Announcement

Collapse
No announcement yet.

Intense flare of papulopustular rosacea 1 month into isotretinoin 10mg

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Intense flare of papulopustular rosacea 1 month into isotretinoin 10mg

    Hey all!

    I've been prescribed 10mg of isotretinoin daily o control my papulopustular rosacea and mild acne. Things were going brilliantly for the first 3 weeks, but now 1 month and almost 1 week into treatment, I'm having the most intense flare I've had in my whole life.

    My cheeks are red, burning and covered in small puss filled pustules. My derm says this can happen and to stick with it, but it's so uncomfortable and painful I am terrified! Has anyone else experienced this on isotretinoin? Should I ask for anything else (topical?) to help?


  • #2
    It sounds like a massive die off of demodex skin mites. The isotretinoin greatly reduces the oil output of the skin. Oil is the primary food source for demodex skin mites. The overpopulation of mites is what causes the papules, pustules and blackheads common in Rosacea Subtype 2 with papules and pustules. Isotretinoin typically starves the mite population down but will not cure the real source of the problem. A healthy immune system keeps the mite population in check. If the mite population gets out of control, the problem is with the immune system in the gut.

    Rosacea Subtype 2's underlying cause is frequently Small Intestinal Bacterial Overgrowth (SIBO) and/or Small Intestinal Fungal Overgrowth (SIFO). I had SIBO with Rosacea Subtype 2 with papules and pustules, and Rosacea Subtype 3 (ocular rosacea/blepharitis demodex) eye issues literally for decades. It was misdiagnosed by multiple board certified doctors as 3 separate unrelated problems: bacterial acne, allergic conjunctivitis and "gee, it must have been something you ate or a bug". No treatment they prescribed ever worked.

    The ocular rosacea finally became so severe that my eye lashes were falling out and my eyes were so severely dry that it felt like my lids were made of velcro when I blinked. I found the following online medical study treating patients confirmed to have skin conditions caused by demodex skin mites. The study compared using Oral Ivermectin alone versus Oral Ivermectin + Oral Metronidazole. The combined 2 drug, 2 week treatment was far more effective.

    https://www.sciencedirect.com/scienc...0197121201315X

    At the time of this study, the doctors did not know why the Oral Metronidazole worked. Doctors in Europe in the 1980's reported success when they treated their patients with Oral Metronidazole but they didn't know why it worked at the time. Oral Metronidazole is highly effective at clearing 2 types of bacteria known to cause SIBO. Oral Metronidazole is highly effective against H. Pylori bacteria overgrowth which is associated with Rosacea Subtype 1.

    The 2 week, 2 drug combined treatment of Oral Ivermectin + Oral Metronidazole worked for me. The 2 weekly doses of Oral Ivermectin kill the demodex skin mites rapidly. The Oral Ivermectin killed the mites in the eye oil glands which are very difficult to treat. The Oral Metronidazole cleared the SIBO infection. I am still clear nearly 4 years later.

    A second medical study, used the very expensive antibiotic Rifaximin to treat Rosacea patients with SIBO. Rifaximin is highly effective at clearing certain types of E. Coli infections. But Rifaximin is not the most effective antibiotic for other types of bacteria which are known to cause SIBO.

    https://www.jaad.org/article/S0190-9...330-4/fulltext

    Multiple types of bacteria can cause SIBO. The best choice of treatment for SIBO will depend on the type of bacteria causing the condition. There are 2 types of SIBO tests available. The general screening breath test can check for 2 or 3 of the gases emitted by the SIBO bacteria. The breath test does not identify the specific bacteria but can give a general idea of the types of bacteria. The gold test is the Endoscope Test which collects a small sample of small intestinal fluid. The fluid is cultured for bacteria and fungus. The Endoscope test identifies the bacteria and/or fungus that is causing the SIBO and/or SIFO. The doctors can then select the best antibiotic and/or antifungal treatment to clear the condition. The condition can typically be cleared in 1 to 3 weeks with the correct drugs.

    A healthy well balanced, high fiber, low sugar diet with probiotics and prebiotics in food or supplements can help maintain good gut health and keep the immune system healthy. Too much sugar in the diet makes your skin oilier and may feed the bad bacteria and/or bad fungus causing the SIBO/SIFO conditions.

    Some people prefer to use the healthy diet and natural remedies to treat the condition as opposed to drugs. This approach can work, but may also take longer.

    Comment


    • #3
      Originally posted by ElaineA View Post


      The 2 week, 2 drug combined treatment of Oral Ivermectin + Oral Metronidazole worked for me. The 2 weekly doses of Oral Ivermectin kill the demodex skin mites rapidly. The Oral Ivermectin killed the mites in the eye oil glands which are very difficult to treat. The Oral Metronidazole cleared the SIBO infection. I am still clear nearly 4 years later.

      Thanks Elaine! I was wondering if mites die off could be a to blame. Unfortunately, I won't have any chance of getting oral ivermectin/metro - I don't believe this method is approved for treatment in the UK, so no doctor will prescribe it. Similarly, no doctor on our health system would test for bacterial/fungal flora of the gut without pretty severe symptoms, which I don't have. Even a private appointment outside of the health system would require a GP referral. I see SIBO breath tests available online, but I have my doubts about them being legitimate...

      But I do have an option of getting compounded ivermectin/metro cream and I've been told it's safe to use along with isotretinoin, I'm hesitant however, not to make things worse, because my skin is so so sore. Metro gel used to work for me in the past very well (as a treatment but not prevention), so I may give this a go, and look more into diet! I generally eat very healthy (plant based, plenty of fibre, protein and healthy fats) but I do have slip ups - especially when I get stressed about my condition ;-(

      Comment

      Working...
      X