the lids is thin, and a higher concentration can cause irritation to this delicate area.

My doctor's thoughts about Ivermectin Plus

After watching his video, I decided to ask about using it at my next IPL treatment visit. My doctor was supportive and wrote me a prescription for it. He advised me to use it for 30 days every night before bed and that I wash it off in the morning. Then, I could use it periodically (a couple of times per week) for maintenance.

When I received my prescription in the mail, I noticed that the ivermectin for the lids was in a smaller, pump container than the ivermectin for the face. Also, the lid concentration was smoother and oilier while the face concentration was a little more gritty. My doctor advised that I use just a small amount on both my eyelids and face and that I work the lid formula into my eyelashes as well.

After using Ivermectin Plus for about a month, I noticed that my left eye, which is usually more irritated and swollen feeling, was a little less inflamed. Also, my facial skin was much smoother. I haven’t really noticed a difference in eye dryness yet though. I will continue using the medication until I run out of it and then evaluate whether or not the cost of $100 for the lid cream and $100 for the face cream is worth it.