Soolantra

I just received my prescription for Soolantra from my derm. As I anticipated, she had no idea what pityriasis folliculorum is. But I'm grateful that she is allowing me to try to rule out democidosis.

Here are my symptoms I'm hoping to alleviate:

1) follicular scaling- small white scales protruding from the pores on my cheeks and temples giving my skin a rough, dry, sandpaper like texture.

2) Superficial pustules. These are tiny pimples with a white center and inflammation around it. I have 2-3 of these on my face frequently.

3) Erythema/redness affiliated with my scaling

Fingers and toes crossed I'm able to tolerate this cream and it works!

Quote:

---

Originally Posted by sks42

Tom, months ago when my dermatologist suggested I may have rosacea he prescribed retin-A. It seemed an odd choice, but after going through a month of holy terror, my "rosacea" improved by half. After months of retin-A use my skin is pretty amazing and although I'm 42 I genuinely look about a decade younger. A bit of genetics, but also the use of retin-A. Retin-A can only be used in the evening, thus why I use my demodex products in the morning.
I think my results have been hindered by my morning use, so I may take longer to heal than most people. I agree with your assessment that the die-off cycles could be more variable depending on demodex type. Having read these forums I have found that people have varied results and so I try to be patient and just judge overall improvement over the weeks.

---

This seems rather peculiar to me. If your condition is caused by Demodex Mites and you indeed have Demodectic Rosacea, then you should surely be treating your Rosacea with Demodectic Rosacea defeating products which will return your skin to normal or close to normal, such as Soolantra or ZZ Cream.

Does your derm know specifically about Demodex Mites / Demodectic Rosacea?

It sounds like they may have prescribed Retin-A for 'adult acne'.

ZZ Cream definitely can't be applied in the morning, though you could pass with a weak dilution. Note that I only use a weak dilution to control my Rosacea because I have already used a fairly strong dilution for 1 - 2 months which eliminated my Demodex Mites.

Still, it makes no sense limiting ZZ Cream (or Soolantra) treatment to mornings, and prioritising a non Demodectic Mite combating product to the evenings, which is not going to resolve your problem.

Unless I am mistaken?

Quote:

---

Originally Posted by MissM

I just received my prescription for Soolantra from my derm. As I anticipated, she had no idea what pityriasis folliculorum is. But I'm grateful that she is allowing me to try to rule out democidosis.

Here are my symptoms I'm hoping to alleviate:

1) follicular scaling- small white scales protruding from the pores on my cheeks and temples giving my skin a rough, dry, sandpaper like texture.

2) Superficial pustules. These are tiny pimples with a white center and inflammation around it. I have 2-3 of these on my face frequently.

3) Erythema/redness affiliated with my scaling

Fingers and toes crossed I'm able to tolerate this cream and it works!

---

Great news, I'm sure you're feeling somewhat of a sense of relief even if only in anticipation.

Quote:

---

Originally Posted by RedRecluse

This seems rather peculiar to me. If your condition is caused by Demodex Mites and you indeed have Demodectic Rosacea, then you should surely be treating your Rosacea with Demodectic Rosacea defeating products which will return your skin to normal or close to normal, such as Soolantra or ZZ Cream.

Does your derm know specifically about Demodex Mites / Demodectic Rosacea?

It sounds like they may have prescribed Retin-A for 'adult acne'.

ZZ Cream definitely can't be applied in the morning, though you could pass with a weak dilution. Note that I only use a weak dilution to control my Rosacea because I have already used a fairly strong dilution for 1 - 2 months which eliminated my Demodex Mites.

Still, it makes no sense limiting ZZ Cream (or Soolantra) treatment to mornings, and prioritising a non Demodectic Mite combating product to the evenings, which is not going to resolve your problem.

Unless I am mistaken?

---

Hey,
No, my derm doesn't really know about demodectic rosacea. He prescribed retin-a for what he thought was rosacea subtype 2. I do not have adult acne, and that isn't what he said he thought it was. Perhaps subtype 2 is considered adult acne. I don't know his reasoning to be frank. At the time I did not even ask because I was new to having any kind of skin issue. I also wouldn't say that retin-a hasn't helped with demodex. It dramatically increases skin cell turnover and constantly keeps your pores cleared out and lowers sebum production. It would stand to reason that it would make a more difficult living environment for demodex. I did notice a 50% reduction of my symptoms after about a month on retin-a. On my own I researched demodex and asked my derm if he would be willing to call me in a prescription for Soolantra so I could see if it helped. He did and here I am:)

Quote:

---

Originally Posted by sks42

Hey,
No, my derm doesn't really know about demodectic rosacea. He prescribed retin-a for what he thought was rosacea subtype 2. I do not have adult acne, and that isn't what he said he thought it was. Perhaps subtype 2 is considered adult acne. I don't know his reasoning to be frank. At the time I did not even ask because I was new to having any kind of skin issue. I also wouldn't say that retin-a hasn't helped with demodex. It dramatically increases skin cell turnover and constantly keeps your pores cleared out and lowers sebum production. It would stand to reason that it would make a more difficult living environment for demodex. I did notice a 50% reduction of my symptoms after about a month on retin-a. On my own I researched demodex and asked my derm if he would be willing to call me in a prescription for Soolantra so I could see if it helped. He did and here I am:)

---

It really infuriates me that dermatologists (at least the ones that I have been to) don't know jack sh*t about rosacea!! I mean, seriously, isn't that their job to know about these conditions? It's not like rosacea is some sort of unique, random condition!!

