Who "cured" their rosacea and how?

[Brady Barrows]

Brady, are you allergic to the medication that Elaine took for Demodex

Not sure what you are referring to. If oral ivermectin, I have never taken oral. I have used ivermectin topical (horse paste) and Soolantra and am not allergic to it. I use her borax/epsom salt bath treatment on a regular basis and am not allergic to it.

[Angela40]

Hi how are you Elaine and Brady,
Brady did the oral Ivermectin work for you

[Angela40]

Sorry Brady I meant topical ivermectin

[Brady Barrows]

Sorry Brady I meant topical ivermectin

Yes, the topical ivermectin works somewhat for me, I preferred the horse paste over the Soolantra, mainly because there are very few inactive ingredients in the horse paste while Soolantra has a huge amount of them. If you want to view the comparison, read this spreadsheet since Soolantra claims Cetaphil "as the basis for the vehicle." Furthermore, the horse paste is about twice as much ivermectin (1.87%) over the 1% ivermectin in Soolantra. The most compelling reason is horse paste is way cheaper. A gram of horse paste cost approximately $1.16/gram while Soolantra costs approximately $13/gram (Six doses of Durvet Horse Paste at Amazon costs about $20 [six doses include 36 grams which is only 55 cents per gram] and lasts approximately six weeks which should be enough to know if it works better than Soolantra).

My Soolantra review can be read here. I gave it a fair shot with many months.

I tried the horse paste for a number of months and while I like it better than Soolantra, I only use it once in a while now and prefer the ZZ cream.

My favorite is the ZZ cream which doesn't have ivermectin. The active ingredient is sublimed sulphur (kills mites). Here is my review. Now I am using my blog to post what I am currently using.

[Angela40]

I am enjoying reading your blog and love this, hope you continue writing, your amazing glad I meet you online! I am using ketoconazole shampo, if you haven’t tried it maybe it can help you, maybe at your next appointment you can ask your doctor

[Brady Barrows]

I am enjoying reading your blog and love this, hope you continue writing, your amazing glad I meet you online! I am using ketoconazole shampo, if you haven’t tried it maybe it can help you, maybe at your next appointment you can ask your doctor

When you figure out your regimen that works for you, you can create your own blog at the RRDi and refer to your own blog whenever you want. It is totally free, and provided by the RRDi and you would be the third blog since me and Mollie are the only current blogs there. Cool, huh?

[Angela40]

Hi Elaine and Brady how are you guys doing, hope all is well, last night I tried your recipe for the bath and I don?t think I notice any difference, my skin still looks the same like before (dry and discoloration because of fungus) hopefully some mites died not sure. Did you guys have some tiny white looking dots on top of the bath (maybe dry skin) , I guess lots of baths will be needed to see a difference. Thanks again and hope you are safe and well.

[Angela40]

Hi Elaine and Brady how are you
I went to the dermatologist on Friday and she said everyone has Demodex, it?s normal flora.I told her my doctor sent me to you because I may have an overpopulation. She prescribed metronidazole gel.

[ElaineA]

Hi Elaine and Brady how are you
I went to the dermatologist on Friday and she said everyone has Demodex, it?s normal flora.I told her my doctor sent me to you because I may have an overpopulation. She prescribed metronidazole gel.

It is a true statement that everyone has demodex. While a low level is normal, an overpopulation is not.
Did the dermatologist do any tests at all? Or did the doctor just do a visual exam? What did they diagnose?

Unfortunately, that is a typical response especially from an older dermatologist. Dermatologists have been incorrectly taught for over a 150 years that demodex were harmless. A few Demodex were discovered in 1840 on corpses. Corpses that had no skin diseases. They assumed at the time that they were just a normal part of the human biome. Researchers have never been able to culture demodex so they have never been studied in the lab.

Of the 5 dermatologist that I have seen professionally, just one knew what demodex were, how to test for them and he knew about the 2 drug oral treatment. He told the young colleague who was with him that day "that it was like a miracle when it worked". She asked him "How do you test for demodex?" Apparently, she had not been taught this in school. He described to her how you tested for them. The anti-parasitic treatment only works to clear a demodex overpopulation of demodex. That is why it is important to test for them to nail the diagnosis down to the right problem.

Around 2008, some opthalmologists (eye doctors) started noticing that their patients with blepharitis had large amounts of demodex around the eyelashes and in the eye glands. Those patients also had large blackheads. They started treating patients with tea tree oil based eye lid scrubs. One of the doctors invented Cliradex Wipes with a tea tree oil extract. Blepharitis Demodex is what a dermatologist would call ocular rosacea. The opthalmologists seem to be more knowledgeable about the problems caused by demodex.

[Brady Barrows]

Hi Elaine and Brady how are you
I went to the dermatologist on Friday and she said everyone has Demodex, it?s normal flora.I told her my doctor sent me to you because I may have an overpopulation. She prescribed metronidazole gel.

Angela,
There is general consensus that demodex is part of the normal human microbiome within certain numbers, however, it is believed that the numbers increase in certain rosacea sufferers. Why this occurs is not known. Metronidazole is an antibiotic and antiprotozoal medication, not an insecticide. Demodex are "small arthropods belonging to the class Arachnida and the subclass Acari. Mites are not a clade as they span two different groups of arachnids: the Acariformes are sister to the camel spiders, while the Parasitiformes are sister to the false scorpions; also, they exclude the ticks, order Ixodida, although ticks and mites are closely related. Mites are distantly related to spiders and scorpions." [Source: Mites, Wikipedia]. The type of mites on humans are demodex (there are two types).

