Tranexamic acid/ivermectin/doxy

[Emmakate]

Hello everyone,

I just got back from my dermatologist and I'm feeling a bit confused on what protocol to do! My Derm recommended I topically apply Tranexamic acid for flaring and sensitivity. I seem to have a weird case of rosacea because I have eczema prone skin and another contributor is that I've been going through topical steroid withdrawal for the last five years. I am skeptical of any topical after my horrendous and traumatic experience with steroids. I called two different pharmacist who assured me that the mechanism was different than it is when working with steroids. While explaining my history to my pharmacist, she suggested that I might want to try ivermectin cream first. I know that I have some kind of mite issue, though it has seem to improved over the years as I've worked on my diet. For an example my blepharitis used to be at a 10 and now it is at a three as far as discharge is concerned. She recommended that I start with and ivermectin cream and because its a compounding pharmacy she can eventually add in the TXA after I kill the initial mites. I also will start LDN in a few weeks. The LDN was prescribed by my holistic Doctor Who is helping me balance my immune system. I have checked, and all three of these medication's will be fine together. Lastly, my dermatologist advised me to also take doxycycline. I've researched a bit and it looks like doxycycline is mostly used for managing the pustules? I do not have any pustules at this point nor have I in the last few years. WOW sorry this is so long. I would love to hear anyone's opinion!

[ElaineA]

Small Intestine Bacterial Overgrowth (SIBO) and its fraternal twin brother Small Intestine Fungal Overgrowth (SIFO) are known to trigger Rosacea, Ocular Rosacea (Blepharitis Demodex), Eczema and demodex skin mites.

I had misdiagnosed SIBO causing Rosacea Subtype 2 with papules and pustules and blepharitis demodex (ocular rosacea) literally for decades. It was repeatedly misdiagnosed as 3 separate problems: bacterial acne, allergic conjunctivitis and "gee, it must be a bug or something you ate". No acne treatment ever worked to clear it including Minocin a relative of Doxycyclin. Minocin did seem to help for a short time, but the effect quickly wore off. Towards the end, the blepharitis was severe. Long story short, what cured it is an inexpensive 2 week, generic 2 drug combined treatment with Oral Ivermectin + Oral Metronidazole. 3.5 years later the SIBO is still gone and my skin is still clear. Treatment consists of 2 once a week doses of Oral Ivermectin based on body weight. That kills the demodex and gets them out of the eye oil glands. The Oral Metronidazole is highly effective against several of the bacteria known to cause SIBO (bacteriodes, eggerthella lenta) and H. Pylori that is associated with Rosacea Subtype 1 and stomach ulcers. In 1985 European doctors reported that Oral Metronidazole was highly effective against Rosacea but they didn't know why at that time. Now, they can do an endoscope test for the type of bacteria or fungus causing SIBO or SIFO to make sure they prescribe the most effective drug to treat it.

The treatment was published in a medical study in the May 2013 in the International Journal of Infectious Diseases, url to paper is here:

https://www.sciencedirect.com/science/article/pii/S120197121201315X

The very expensive antibiotic Rifaximin was shown in a different study to be highly effective at clearing the SIBO in patients verified to have both SIBO and Rosacea. Paper was published as a letter in May 2013 in the American Academy of Dermatology. Rifaximin is highly effective against the bacteria E. Coli also known to cause SIBO. Paper link is here:

https://www.jaad.org/article/S0190-9622(12)02330-4/fulltext

Doxycycline is a standard drug routinely prescribed for rosacea BUT Doxy may not be necessary unless you have a secondary skin infection possibly caused by bacillus oleronius often associated with demodex skin mites. Some doctors prescribe doxy to treat a Helicobacter pylori infection that can cause stomach ulcers. It is usually given to people who are allergic to penicillin. However, Helicobacter pylori requires a high dosage of doxy to eradicate an H. pylori infection. For rosacea, normally a low dose of Doxy is prescribed. For Rosacea, doxy seems to help some at first but the good effect wears off within less than 2 months. I doubt the Doxy will help in the long run. Long term use of antibiotics is not recommended.

[Emmakate]

I am actually looking into a Sibo test! I was stuck in Singapore during the pandemic and ended up getting several infections and had to be on anabiotic's for over seven months. It was a very scary time and I'm sure that completely destroyed my gut. I'm a little discouraged because I have been on a very strict diet for the last five years and though my eczema has healed this weird flushing highly sensitive face has not. This is led me to believe there is some thing else going on besides gut health. Either way, I'm excited to take a sibo test it will move forward with treatment if needed. I'm going to see my holistic MD next week so I'm going to share all of this information with her. Do you have any feelings about ivermectin cream? The pharmacist I talked to wanted me to try that before anything else.

[antwantsclear]

I was tested for SIBO and it came back negative. Though who knows whether this was the situation when I originally got rosacea. However, I did get a fungal skin infection across the armpits etc and used a supplement that my dermatologist had actually recommended for a potential fungal element of rosacea and flushing, Thorne SF722. I found a very small amount of SF722 - 3 capsules - less than half the recommended amount does seem to help control the rosacea flushing.