Another paper on demodex mites and rosacea

[Brady Barrows Senior Member Find all posts View Profile Close Brady Barrows]

Another paper has been published on demodex and rosacea which I have added to the compressive list of articles on this subject which is interesting.

The study concluded:
"The association between DF and oily skin rather than rosacea lesions gives no support for this agent being implied in disease pathogenesis."

Why this is interesting is that for years, it has been reported that rosacea patients have a higher demodex density count than those without rosacea. However, there have been no real studies that prove this.

The recent study was trying to determine "whether a relationship exists between the presence of the mite in rosacea and oily cutis." RESULTS: "While comparisons on the density of DF revealed no differences between patients and controls (Mann-Whitney U-test, P = 0.35), persons with an oily cutis had increased amounts of this mite on the skin surface (Mann-Whitney U-test, P < 0.05), irrespective of whether they had rosacea or not."

What this paper shows is that we need more data on this subject. Especially we need more rosacea patients obtaining demodex density counts to compare the results with the general population demodex density count. There really are not any papers published on this. It may be possible that the demodex density count may have no relationship with a rosacea flareup. It may be possible that a normal demodex density count is found in many rosacea patients. And if it is true that a higher demodex density count is found in rosacea patients there should be proof to confirm the higher numbers that are proposed. And what is a normal demodex density count on average in the general population that has no rosacea signs/symptoms?

Since this subject is one of the more researched papers published in the rosacea field, hopefully more papers will give us information on this.

[Rory Senior Member Find all posts View Profile Close Rory]

Thats incredible. I always thought it was a given that Rosaceans had anywhere between 5 to 10 times higher colonization of Demodex than normal skin. This really throws a spanner(wrench for our american friends) into the ironworks. According to this latest study it is those of us that suffer Seb Derm or oily skin and Rosacea/POD have higher counts of Demodex than normal skin and Rosacea skin. But having said that,I have used Ivermectin(injectable used topically) and it didnt do anything for me. Its no wonder they havent figured this thing out since they cant even do a proper count of this parasite. They can do counts of microbials that are a thousand times smaller than Demodex so how could something like this have happened. Truely amazing.

[snoopy Junior Member Find all posts View Profile Close snoopy]

Yeah, there was another paper I read that said everyone performs the mite counts differently - the researchers do not do the scrapes, biopsies, etc the same way and they don't examine the tissues the same way - which lead to the differing counts of mites in all these studies. So is the study posted above the most correct or not? Hard to tell IMO. (I'd go more by what treatment works for someone rather than mite counts.)

Insert rant about the supposed superiority of science here.

Also on the topic of mites, there is a 10 year meet your mite study underway in North Carolina. You can google meet your mites to find it. They will be doing scrapes over a 10 year period - the study is to learn more about the mites, and is not treatment oriented. But I would imagine it ends up being helpful in the long run for skin issues. One of the hints the researchers have on their website is that humans can host more than the 2 well known mites - brevis and folliculorum. Iow, there are mites out there that mainstream health doesn't really know about yet.

[Rory Senior Member Find all posts View Profile Close Rory]

Actually I made a mistake in my previous post. I know that not all Rosaceans have a demodex problem. Snoopy you bring up a good point. Maybe there is another parasite they havent identified yet although it seems hard to believe in this day and age. Looking at the latest study on POD they used a topical ointment with 3% Praziquantel with good results. I cant find much info on this Drug other than it seems to be some type of parasite killer. I have already used Ivermectin to no avail so maybe this stuff is killing something else. Heres the study

http://www.ncbi.nlm.nih.gov/pubmed/24825135

[Brady Barrows Senior Member Find all posts View Profile Close Brady Barrows]

Praziquantel is some mean treatment. The side effects are significant to consider.

"The majority of side effects develop due to the release of the contents of the parasites as they are killed and the consequent host immune reaction. The heavier the parasite burden, the heavier and more frequent the side effects normally are."

So while killing off a plethora of different kinds of parasites using Praziquantel may kill the culprit, you may be killing of some beneficial microbes which are not considered parasites.

So let's discuss the subject of parasites and symbiosis.

When you consider that bacteria is considered a parasite, you might need to consider whether or not killing off bacteria with antibiotics is worth the long term risks. Not all bacteria is bad. Some bacteria is good, i.e., gut flora.