During my derm visit today, I was so frustrated that my derm barely looked at my skin and didn't want to hear anything about my concerns regarding pityriasis folliculorum (a type of demodex infestation). To top it off, she didn't even know what I was talking about. I brought in some scholarly articles about the condition, and she didn't even blink an eye. If I was a doctor trying to help people with their skin conditions, I would have snatched up those journal articles from the patient presenting them to me and looked into it for the sake of my patient's well being and to simply further my knowledge as a practicing dermatologist!!

Subtype 2 rosacea is NOT adult acne. Retin-A could have caused inflammation and harm to someone suffering from rosacea. I feel like it's not ethical to throw prescriptions at patients without the knowledge of the disease pathology, especially when harsh exfoliates like BHA/AHA and Retin-A are usually contraindicated for someone who has rosacea. With that said, I'm glad that the Retin-A didn't harm your skin, but it could have, and that sucks. Your derm should also know that demodex comes out at night and perhaps that's when you should apply the Soolantra for best efficacy.

Sorry about the rant. I am glad that you advocated for yourself and asked about Soolantra. I had to do so myself, and at the very least, I did get a prescription today.

Quote:

---

Originally Posted by MissM

Subtype 2 rosacea is NOT adult acne. Retin-A could have caused inflammation and harm to someone suffering from rosacea. I feel like it's not ethical to throw prescriptions at patients without the knowledge of the disease pathology, especially when harsh exfoliates like BHA/AHA and Retin-A are usually contraindicated for someone who has rosacea. With that said, I'm glad that the Retin-A didn't harm your skin, but it could have, and that sucks. Your derm should also know that demodex comes out at night and perhaps that's when you should apply the Soolantra for best efficacy.

Sorry about the rant. I am glad that you advocated for yourself and asked about Soolantra. I had to do so myself, and at the very least, I did get a prescription today.

---

I hope your prescription really works for you! Good Luck. I'm not sure where you are located, but I'm in America and I have read articles that suggested that American dermatologists are not as open to the concept of demodex and it's link to rosacea as some other countries may be. I have no idea if that's true, it's just what I've read.

Quote:

---

Originally Posted by sks42

Hey,
No, my derm doesn't really know about demodectic rosacea. He prescribed retin-a for what he thought was rosacea subtype 2. I do not have adult acne, and that isn't what he said he thought it was. Perhaps subtype 2 is considered adult acne. I don't know his reasoning to be frank. At the time I did not even ask because I was new to having any kind of skin issue. I also wouldn't say that retin-a hasn't helped with demodex. It dramatically increases skin cell turnover and constantly keeps your pores cleared out and lowers sebum production. It would stand to reason that it would make a more difficult living environment for demodex. I did notice a 50% reduction of my symptoms after about a month on retin-a. On my own I researched demodex and asked my derm if he would be willing to call me in a prescription for Soolantra so I could see if it helped. He did and here I am:)

---

Thought so. I am 99% convinced that Rosacea Subtype 2 is Demodectic Rosacea, caused by Demodex Mites. The 'traditional' and commonly known Rosacea, Subtype 1, is not caused by Demodex Mites. It is a 'vascular' and caused by mostly unknown reasons, not Demodex Mites. Please read here - https://rosaceagroup.org/The_Rosacea...l=1#post337009.

Please consider scrapping the Retin-A and using only Soolantra at night. You are being guided by someone who does not know what you are suffering from, and who may even not believe in Demodex Mites, which is fact. If you still have pustular breakouts, then you really ought to move onto ZZ Cream (correctly at night).

Is it me or things are moving quite fast with soolantra? Yesterday evening (day 9) several red volcanoes popped up on both cheeks before bed, now i wake up and they morphed into small, discrete pustules? Maybe because i started using it twice a day? I am trying to get over the bumpy ride faster!

Quote:

---

Originally Posted by sks42

I hope your prescription really works for you! Good Luck. I'm not sure where you are located, but I'm in America and I have read articles that suggested that American dermatologists are not as open to the concept of demodex and it's link to rosacea as some other countries may be. I have no idea if that's true, it's just what I've read.

---

Thank you, sks42! I think you are right...doctors aren't down with the demodex knowledge here. Hopefully, that will change as people get better on formulas such as Soolantra and ZZ ointment/cream.


On another note, I started Soolantra last night. My skin seemed to tolerate the application well...no burning, stinging or flushing. Today I woke up with a bunch (more than usual) of new pustules in my usual breakout spots. Is it possible to have a die off within 24 hours or is this a fluke?

Quote:

---

Originally Posted by MissM

Thank you, sks42! I think you are right...doctors aren't down with the demodex knowledge here. Hopefully, that will change as people get better on formulas such as Soolantra and ZZ ointment/cream.


On another note, I started Soolantra last night. My skin seemed to tolerate the application well...no burning, stinging or flushing. Today I woke up with a bunch (more than usual) of new pustules in my usual breakout spots. Is it possible to have a die off within 24 hours or is this a fluke?

---

More than likely a fluke, it'll take a few days.