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  • Demodex

    Has anyone discovered a remedy that works well for Demodex? I have the shampoos, sulfur, tea tree oil, permethrin, etc., it just seems like they all take forever and there are still mites down in the skin that aren't affected by the topicals. Thanks!

  • #2
    I'm in the same boat... I have everything on hand, just trying to figure out which one is the right treatment... but I think the first step is to look at it as something that's probably not going to be a quick fix, and will probably require long-term maintenance. For me so far the best thing was probably the tea tree oil to provoke a terrifying die-off (you saw the photos) to reduce the population of mites dramatically, and then just really really good skincare for now. I'm still in an intermediary stage as my dermatologist wanted my skin to heal from that huge flare-up before starting to try to fix the redness, but I am seeing the benefits of very, very assiduous skincare even without specifically rosacea treatments right now. But the tea tree oil thing was traumatic, just so you know.

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    • #3
      Have you tried either Soolantra or the ZZ cream?
      Brady Barrows
      Blog - Join the RRDi


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      • #4
        I think I got lucky in that permethrin worked wonders for me. Noticeable results in about 3 days.

        Been using for near two months now and the permanent redness I had is all near completely gone as is any sign of papules, etc. I’m only using once every few days now rather than every night.

        I didn’t see any noticeable results when I used soolantra. Which was weird.

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        • #5
          Yeah, I’ve tried so many things. I recently mixed up a bunch of different ingredients together and have been trying that. I was just hoping someone might have found something I haven’t tried yet, lol. Dryad—yes I’m very familiar with the tto die off trauma. I get a terrible inflammatory rash that’s so bad I can hardly sleep, large peeling bleeding lesions, ugh! I get it from permethrin too. This time around I was able to mitigate it with metronidazole, but it’s awful. Thanks for the responses.

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          • #6
            Brady—I’ve never tried the zz cream specifically, no, but I have used sulfur based creams.

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            • #7
              I had demodex that got misdiagnosed for decades as acne vulgaris and allergic conjunctivitis. The "allergic conjunctivitis" evolved into a severe case of ocular rosacea / blepharitis demodex. The topical tea tree oil and Cliradex wipes helped but could not wipe the demodex out even after months of use.

              I took the 2 week combined oral treatment published in the International Journal of Infectious diseases in May 2013. It worked. I had no side effects from the 2 drugs. I am still clear over 7 months later.
              Here's the link to the article: https://www.sciencedirect.com/scienc...0197121201315X

              The combined treatment drugs are: Oral Ivermectin and Oral Metronidazole. These drugs are both available as inexpensive generics. With insurance the co-pay was $13.03 USD. Without insurance the cost is about $52 retail.

              The Oral Ivermectin dose is based on body weight. 200 micrograms per Kilogram. The pills are sold in 3 milligram size so my doctor rounded the dose up slightly to 12 milligrams per weekly dose so breaking tablets would not be necessary. Some oral ivermectin treatment regimens prescribe up to 250 micro-grams per kilogram so rounding the dose up a little was not going over the recommended dosage for the drug.

              Dosage:
              1. Oral Ivermectin is taken in 2 doses, 1 week apart. First day of treatment and 8th day of treatment. Take on an empty stomach with a large glass of water.
              2. Oral Metronidazole is taken daily at 250 mg per dose, three times a day with food. Do not drink alcohol while taking Oral Metronidazole and for 3 days after finishing the last tablet.

              Note: The oral metronidazole has been found to be far more effective against demodex mites than the topical version like Metrogel. One study even put live demodex mites into a solution of liquid metronidazole and it did not kill them. The oral metronidazole is very effective. They believe that the oral version of the drug changes the environment for the mites killing them off.
              Last edited by ElaineA; 2 October 2018, 01:56 AM. Reason: Fixed units on body weight for max dose per KG

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              • #8
                Elaine, I completely agree that oral metro 250 x 3 has been the most effective approach in eliminating the symptoms, followed by oral ivermectin. The problem with oral ivermectin is that it can’t get all of them in 2 weeks because the body eliminates it quickly, system levels are like a downward J shaped curve and by day 4 or so it gets pretty low. The 3 x per day metro sufficiently maintains concentration of the medication in your system. A longer course of ivermectin, like 5 or 7 weeks, might do it but doctors don’t seem to want to prescribe more than 2 weeks worth. Do you do anything to maintain, or was it just completely gone after your initial 2 week treatment?

                Edited to clarify: by “eliminating the symptoms” I mean the relatively severe symptoms of an advanced condition or outbreak. And unfortunately, yes it does seem to return after being cleared up by the treatment. It seems that maintenance or preventative treatment is necessary. However, as a person with a highly inflammatory version of this condition, just getting to the maintenance/prevention stage is a big accomplishment.
                Last edited by btsarah; 1 October 2018, 06:05 PM. Reason: Add comment

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                • #9
                  There is a new medication called moxidectin, it’s related to ivermectin but has a much longer half life. I think it was just approved by the FDA this year but only for onchocerciasis—hope I spelled that right, lol. This could become another option in the future.

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                  • #10
                    Elaine, this sounds like an effective way to manage demodex but the antibiotic may worsen folliculitis for those of us suffering from it as a result of antibiotics.

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                    • #11
                      Just beware, it's not a treatment without side effects and it also isn't effective for everyone. And even if it is effective, often the results aren't long lasting. So it's better to find a topical that you can also use as a maintenance for a long time, because these orals can't be used that way. Elaine is lucky it worked for her as a one time treatment.

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                      • #12
                        Maria and Shaun, what has worked best for you?

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                        • #13
                          Metronidazole cream, tea tree oil 50% and zz cream. Not at the same time, of course.

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                          • #14
                            Has anybody tried azelaic acid? I haven’t tried this. You can get it in 10%, 15% and 20%. Also, I haven’t tried the zz cream. I have tried sulfur creams, is the zz cream different?

                            I don’t just have this on my face—it’s everywhere. I have a problem with excessive inflammation from just about everything, so that may be a contributing factor, but I’m pretty sure that everyone has these things all over, not just on the face. I know this is disgusting, but they were even coming out of the inside of my nose and out of my tongue! Ewww! So I approach this like it’s lice, cover yourself from head to toe with medicated cream, hair too.

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                            • #15
                              A lot of people tried azelaic acid, type it in the search box in the upper right corner. I used it only once and had to wash it off, because of the burning sensation.
                              Zz cream is different from the other sulfur creams because of its unique composition. Just visit the demodexsolutions website to read more, a lot of useful information there.

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