Rosacea is a common long-term skin condition that causes facial redness, flushing, and sometimes acne-like bumps and spots. Ivermectin 1% cream (Soolantra) is a prescription treatment for the bumps and spots, called papulopustular rosacea.

How it works

Tiny mites called Demodex live on everyone’s skin, but people with rosacea often have more of them. Ivermectin reduces these mites and also calms inflammation in the skin.

How to use it

• Apply a pea-sized amount to each area of the face (forehead, chin, nose and each cheek) once a day, spreading it thinly.
• Avoid the eyes, lips and mouth.
• You can apply moisturiser and sunscreen after it has dried.

How long until it works?

Many people see fewer spots within about 4 weeks, with the full effect by around 12 weeks. Rosacea is long-term, so spots can return after stopping, and some people need repeat or ongoing treatment.

Side effects

Side effects are usually mild: a burning or stinging feeling, skin irritation, itching or dryness. Tell your doctor if they don’t settle.

Other treatment options

• Metronidazole gel or cream and azelaic acid: other creams for bumps and spots.
• Brimonidine gel or oxymetazoline cream: reduce persistent redness. Ivermectin doesn’t treat redness or flushing.
• Antibiotic tablets such as low-dose doxycycline for more widespread spots.
• Laser or light treatment for visible blood vessels.

Everyday tips

• Use a gentle, fragrance-free cleanser and moisturiser.
• Wear sunscreen (SPF 30+) every day.
• Notice your triggers. Common ones are sun, heat, spicy food, alcohol, hot drinks and stress.

Is this the same as ivermectin tablets?

No. The cream acts on the skin, and very little reaches the bloodstream. Ivermectin tablets are used for certain parasitic infections. See ivermectin uses and safety.

Ivermectin cream needs a prescription. Ask your doctor or a dermatologist if it’s right for you.

More in our Skin and Fungal Infections guide: all our articles and products on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Sleep is the most overlooked part of weight management. Regularly sleeping less than 7 hours is linked to a higher risk of weight gain and obesity, and improving sleep can make it easier to eat less.

How poor sleep affects weight

• Hunger hormones change. Short sleep raises ghrelin (which makes you hungry) and lowers leptin (which tells you you’re full).
• Cravings increase, particularly for sugary, salty and high-fat foods.
• More time awake means more time to eat, especially late-night snacking.
• Tiredness reduces activity and makes healthy choices harder.

In one study, people who usually slept less than 6.5 hours were helped to sleep about an hour longer. They ended up eating around 270 fewer calories a day without being told to diet.

How much sleep do adults need?

Most adults need 7 or more hours a night.

Tips for better sleep

• Go to bed and wake up at the same time every day, including weekends.
• Get daylight in the morning and stay active during the day.
• Avoid caffeine after early afternoon and limit alcohol, which disrupts sleep later in the night.
• Finish large meals 2 to 3 hours before bed.
• Keep the bedroom cool, dark and quiet.
• Put screens away 30 to 60 minutes before bed.
• If you can’t sleep after about 20 minutes, get up and do something calm until you feel sleepy.

Could it be sleep apnoea?

Loud snoring, pauses in breathing, gasping at night and feeling very sleepy during the day can be signs of obstructive sleep apnoea. It’s more common with excess weight and can make weight loss harder. It’s treatable, so see a doctor if this sounds familiar.

See also: how to lose weight safely and how to lose belly fat.

Related guide: Ashwagandha: benefits, side effects and who should avoid it

More in our Weight Management guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Fat around the middle isn’t just about appearance. The fat deep inside the abdomen, around the organs (visceral fat), is linked to type 2 diabetes, heart disease and high blood pressure. The good news is that it’s often the first fat to go when you lose weight.

Measure your waist

Measure around your middle, just above your hip bones, after breathing out. Health risks rise when the waist is more than 40 inches (102 cm) for men or 35 inches (88 cm) for women. Tracking your waist is also a good way to see progress the scale might miss.

What doesn’t work

• Spot exercises. Sit-ups and crunches strengthen the muscles but don’t burn the fat on top of them.
• “Fat-burning” supplements, teas and wraps. There’s no good evidence they work, and some supplements have been found to contain hidden drugs.