"Parasitism is a non-mutual symbiotic relationship between species, where one species, the parasite, benefits at the expense of the other, the host." source

While demodex is considered a parasite, what if there is a symbiotic relationship since most humans have no observable issues with demodex, i.e., no rosacea? In past papers on demodex, it has been stated that the reason for the presence of demodex on humans is unknown. However, it is quite obvious they love to eat sebum, which is a no brainer.

Maybe under certain unknown conditions the demodex are reacting to something (a bacteria has been proposed that is on the skin of the demodex mite) which exacerbates rosacea? It is the old chicken or egg enigma.

Symbiosis is a controversial subject, but it is generally accepted that the definition is "the living together of unlike organisms." The question is whether demodex is symbiotic with humans?

The classic example is Helicobacter Pylori which has been reported to be in 50% of the human population. [1] Why the other half the human population doesn't have H Pylori is an intriguing question. And to really get you confused, "Over 80% of individuals infected with the bacterium are asymptomatic." Could it be that H Pylori has a symbiotic relationship with humans and at times runs amuck and causes issues? Could demodex be in this same symbiotic relationship with humans? If you want to read more about H Pylori be my guest.

My point is that not all microbes in humans are parasites. Since "D. folliculorum was first described in 1842 by Simon; D. brevis was identified as separate in 1963 by Akbulatova," do you really think science and medicine have everything figured out on this subject? While demodex do look ugly so do some types of bacteria. Antibiotics sometimes help humans but wiping out the beneficial bacteria has risks and long term side effects. Could it be possible that the long term eradication of demodex have some long term risks or side effects later down the road? Of course, if eradicating the mites does indeed improve your rosacea, you simply have to decide if the benefit is worth it? Most would opt for the benefit of a clear face over what may happen long term wiping out the mites. And besides, all the evidence suggests the mites will come back anyway. What we need to figure out is how to live with the mites the way most of the human population does without having rosacea.


End Notes

[1] Helicobacter pylori infection in skin diseases: a critical appraisal.
Wedi B, Kapp A.
Am J Clin Dermatol. 2002;3(4):273-82.

[snoopy Junior Member Find all posts View Profile Close snoopy]

Like h pylori, not everyone has mites. Most 20 year olds don't. So I am dubious that we somehow need them. In addition, there may indeed be an overgrowth issue. The vets will tell you dogs have demodex, but in some dogs - likely due to immunity issues - the demodex proliferate and cause issues. That happens with candida, so there is precedence. Somethings can get out if control. Out of all the success cases reported here, most are either due to demodex treatment or diet ( or both).

I think researchers and doctors start with the assumption that demodex aren't bad - but until we know the why and what of demodex - I think that is a dangerous assumption because it will cause tunnel vision.

That said, however, I do think there is a risk that killing off demodex may also kill off other things we do need.

[Rory Senior Member Find all posts View Profile Close Rory]

Brady Im an oily. Have been since the age of 12 when the nightmare began.First severe acne all through my teens and twenties. Then to add to the problem along comes Seb derm,and now the icing on the cake POD. To this day my facial skin is prone to acne. Im sure I havent had a normal skin microflora since that first pimple emerged and I dont think I ever will have until the powers that be discover what causes over-active sebaceous glands. Thats where the real problem is. Oilies also have much higher counts of Demodex than normal skin and the never ending occlusion is forever causing microflora imbalance. I have no choice but to kill everything. I wish there was an alternative but for those of us that suffer oily SD and Rosacea/POD its a constant battle to keep fungi and bacteria under control. I appreciate your advice but wild horses couldnt stop me from trying out this Praziquantel. I just wish I knew what prompted these guys to use this stuff to treat POD. Did they discover something about POD that hasnt been published before. Praziquantel is used to treat animals infected with worms and from what I have read so far its not effective against mites. Any Vets out there?

[Brady Barrows Senior Member Find all posts View Profile Close Brady Barrows]

Rory,

I am not telling you what to do. I am merely suggesting that you understand that the science and medicine behind all this is limited and without a doubt sometime in the future there will be more knowledge on this subject.

It is your face, your body, and you can, of course, use whatever treatment you think is necessary for rosacea.

You seem quite knowledgeable about the subject and have educated yourself about the risks and side effects of using Praziquantel or for that matter any treatment for rosacea.

