Is topical ivermectin approved or recommended by dermatologists for basal cell carcinoma treatment?
Executive summary
Topical ivermectin is not an approved or standard dermatologic therapy for basal cell carcinoma (BCC); major dermatology guidance explicitly discourages its use for skin cancer and the peer-reviewed literature supports established topical agents and surgical options instead [1] [2] [3]. Small laboratory studies and scattered case reports or online anecdotes have prompted interest, but they do not amount to regulatory approval or guideline endorsement [4] [5] [6].
1. What “approved” would mean — regulators and guideline bodies say no
Regulatory and professional lists of approved skin‑cancer drugs and formal dermatology guideline statements do not include topical ivermectin as a treatment for BCC: cancer drug pages and approval compendia list agents authorized for skin cancers but do not list ivermectin for BCC [7], and the American Academy of Dermatology has been reported to recommend against using topical ivermectin for skin cancer because evidence is lacking [1].
2. The evidence base: laboratory signals, but no reliable human trials for BCC
Basic science and preclinical work have explored ivermectin’s antiproliferative effects in various cancer cell lines and animal models, producing hypotheses about anticancer activity [4], yet systematic reviews and clinical summaries of topical treatments for BCC show that topical approaches are evidence‑based only for select low‑risk superficial lesions and emphasize agents with demonstrated clinical trials (e.g., imiquimod in Europe), not ivermectin [2] [3].
3. Dermatology practice and off‑label use: what clinicians are saying
Practicing dermatologists and specialty clinics note that using ivermectin for skin cancer is off‑label and “not scientifically proven,” warning of risks such as scarring, infection, and delayed definitive therapy while pointing out that there are proven, supervised alternatives for BCC that preserve function and cosmetic outcome [8] [3] [2].
4. Ivermectin’s dermatologic footprint — legitimate uses, limited percutaneous delivery
Ivermectin has established dermatologic uses (for example, topical ivermectin formulations for parasitic dermatoses and oral ivermectin for scabies in some guidelines), and literature documents little transdermal absorption after topical application and known pharmacokinetic nuances that matter clinically [9] [10], which further undercuts any presumption that a commercially available topical would reliably deliver anti‑tumor doses into BCC tissue.
5. Anecdotes, case reports and the risk of misleading success stories
A small number of case reports and internet compilations tout “success stories” of ivermectin (topical or systemic) against skin cancers, but these are anecdotal, often lack controls, and are not substitutes for randomized trials or regulatory review; research repositories and practitioner summaries emphasize that such reports do not justify recommending ivermectin for BCC in standard practice [5] [6] [8].
6. Bottom line for clinicians and patients: not approved, not recommended
Given the absence of regulatory approval for BCC, explicit discouragement in dermatology guidance, the lack of rigorous clinical trial evidence for topical ivermectin in BCC, and available proven local therapies (surgical and selected topical agents) that are recommended for appropriate lesions, topical ivermectin should not be considered an approved or recommended treatment for basal cell carcinoma by dermatologists [7] [1] [2] [3].