Horse paste contains ivermectin, the same active ingredient as Soolantra, a Food and Drug Administration-approved topical gel that is commonly prescribed to treat rosacea. Soolantra is very expensive and typically sells between $550 and $615 and is usually prescribed as a part of step therapy. Patients are often required to take a battery of other medications before using Soolantra.
On Facebook and Reddit, users are sharing their experiences using horse paste as a more affordable alternative. A single dose of the paste goes for as little as $2 online, and no prescription is required. To make it easy to digest, the paste comes in a syringe and sometimes comes with artificial flavoring to make it appealing to the horses.
Physicians are growing concerned about horse paste’s rising popularity. Although it’s cheaper, it hasn’t been tested on humans, and it contains almost double the dosage of ivermectin (1.87 percent versus Soolantra’s 1 percent). Margo Weishar, MD, a cosmetic dermatologist based outside of Philadelphia, says that horse paste “may be irritating, cause allergy, or worse when applied to skin.”
However, according to INSIDER, there are success stories of patients using horse paste. One anonymous Reddit user said that after applying horse paste twice a day for four months they noticed their type 1 rosacea improving. "I decided to try horse paste because I saw some before and after pictures of a young woman on a rosacea support page on Facebook," they said. "I never achieved the reduction of brightness I was hoping for, but I understand everyone is different and I'm happy with my results. I know it doesn't work for everyone, but they won't know until they try it, and they can't try it if they don't know about it."