As for contacting the authors of the paper you mention, they are in the Ukraine. There used to be a vet in this forum who had rosacea, I forget his name, but he used to be with the now defunct RRF. He was from the south.

Let us know your results.

[Rory Senior Member Find all posts View Profile Close Rory]

Thanks Brady.I wish there was an easier way but so little is known about chronic POD and when something like this study comes along..Well, I just dont want to leave any stone unturned. I have absolutely no idea about what side effects this drug causes and to be honest if you told me that its the most potent carcinogenic substance known to man,I would still use it. There are many people on this forum who have taken plunges into the unknown and have achieved amazing results. I look at Tom Busby who in my opinion has created the ultimate topical for Seb Derm. He has inspired me to do the same and I now have no trace of SD even though I am back on antibiotics which drive my SD crazy.

I used to have a friend who was a Vet but she emmigrated. Anyway I will let you know how it goes. I just hope this stuff is available in my neck of the woods.

[Brady Barrows Senior Member Find all posts View Profile Close Brady Barrows]

Dr. Frank C. Powell who wrote THE book on rosacea said at the 72nd annual meeting of the American Academy of Dermatology in Denver which was quoted in the NRS Rosacea Review (Spring 2014) the following which is related to this thread:

“The presence of Demodex is likely to confer some sort of benefit on us, because human physiology is such that we wouldn’t tolerate something like this unless there was something to be gained for us,” he said. Whatever benefit that might be, in rosacea patients something causes the mites to proliferate, possibly triggering an inflammatory response. Large quantities of mites have been found in biopsies of rosacea papules and pustules, leading Dr. Powell to wonder whether the papules and pustules might not be “gravestones to dead Demodex.”

[Brady Barrows Senior Member Find all posts View Profile Close Brady Barrows]

Yet another paper published on demodex and rosacea!

So far I have collected 10 papers on demodex and rosacea this year which I post on this page along with the plethora of other articles on this subject. Here is the latest one:

Adv Clin Exp Med. 2014 March-April;23(2):295-298.
Demodex - An Old Pathogen or a New One?
Rusiecka-Ziółkowska J, Nokiel M, Fleischer M.

[dss203 Junior Member Find all posts View Profile Close dss203]

Hi, just seen this http://rosacea-support.org/3-praziqu...f-rosacea.html

Wow, that's all I can say. I am so thankful the medical community is coming around, I think along way to go though. I am still new here but desperately looking for answers and help from this suffering. I have been diagnosed with Ocular Rosacea, seborrhic dermatitis/malassezia? And possible lupus. I don't think lupus though I think it is all due to this mite as when I treat with permethrin or ivermectin its gets better, no more allergy or coughing no more sebborhea etc., it has definitely migrated. I told the doctors but they just act like there hands are tied. They did prescribe Soolantra but I cant afford it (I currently have state insurance), so I am looking for alternatives. it is more than just my face also scalp neck chest. just terrible. And to mention I Have never had any of these conditions in my life until 2-3yrs ago. I thought it was scabies, treated for that and came down with all these problems.

Bless you all that are helping people by sharing your experiences and going through this- my heart goes out to you as well.

[MariaSt Senior Member Find all posts View Profile Close MariaSt]

Hi, just seen this http://rosacea-support.org/3-praziqu...f-rosacea.html

Wow, that's all I can say. I am so thankful the medical community is coming around, I think along way to go though. I am still new here but desperately looking for answers and help from this suffering. I have been diagnosed with Ocular Rosacea, seborrhic dermatitis/malassezia? And possible lupus. I don't think lupus though I think it is all due to this mite as when I treat with permethrin or ivermectin its gets better, no more allergy or coughing no more sebborhea etc., it has definitely migrated. I told the doctors but they just act like there hands are tied. They did prescribe Soolantra but I cant afford it (I currently have state insurance), so I am looking for alternatives. it is more than just my face also scalp neck chest. just terrible. And to mention I Have never had any of these conditions in my life until 2-3yrs ago. I thought it was scabies, treated for that and came down with all these problems.

Bless you all that are helping people by sharing your experiences and going through this- my heart goes out to you as well.

Check out this thread: http://www.rosaceagroup.org/The_Rosa...oolantra/page2