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Neurogenic and Demodex?

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  • Neurogenic and Demodex?

    I just saw my doctor today and she is thinking that I potentially have neurogenic rosacea. I am curious, can Demodex play a role in that? I've had chronic blepharitis for 10 years as well as some other demodex symptoms. I'm curious if maybe it's possible to have both at the same time if Demodex is not the source of neurogenic?

  • #2
    I have neurogenic rosacea and mine responds to demodex mite treatments. Initially it was thought that demodex mite treatments would suit pustular type 2 rosacea best, but more recently both patients and the rosacea expert Professor Frank Powell have identified the role of demodex mites in the other types of rosacea as well. Medicines like gabapentin can help with neurogenic rosacea. Also, for demodex mites specifically, I use Zhongzhou original ointment - definitely worth trying. Demodex mites are quite hard to treat so you have to persist.

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    • #3
      Wow this is actually great to hear. Thank you for telling me about the professor. I'm getting ready to meet with my dermatologist again next week and I feel like I might need to prove the existence of the mites. I'm sure referencing him will help. My doctor talked about treating me SSRi's. Have you had any experience with those? I prefer to not take them as I know they have their own potentially dangerous side effects. But I'm getting pretty tired of these facial flares. Do the anti-anxiety medication's help because the flaring has to do with stress? If so, I'm wondering if I can find an alternative way to treat anxiety that will then less than the flares.

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      • #4
        Originally posted by antwantsclear View Post
        I have neurogenic rosacea and mine responds to demodex mite treatments. Initially it was thought that demodex mite treatments would suit pustular type 2 rosacea best, but more recently both patients and the rosacea expert Professor Frank Powell have identified the role of demodex mites in the other types of rosacea as well. Medicines like gabapentin can help with neurogenic rosacea. Also, for demodex mites specifically, I use Zhongzhou original ointment - definitely worth trying. Demodex mites are quite hard to treat so you have to persist.
        Have they tested you for SIBO/SIFO? It can suppress the immune system and let the demodex get very overpopulated. SIBO/SIFO can cause eczema as well. Celiac may also cause eczema. I'm curious if, for some, SIBO/SIFO may also lead to sensitive skin issues.

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        • #5
          Where can I be tested for something like that? Does it need to be at a more hollistic kind of place? I wonder if I should just assume I have Sibo and address it through diet? Or are there other measures that need to be taken if I am positive?

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          • #6
            Originally posted by Emmakate View Post
            Where can I be tested for something like that? Does it need to be at a more hollistic kind of place? I wonder if I should just assume I have Sibo and address it through diet? Or are there other measures that need to be taken if I am positive?
            Yes. You can be tested. SIBO 3 hour Breath test is non-invasive. You drink a glucose solution. Then your breath is measured multiple times for 3 hours to measure the Hydrogen, Methane or Hydrogen Sulfide gas triggered by drinking the glucose.

            A second more invasive test, the endoscope test can be done to get the precise bacteria(s) or possibly fungus (SIFO) causing the issue. The doctor inserts the endoscope, a thin flexible tube, into your small intestine to collect a small fluid sample. The fluid is cultured and tested for bacterial (SIBO) or fungal overgrowth (SIFO). They may only do this for hard to treat cases where knowing the specific microbe would help the doctor pick the best treatment.

            Diet is super important. Best to eat a very healthy balanced diet low in sugar and include probiotics either in food and/or from supplements. Sugar feeds the bacteria and may make the skin oilier attracting demodex, etc. Mediterranean style diet is a healthy, balanced diet with plenty of fiber from veggies, fruit and whole grains, lean protein grilled, baked, roasted, sauteed (not deep fat fried), heart healthy oils like olive, canola, etc. Probiotics are also extremely important. Probiotics are available in supplements and thru diet. Diet sources: yogurt, kefir yogurt (intense if you are not used to it), pickled foods like kimchi (pickled cabbage), dill pickles, etc. Beware of Kombacha tea. It is fermented but high in sugar which may cancel the benefits of the probiotics out.

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            • #7
              I think all rosacea treatments should be on the table for neurogenic rosacea. Probably the excessive pain comes from sensitized nerves due to inflammation. Doctors might think too linearly in terms of diagnosis treatment without understanding the complex tangle of rosacea inflammation. Oral ivermectin is easy enough if you can't handle topicals on your skin and topical ivermectin is fairly well tolerated with high potential gain. I know someone on here who had night flushing and burning, mild pustules, used soolantra for near recovery. Demodex upregulates TLR2 which leads to pro-inflammatory cytokines and bad cathelicidins LL-37 and my understanding this leads to vasodilation and sometimes pain. Ivermectin (topical or oral) did not help me, but it did not hurt me either. Low dose accutane dramatically helped my pain and redness. High dose probiotics dramatically helped redness. SSRI's / SNRI's - they help me some too. SSRI's "shouldnt" help with neuropathic pain (i'm told you need 2 neurotransmitters like an SNRI) but antidepressants have anti-inflammatory properties and my theory is this is how they help me

              I do not think stress is the pathological / target here (as much as spicy foods are..). Antibiotics have helped with stress flushing/burning for me eg.

              Maybe seeing an eye doctor would be helpful as well and asking about demodex...

              take care
              Last edited by laser_cat; 20 September 2021, 08:02 PM.

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              • #8
                Thank you so much for this information. I just literally hung up with my dermatologist and she told me she definitely feels that I have rosacea. She did not seem open to testing for Demodex though. She wants me to try TXA. Have you heard of this treatment? I'm concerned because it is a topical and I have been through topical steroid withdrawal. I feel that this is what gave me rosacea as long-term steroid use definitely irritates blood vessels. She also recommended low-dose doxycycline. I am a bit scared of antibiotics as well, but I am almost curious if they help. I actually have some oral ivermectin on hand from a parasite infection I had a few months ago. I wonder if I should try that. I also convinced her to prescribe me low-dose naltrexone as I have seen some people have success with that. I would love to hear your thoughts if you don't mind!! lastly, my face is so highly sensitive that even water makes it flare. But she seems to thinks the TXA is calming enough. I just don't want to take anything that will cause me to have a rebound flare.

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                • #9
                  I would try Zhongzhou cream, e.g. from www.demodex.co.uk. 98% of adults have demodex mites, research suggests - it's just that the development of rosacea may occur, it's suggested, because you have more of them than the average adult. I didn't get much benefit from TXA - a few people have on the forum, but a lot more people got benefit from Zhongzhou cream original. I would say you have to stick with the treatment for a month to see if it works for you.

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