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Can using veterinary ivermectin (horse paste) on the face cause permanent scarring?
Executive summary
There is widespread reporting and some clinical caution about people using veterinary “horse paste” ivermectin on their faces instead of prescription 1% topical ivermectin; veterinary pastes typically have higher ivermectin concentrations (commonly ~1.87%) and contain non‑dermatologic excipients that may irritate skin [1] [2]. Available sources document dermatologists’ concern about irritation, unknown pharmacokinetics and potential adverse reactions, but they do not provide a body of evidence showing how often or whether such use causes permanent scarring [3] [1].
1. Why people try horse paste on their faces: cheap active ingredient, expensive prescription
Patients and commentators report that the active drug in Soolantra (ivermectin 1% cream) is the same antiparasitic compound found in many veterinary horse pastes, and cost pressure drives some to apply the cheaper veterinary product topically for rosacea or Demodex‑related complaints [1] [4]. Consumer accounts describe mixing or diluting horse paste to make it more spreadable and affordable compared with prescription creams that can cost hundreds of dollars [4] [1].
2. What’s different between human topical ivermectin and horse paste
Clinical pieces and dermatologists point out two main differences: concentration and formulation. Human topical ivermectin is a 1% cream with known dermatologic formulation and pharmacokinetics; many horse pastes are labeled ~1.87% ivermectin and are formulated for oral use in horses, containing flavors, thickeners and excipients not intended for facial skin [2] [3]. The pharmacokinetics of applying 1.87% oral paste to human skin are described as unknown in peer‑reviewed reporting [3].
3. Reported harms and dermatologist warnings — irritation more likely than proven scarring
Dermatologists interviewed and clinical commentaries warn against using veterinary ivermectin because off‑label topical application may irritate skin, be hard to spread, and produce unpredictable absorption; these sources express concern but do not provide systematic data proving frequent permanent scarring from such use [1] [2] [3]. A peer‑reviewed note cautions that misuse could cause inadvertent use of other topical agents and raises the specter of resistance, but it does not cite cases of permanent scarring from horse paste on human faces [3].
4. What the literature and product info actually document
Product labeling for ivermectin paste intended for horses records possible swelling and itching reactions in horses and details dosing for equine use; it does not describe human facial scarring because it is not intended for that use [5]. Clinical reports of topical ivermectin 1% (human formulation) show effectiveness and low systemic absorption when used as designed, but those findings don’t transfer automatically to veterinary pastes with different vehicles and concentrations [6] [3].
5. Anecdotes vs. peer‑reviewed evidence — a gap in the record
There are anecdotal patient reports and opinion pieces claiming improvement or tolerance when people used horse paste topically (for example a personal essay reporting improvement over months), yet these are individual experiences and not controlled studies; they do not establish safety or risk of scarring [4]. Peer‑reviewed dermatology commentaries document concern and unknowns but do not quantify long‑term skin injury or scarring rates from veterinary paste use [3] [7].
6. Practical takeaways and competing perspectives
Dermatologists and academic commentators uniformly advise caution: human topical ivermectin has known dosing and formulation; veterinary pastes do not, and they may irritate or be harder to control in dose [1] [2] [3]. Some patients report positive results and cost savings by repurposing horse paste, reflecting a frustration with prescription costs [4] [1]. Available sources do not mention documented cases of permanent facial scarring from applying veterinary ivermectin paste; they instead emphasize unknown pharmacokinetics and risk of irritation and misuse [3] [5].
7. What to do if you or someone already applied horse paste to the face
The reporting recommends consulting a dermatologist rather than assuming safety; clinical sources stress that unregulated use carries unpredictable risks and that professional guidance is missing in the literature about topical application of veterinary paste [3] [1]. If you experience marked swelling, blistering, spreading rash, or persistent wounds after application, seek medical evaluation — current sources do not supply definitive outcomes for such reactions [3] [5].
Limitations: This summary uses the provided reporting, which highlights clinical caution and anecdote but does not contain systematic studies proving permanent scarring from veterinary ivermectin paste used on human faces; available sources do not mention documented rates or confirmed case reports of permanent facial scarring [3] [1].