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Derm prescribed Permethrin today (Demodex/Rosacea link)

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  • Derm prescribed Permethrin today (Demodex/Rosacea link)

    Hi, again. I posted earlier with some questions about Demodex--I'm slightly obsessed with it at the moment.
    Saw my derm today (the doctor in the practice, normally I see the assistant) and shared all I've learned about the demodex rosacea link--and he's heard of it but not very experienced with it and is on the fence about treating for demodex. He said he's only prescribed permethrin (5% -- one time application with second application 7 days later) to a handful of people and they didn't see improvement. (I wonder if it's because they should have been applying more often?)

    So, has anyone had recent experience with permethrin? I wonder if I apply it more often (like nightly), it has a better chance of resolving the demodex, if that's what's at the root of my P&P flare up. (BTW, He didn't do the scrape test for demodex because he said he knows if he did, he'd see that I probably do have an elevated concentration of them in my skin.) My derm suggested it's so potent, I would only want to put it on my skin once in a given week, and the pharmacist echoed that. But I feel as though I read post after post (and have seen study after study) where people are prescribing/using it nightly.

    Also, is there a demodex forum? I've looked around and see lots of threads, but wondered if I should be posting my demodex-related stuff somewhere else? Thanks in advance to any who care to reply!

  • #2
    Hi KAK,

    I can't help thinking that your derm's approach is pretty lame. I've read numerous success stories of people getting their p&p element of rosacea cleared by topicals such as Tea Tree Oil (TTO). Check out Kisha's blog if you haven't already, it's a revelation.


    • #3
      The problem derms have regarding demodex - aside from their scepticism and general lack of knowledge on the subject - is that they don't have ANYTHING in their arsenal to prescribe, without moving outside of their guidelines. There is no licensed treatment for demodex in humans. This is why, if you can get them interested at all, at best they'll improvise with things like permethrin.

      There are a couple of problems straightaway with the permethrin approach. Firstly, there have been reports of adverse reactions - see for more on this. Second, I think I'm correct in saying that, as an insecticide treatment, permethrin is getting close to it's 'sell-by date', to use laymans terms. It is used as a headlice treatment, but it's efficacy in killing the lice is diminishing. Finally, two treatments of anything won't cut it long-term for demodex. They'll be back. An on-going regime is needed - and again, permethrin probably isn't suited for this, either.

      Just some food for thought. For me at this stage of my problem, finding an effective demodex treatment is the big issue. Galderma completed their phase 3 trials of ivermectin about two months, but there's been no information since. And very little interest on these boards, I'm disappointed to say...