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Thread: Rosacea- a doctors experience

  1. #1
    Junior Member
    Join Date
    Nov 2015
    Country: UK

    Default Rosacea- a doctors experience

    Hello everyone… My name is Dan and I’m a 31 year old doctor. This is my first post here but I have read with interest all the good information and experiences on this site. I just wanted to share my own with you.

    I will preface this by saying I am not a dermatologist. I am training in orthopaedic surgery, and so my dermatology knowledge is pretty much limited to the minimum amount required to pass finals at medical school. Only 6 months ago, I knew virtually nothing about rosacea, other than it existed. And no, I also do not have any pecuniary interest in Soolantra either.

    Now I have never suffered with bad skin. Aside from a few pubescent pimples which nearly all teenagers suffer from, my skin has been clear. Inexplicably 6 months ago, my whole face broke out into horrible blotches and pimples. But they were not your typical spots: they didn't come to a head, just raised red lumps which took a long time to go (2-3 weeks). I even attempted to ‘pop’ a few- which released nothing but clear, oedematous fluid. There were also red, scaly patches of skin. These were not raised at all, but looked just as unsightly. At first I thought it was just stress, and they would soon go. But more and more began to crop up. What was most distressing to me was that they often left a brownish discolouration of my skin once they had gone. I also began noticing telangiectasia on my cheeks and bridge of my nose.

    I felt miserable- I avoided looking in the mirror, and my self esteem began to suffer. I hated it when talking to someone and I could see them talking directly to the breakout on my cheek. So I ran a google search and pretty quickly reached the conclusion that it was type 2 rosacea. So I took myself off to the GP- who diligently gave the ‘incurable but how to avoid breakouts’ spiel. He also prescribed topical metronidazole and oral doxycycline.

    At first this seemed to control some of the redness, but it still seemed that every week there would be a new cluster of pimples. My skin also continued to look bumpy and uneven, particularly when stood directly under a light source. But I persevered for upwards of 6 weeks, to little improvement. I also tried countless other avenues: stopping drinking alcohol, stopping smoking, going gluten free, using hypo-allergenic surgical face masks- all really to no avail.

    It was during this time that I found this site, and began reading about the demodex theory and Soolantra. To my mind it made perfect sense. The theory that it is in fact the enteric bacteria released when the mite dies which causes the intense inflammatory reaction could well explain doxycycline’s ability to reduce redness, as the enteric bacteria are sensitive to this antibiotic. But doxycycline would have limited activity against the underlying cause: the mite. My parents’ pet dog had also been suffering from an odd skin condition over the same time frame: his fur was falling out in clumps, leaving him bald over his back and legs. I did wonder if this was in fact demodetic mange. I also had noticed that the breakouts were all in very close proximity to each other- and predominated over the right side of my face. I have since learned that predominantly unilateral rosacea necessitates looking for alternate diagnosis. Such as demodex dermatitis.

    So I returned to the GP, and asked for a prescription for the Soolantra. Frustratingly, he refused. Obviously I was really irritated by this, and, as self-prescribing is frowned upon, instead visited a dermatologist working in my hospital. She had no problems with prescribing it for me. I excitedly rushed home to try it that evening. I had read that this was the time when the mites were most active, and so applied it every evening around 6 o’clock.

    I did not experience the cooling sensation others have detailed. But I will say the cream itself has a very neutral smell- I was half expecting it to smell like a chemical insecticide. It also works well as a moisturiser. I have been taking it together with the doxycyline- my theory is the Soolantra will kill the mite, and the doxycycline will take care of the enteric bacteria which are released when they die off. This is not evidence based in any way.

    As others have seen, after about 5 days I did get a flare up- but this rather encouraged me as I was sure this meant that the critters were dying. Then again at around 3 weeks the same thing happened. Given the gestation period of a demodex egg is around this time, I expect this was a the next generation of mites dying off. Gradually I noticed my skin clearing up.

    At the same time, we took my parents dog to the vets. They said it was more likely to be seasonal baldness, and did not prescribe him anything. Given the side effect profile of ivermectin is pretty mild, I bought some for him. They applied this every morning and night to the bald spots on his back and legs.

    I’ve now been on Soolantra for about three months. And my skin is approaching looking normal again. As others have seen, the texture is once again smooth. No new pimples have appeared for nearly a two months, and I feel so relieved in myself. Likewise, my dogs fur has now completely grown back. There is a chance it could have been seasonal baldness, but I think it's quite a coincidence that I got symptoms at the same time, and it also responded to the ivermectin...

    I don’t know what everyone else’s experience is of getting Soolantra from their GP, but I was fairly shocked when he wouldn't prescribe it, especially given how its clinical effectiveness is fairly well documented. I certainly would have no qualms in prescribing it for anyone suffering from this condition.

    Anyway thanks for reading- it was quite cathartic writing this and hope it contains some information which may help others. Dan

  2. #2
    Junior Member
    Join Date
    Dec 2015
    Country: United States

    Default Thank you!

    Very good to hear a medico perspective.

  3. #3


    Nice to hear from a doctor from the view of a patient and sufferer of rosacea.

    All the best.
    Get Rosacea News here -

  4. #4
    Junior Member
    Join Date
    Apr 2015

    Default More doctors need to keep open minds

    I've read journals written in other countries that treat it as fact that demodex is responsible for some forms of rosacea, and is really a form of demodectic mange similar to that found in dogs. It boggles my mind that American doctors (to name just a few) can fully believe in sarcoptic mange going from dog to human, but that demodex going from dog to human is simply impossible. Yes, we could be reacting to the bacteria in the mite instead, or maybe something else entirely. But why are they so adamant demodex transmission is impossible but sarcoptic is a given?

    Using this message board supplemented with Mr. Google, I decided on a course of treatment that has made my skin so good of late, I no longer put my hand in front of my face when someone unexpectedly wants to take a picture. It only costs me about $18 a month. I found a GP that agrees to prescribe everything I ask for after consulting him, which makes life easier.

    I don't know for sure if it's demodex, but from what I've read and my own personal experience, it seems like the answer to me. As a teenager my face and neck and back were super oily, and full of acne. In my early 30s my back "dried up" and cleared up for the most part. Then my neck did the same... Then my face got better but still oily and acne prone. Demodex thrive in the oil, and less demodex and less bacteria in demodex guts = better skin for me.

    Is it possible a bacteria or organism unrelated to demodex is thriving in oily parts of my body, and the mites are innocent? Yes. Do I trust these dermatologists that try to get me on $500 a month brand- name only meds? No. I just hope more med students think for themselves and don't get sucked into the world of Big Pharma! Thank you future doctors of the world, the ones of you that don't just blindly memorize textbooks.

  5. #5
    Junior Member
    Join Date
    Jan 2016
    Country: United States


    This is all confusing and overwhelming, this site has so much information.

  6. #6
    Senior Member
    Join Date
    Jan 2015


    Quote Originally Posted by soriahmccord View Post
    This is all confusing and overwhelming, this site has so much information.
    Yes, it takes a good while to digest and there is ways something new to be found. Hang in there!

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