Soolantra

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Originally Posted by Tso

Soolantra seems to work well for my skin, but I wonder whether it can be contributed to demodex-killing, because Soolantra also has other properties: http://www.soolantra.com/hcp/mechanism-of-action

• It is anti worms.
• It is anti demodex.
• It contains Cetaphil Moisturizing Cream.
• Anti-inflammatory: Decreases cellular and humoral immune responses.
• Parent compound avermectin has been shown to significantly regulate TNF-α, IL-1β and IL-10 in lipopolysaccharide-induced inflammation in in vitro studies.

So in theory, it maybe could simply be suppressing my symptoms?

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It's possible that it can be something else besides killing demodex mites, but since soolantra was made for the purpose of killing demodex mites, I'd say the bacteria left behind from dead demodex mites are the leading cause of papulopustular rosacea, in my opinion. After using soolantra for a long time, and then stopping, studies have shown that rosacea does not come back for a much longer period of time than when using tetracyclines, or any other topical medications. This again points in favor of Demodex being the culprit. To me is shows that your Rosacea returns once the overpopulation of Demodex returns. Being rosacea suffers, if we are susceptible to demodex overpopulation once, we surely will be again without continued treatment.

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Originally Posted by Evan1986

It's possible that it can be something else besides killing demodex mites, but since soolantra was made for the purpose of killing demodex mites, I'd say the bacteria left behind from dead demodex mites are the leading cause of papulopustular rosacea, in my opinion. After using soolantra for a long time, and then stopping, studies have shown that rosacea does not come back for a much longer period of time than when using tetracyclines, or any other topical medications. This again points in favor of Demodex being the culprit. To me is shows that your Rosacea returns once the overpopulation of Demodex returns. Being rosacea suffers, if we are susceptible to demodex overpopulation once, we surely will be again without continued treatment.

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I don't think I had a mite overpopulation before using Soolantra, unless the ratio between mites on skin surface compared to inside pores is large. Studies that talk about demodex count per square centimeter, usually talk about a lot of mites. For example http://www.nature.com/jid/journal/v1...d2010335a.html says:

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The density of mites on the face ranged from 0 to 384 mites/cm2, with a mean of 214 mites/cm2

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While it is difficult to find mites on my face using a skin microscope. I my case, It would be closer to something like 0.2 mite/cm2 when counting on skin superficial surface. Most mites probably life inside the pores (which I can't see with the microscope), so I can't really tell the correct amount per cm2.

Btw, also note that I found demodex on top of my scalp. So I'm also applying Soolantra there.

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Originally Posted by Tso

I don't think I had a mite overpopulation before using Soolantra, unless the ratio between mites on skin surface compared to inside pores is large. Studies that talk about demodex count per square centimeter, usually talk about a lot of mites. For example http://www.nature.com/jid/journal/v1...d2010335a.html says:

While it is difficult to find mites on my face using a skin microscope. I my case, It would be closer to something like 0.2 mite/cm2 when counting on skin superficial surface. Most mites probably life inside the pores (which I can't see with the microscope), so I can't really tell the correct amount per cm2.

Btw, also note that I found demodex on top of my scalp. So I'm also applying Soolantra there.

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It's possible that some people take reaction differently to demodex bacteria than others, much like an allergy. In that case, any demodex population that will cause this reaction would be considered an overpopulation. Since I've started using soolantra I have also found a lot more "scalp activity". That's why I started putting tea tree oil in my shampoo a couple weeks ago.

I started using Soolantra on thursday (14/10/2015) and my initial results are not encouraging.

My skin has gotten more red and inflamed, although my skin does not itch. Actually, i hasn't felt any itchiness since i started using salt water for my sebderm.

I decided to upload some photos taken today, because I want to ask you if you think that i have rosacea or any kind of similar condition. And, for what you can see on the photos, if you think it's subtype 1 or 2. I always thought i have had subtype 2 but the majority of my bumps are realy small and red, and the major ones just seem like swollen inflamed areas.

For last, could it be demodex if i don't feel any itchiness?Attachment 3642Attachment 3643Attachment 3644Attachment 3645Attachment 3646

^ You're pores look similar to mine with tiny little flakes in them. Also, I can see the oiliness that I have too in those photos. I wouldn't use salt water, it's too harsh and will cause irritation and rebound oiliness.

I've been using Soolantra for about a month. The results are ok, nothing special but better than any other topical i've used. I use it at night and wash it off in the morning. I'm still trying to figure out what to wash it off with. I was using neutrogena's oil free acne wash but I think that over time was too harsh and causing my skin to become oilier than it should. Right now i've been using a mix of tea tree oil (20%), with mct oil (80%) and a bit of xylitol. I mix all of it in a small container and then put it on my face for about 10 mins before I shower in the morning.

My pores are definitely smaller using Soolantra although the condition is still there and the redness hasn't really gone down much.

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Originally Posted by johny

^ You're pores look similar to mine with tiny little flakes in them. Also, I can see the oiliness that I have too in those photos. I wouldn't use salt water, it's too harsh and will cause irritation and rebound oiliness.

