Ivermectin 1% cream (Soolantra) beats metronidazole — the previous rosacea gold standard — from week 3 in head-to-head trials. This 2026 dermatology guide covers FDA-approved topical uses (rosacea + head lice Sklice), the dual Demodex-killing + anti-inflammatory mechanism, topical scabies evidence, correct application technique, a topical vs oral comparison table, and realistic result timelines.