What works

• Overall weight loss. Losing 5 to 10% of your weight reduces visceral fat noticeably. See how to lose weight safely.
• Aerobic exercise. Regular brisk walking, cycling or swimming is particularly good at reducing visceral fat, even before the scale moves much. See walking for weight loss.
• Strength training twice a week to keep muscle.
• Cutting sugary drinks and refined carbs such as white bread, pastries and sweets.
• Limiting alcohol. Heavy drinking is closely linked to belly fat.
• More fibre and protein. Vegetables, beans, whole grains and lean protein keep you full. See protein for weight loss.
• Sleep and stress. Short sleep and long-term stress are both linked to more belly fat. See sleep and weight loss.

How long does it take?

Most people notice a difference in their waist within 2 to 3 months of consistent changes. Aim for steady progress rather than quick fixes.

See a doctor if

Your waist is above the levels above, or you have a family history of diabetes or heart disease. A doctor can check your blood pressure, blood sugar and cholesterol.

More in our Weight Management guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Antifungal creams for athlete’s foot, jock itch and ringworm fall into two groups. Some kill the fungus, and others stop it growing. That difference mostly affects how long you need to use them.

The main options

• Butenafine 1% (sold as Lotrimin Ultra, and as Mentax): kills the fungus.
  Athlete’s foot between the toes: twice a day for 1 week, or once a day for 4 weeks. Jock itch and ringworm: once a day for 2 weeks.
• Terbinafine 1% (Lamisil AT): kills the fungus.
  Athlete’s foot between the toes: twice a day for 1 week. On the bottom or sides of the foot: twice a day for 2 weeks. Jock itch and ringworm: once a day for 1 week.
• Clotrimazole 1% and miconazole 2%: stop the fungus growing.
  Usually twice a day for 2 to 4 weeks.

All of these are available without a prescription and are suitable for adults and children aged 12 and over (2 and over for clotrimazole and miconazole). Ask a doctor for younger children.

Which is best?

All work well when used correctly. Butenafine and terbinafine clear infections in a shorter course, which makes it easier to finish treatment. Clotrimazole and miconazole are cheaper and widely available, and they also work against yeast (Candida) infections in skin folds.

The most common reason treatment fails is stopping too early, when the skin looks better but the fungus is still there.

Tips for using antifungal creams

• Wash and dry the area thoroughly, including between the toes, before applying.
• Apply a thin layer to the rash and about 2 cm (1 inch) of the skin around it.
• Wash your hands afterwards.
• Finish the full course on the label.
• Keep the area dry, change socks and underwear daily, and don’t share towels.

See a doctor if

The rash hasn’t improved after the full course, it’s spreading, the skin is cracked, oozing or very painful, it affects the scalp or nails, or you have diabetes or a weak immune system.

Related guides: how to get rid of athlete’s foot and jock itch vs ringworm.

Shop Butenafine cream.

More in our Skin and Fungal Infections guide: all our articles and products on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Imodium contains loperamide, which slows down the gut so more water is absorbed and stools become firmer. It works well for short bouts of diarrhoea, but it’s important to stick to the dose on the label.

Dose for adults and children 12 and over

• 4 mg (2 capsules or tablets) after the first loose stool.
• Then 2 mg after each further loose stool.
• Don’t take more than 8 mg in 24 hours unless a doctor tells you to.

Dose for children

• 9 to 11 years (60 to 95 lb): 2 mg after the first loose stool, then 1 mg after each further loose stool. No more than 6 mg in 24 hours.
• 6 to 8 years (48 to 59 lb): 2 mg after the first loose stool, then 1 mg after each further loose stool. No more than 4 mg in 24 hours.
• Under 6: ask a doctor. Loperamide isn’t suitable for children under 2.

Liquid forms are easier for measuring children’s doses. Always use the measuring device that comes with the product.

How long to use it

Don’t use loperamide for more than 2 days. See a doctor if diarrhoea lasts longer.

Don’t use loperamide if you have

• blood or black colour in your stools
• a high fever
• diarrhoea after taking antibiotics, unless a doctor advises it

In these cases, slowing the gut can keep an infection inside for longer.

Never take more than the label says

The FDA has warned that taking much higher doses than recommended can cause serious heart rhythm problems and death. Check with a pharmacist if you take other medicines, as some can raise loperamide levels in the blood.

Drink plenty of fluids

Diarrhoea causes the body to lose water and salts. Sip water often, and use oral rehydration solution for children, older adults or anyone with a lot of diarrhoea. See a doctor for signs of dehydration: very dark urine, dizziness or a dry mouth.

More help: how to stop diarrhea fast and travellers’ diarrhoea.

Shop Imodium (Loperamide).

More in our Digestive Health guide: all our articles and products on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.