I've been using Soolantra for about a month. The results are ok, nothing special but better than any other topical i've used. I use it at night and wash it off in the morning. I'm still trying to figure out what to wash it off with. I was using neutrogena's oil free acne wash but I think that over time was too harsh and causing my skin to become oilier than it should. Right now i've been using a mix of tea tree oil (20%), with mct oil (80%) and a bit of xylitol. I mix all of it in a small container and then put it on my face for about 10 mins before I shower in the morning.

My pores are definitely smaller using Soolantra although the condition is still there and the redness hasn't really gone down much.

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Thanks for the answer

Have you ever tried Finacea or Metro? Did your face got worst when you started using soolantra?
What are these tine little flakes inside the pores? Is this rosacea subtype 2?

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Originally Posted by PdemP

Thanks for the answer

Have you ever tried Finacea or Metro? Did your face got worst when you started using soolantra?
What are these tine little flakes inside the pores? Is this rosacea subtype 2?

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Hi, doesn't look like subtype 2 rosaca. You would have obvious red inflammatory bumps and/or pustules. That's why you're not seeing results from Soolantra. It's designed to help with the bumps/pustules - so for subtype 2 folks.

Have you been diagnosed with seb derm? Many people do have rosacea and seb derm together. But not everyone. It's hard to tell from your photos.

There are many threads and lots of info on seb derm and how to treat it. You can search in the search box and find a lot of guidance. Perhaps your doctor also prescribed some things - if you were diagnosed with seb derm. There are certain shampoos that help some seb dermers on their face and scalp. Various lotions or home remedy treatments. Plus a lot of seb dermers are here that can help you. I'm a flushing type 1 rosacean - but I hope I was helpful nonetheless! :)

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Originally Posted by hg24

Hi, doesn't look like subtype 2 rosaca. You would have obvious red inflammatory bumps and/or pustules. That's why you're not seeing results from Soolantra. It's designed to help with the bumps/pustules - so for subtype 2 folks.

Have you been diagnosed with seb derm? Many people do have rosacea and seb derm together. But not everyone. It's hard to tell from your photos.

There are many threads and lots of info on seb derm and how to treat it. You can search in the search box and find a lot of guidance. Perhaps your doctor also prescribed some things - if you were diagnosed with seb derm. There are certain shampoos that help some seb dermers on their face and scalp. Various lotions or home remedy treatments. Plus a lot of seb dermers are here that can help you. I'm a flushing type 1 rosacean - but I hope I was helpful nonetheless! :)

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Thanks for the help hg24,

yes, i've been also diagnosed with seb derm, but my doctors never prescribed me a thing for that condition, only for rosacea. Is it possible that it's only sebderm? maybe that's why all my previous treatments didn't work.

Yes, it's possible it's only seb derm. Seb derm has it's own redness and some texture issues with the flakiness. It's fairly common for rosacea and seb derm to be misdiagnosed for the other. But it's also common for the two to co-exist.

Weird that the doctors didn't give you suggest any treatments and/or offer guidance for your seb derm. If you search around, you'll see there are some shampoos OTC you can try. You basically wash you face gently with them. Head and Shoulders. Nizoral (ketoconazole). There are other OTC/home remedy approaches that some find helpful. Nothing harsh. It's not to be approached as you would acne. And no steroid cream. Some people have luck with tea tree oil diluted in a carrier oil such as sweet almond oil, jojoba or a a couple of drops in your gentle moisturizer. There are many threads on that - search tea tree oil. Tea tree oil can burn so it has to be diluted in something and used sparingly. It's not to be lathered on. A few drops.

Anywho, there are other things, too. So look around. Threads old and new can help. It's trial and error, which can be frustrating. Certain treatments can help some but not others. But there are many treatment options for seb derm that work, so you'll find what works for you. :)

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Originally Posted by hg24

Yes, it's possible it's only seb derm. Seb derm has it's own redness and some texture issues with the flakiness. It's fairly common for rosacea and seb derm to be misdiagnosed for the other. But it's also common for the two to co-exist.

Weird that the doctors didn't give you suggest any treatments and/or offer guidance for your seb derm. If you search around, you'll see there are some shampoos OTC you can try. You basically wash you face gently with them. Head and Shoulders. Nizoral (ketoconazole). There are other OTC/home remedy approaches that some find helpful. Nothing harsh. It's not to be approached as you would acne. And no steroid cream. Some people have luck with tea tree oil diluted in a carrier oil such as sweet almond oil, jojoba or a a couple of drops in your gentle moisturizer. There are many threads on that - search tea tree oil. Tea tree oil can burn so it has to be diluted in something and used sparingly. It's not to be lathered on. A few drops.

Anywho, there are other things, too. So look around. Threads old and new can help. It's trial and error, which can be frustrating. Certain treatments can help some but not others. But there are many treatment options for seb derm that work, so you'll find what works for you. :)

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I am very grateful for your tips,

I'll try to use a soap composed by climbazol that i used a long time ago - 10 years - when i got tinea versicolor on my face and upper body. Hope it works!