Ivermectin cream beats metronidazole for rosacea (RCT, 2015)

962 people with moderate to severe rosacea bumps were randomly given either ivermectin 1% cream once a day or metronidazole 0.75% cream twice a day, for 16 weeks. Bumps fell 83.0% on ivermectin against 73.7% on metronidazole, and the gap showed up as early as week 3. More people were rated clear or almost clear on ivermectin too (84.9% vs 75.4%), and it was slightly easier on the skin. This is a large head-to-head trial, which is what makes it useful — most creams are only ever compared with a placebo. The assessors were blinded but the patients were not, since the two creams are used on different schedules. Manufacturer-funded.