So, the medicine used currently to treat demodex is ivermectin (Soolantra) which is a topical insecticide used to kill parasites and it is now well established as part of the rosacea armamentarium used in treating rosacea, part of the gold standard treatment used by up to date, state of the art, knowledgable dermatologists who keep up with rosacea. Ivermectin has been shown superior to metronidazole. Some dermatologist are simply not keeping up with the latest state of the art medical treatment for rosacea and are still prescribing metronidazole topically. One of the treatments sometimes used is oral ivermectin along with oral metronidazole which has been reported to work well. Some dermatologists prescribe topical ivermectin along with topical metronidazole. You may want to read the Soolantra thread here at RF for thirty minutes.

Some dermatologists are taking a demodex density count while others do not. There are a number of methods of doing this.

There are a number of over the counter treatments for demodectic rosacea, i.e., ZZ cream, Ungex, horse paste, etc., and it has been reported that IPL kills mites. If after thirty to sixty days of using metronidazole gel you are not improving, you may want to ask your dermatologist about some of these treatments mentioned.

Not all rosacea is demodectic, but generally, the first line of treatment informed dermatologists are prescribing is the gold standard treatment and if this doesn't improve with sixty days, there are other treatments.

[Angela40]

Thank you Elaine and Brady
I told the dermatologist that I had Demodex on My eyelashes and use cliradex. My primary care doctor referred me to dermatologist to do a skin scraping. I made an appointment for skin scraping and the dermatologist said that I don?t need a skin scraping, I told him that?s what my doctor is requesting and the dermatologist just prescribed metronidazole gel for rosacea. I did not want to argue, I just need to find another dermatologist. So if metronidazole Gel doesn?t kill the Demodex I want to stop using it or do you guys know if the metronidazole gel will kill the Demodex?

[Angela40]

Also what kind of ipl do I request when I call the dermatologist office to kill the Demodex

[Brady Barrows]

Angela,
Metronidazole is an antibiotic and antiprotozoal medication. It has been used topically to treat rosacea for many years. There is one paper indicating success in using oral metronidazole along with oral ivermectin in treating rosacea. There is no evidence that metronidazole kills demodex mites. Demodex mites are in the class called Acari, hence are not protozoa, so metronidazole isn't an antiparasite medication (ivermectin is an antiparasite medication).

Applying the topical metronidazole may improve your rosacea, but if it doesn't in thirty to sixty days, you may want to try Soolantra (ivermectin) which a more informed dermatologist would know about this. Some dermatologists reason that it is not necessary to take a demodex density count and will prescribe Soolantra (ivermectin) and see if the condition improves in thirty to sixty days. If so, then obviously the issue is demodex and the Soolantra works. Hence, they don't bother to take a demodex density quantification. However, a few dermatologists do indeed take these tests to confirm if the patient has an increased number of demodex mites, which has been associated with demodectic rosacea, a rosacea variant. You may not have demodectic rosacea, since there are a number of other variants.

Mites don't like light, hence they dig deep into the skin during the day and usually move and come out at night usually along hair follicles. You can learn a lot about mites in this post. Hence, there is data suggesting that IPL kills mites (check the second post). There are a number of over the counter IPL devices available.

A cheap and inexpensive way to know if ivermectin improves your rosacea is horse paste (ivermectin). Thousands of rosaceans have used it. Just use the Rosacea Forum search box and type in 'horse paste' to browse the threads. A popular topical here at RF is the ZZ cream (use search box tool top right corner) which also kills the mites (sublimed sulphur).

[Stu_]

I have/had type 2 for about 3/4 years.

Doc gave me Lymecycline to start which cleared up pretty much straight away but then returned worse when I stopped.

Finally saw a proper derm and she prescribed Soolantra. I used that for a while but couldnt get it on presciption after the first month so I researched and came across Ivermectin Horse paste. I ordered some and started to apply every night mixed with a moisturiser (benton aloe proplois sooth gel)

I also started to use screen daily (Elta MD SPF46)

After 12 weeks my skin had returned to normal.

I use the Horse paste mixed with the moisturiser once a fortnight now, but I still apply the SPF every morning.

Havent had an issue for about a year now.

[mcgrannity]

Acne Rosacea subsided

Hi All,
Just a quick message to say how I finally got my acne Rosacea under control.
I've had various forms of dry/combination skin, flushing on the cheeks/temples/forehead, acne like pustules, rough scaly skin on my face and on my neck just behind my ears on and off for about 3 years. I'm a 36 yo male from Ireland, non smoker, I drink alcohol, my diet isn't amazing but it's not terrible either and I exercise fairly regularly. Pretty normal!

It really affected my confidence. I'm not sure if it is linked, but it started to happen shortly after my mother passed away from a brief illness.

I've found tetralysal very effective, I took it at one stage for about 5 months but shortly after completing the prescription the symptoms returned. Rosex did not work, nor did tea tree oil mixed with coconut oil. It did however make it shinier and more noticeable!

Earlier this year, after a particularly severe flare up, i asked to be referred to a dermatologist who prescribed Soolantra. The relief was only slightly noticeable which made me a bit frustrated. Then after doing some research I found articles that suggested using selsun shampoo to treat acne Rosacea.

Immediately I noticed an improvement, and I mean within a few days. Not only did my skin clear up but it started to feel normal. I stopped using the Soolantra with the selsun after 2 weeks, now I keep my acne Rosacea under control using selsun shampoo on my head, face and neck twice weekly. My skin has not been this good in years. I hope this helps!