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Thread: I need your help please. I have posted pictures. Could it be Demodectic Rosacea?

  1. #1
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    Default I need your help please. I have posted pictures. Could it be Demodectic Rosacea?

    Dear all,

    last November, I moved to New Zealand on a working Holiday visa and developed a facial rash. I have seen several doctors around the country but none of them have been able to make a proper diagnosis on my skin condition.

    Below is a letter written by one of the dermatologists I saw :

    "I first saw patient XXX on XXX for a facial rash of uncertain duration - it had been coming and going maybe for a few months. He had already seen a variety of doctors on his travels around New Zealand and had been given various diagnoses (impetigo, seborrheic dermatitis etc) and a variety of treatments (ketoconazole cream, hydrocortisone cream, fucidin cream, doxycycline tablets, itraconazole tablets, prednisolone cream, flucloxacillin tablets, pimecrolimus cream).

    At the time I first saw him there was erythema and scaling and some pustules in a perioral distribution - it was a bit like a perioral dermatitis except the pustules were bigger than one would expect for that condition and furthermore there was a history of pustules on the forehead which would be an unusual site. It wasnt typical of acne either (no comedones). The pustules seemed a bit large for seborrheic dermatitis also. So it didnt fit neatly with any one condition. I gave him minocycline tabs and did a swab which was negative.

    He was booked for a biopsy on XXX but the rash at that stage was quiescent and I felt that there was a low chance of getting useful information at that stage. The diagnosis is still uncertain - an inflammatory dermatosis with pustules, which includes things like perioral dermatitis, seborrheic dermatitis, rosacea, demodex folliculitis and others); infection has been excluded. A biopsy will give better results if it is done during a flare up phase."

    I am currently traveling around Indonesia and my condition has not improved. This thing is not only very itchy, it is also ruining my self-esteem. I have read about demodectic rosacea and have been using permethrin 5% for about a week now but my skin is at its worst. If it is a mite infestation, is it normal that the skin gets inflamed like this? Thank you so much.


    DSC07494.jpgDSC07510.jpgDSC07511.jpg

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    Yes, it looks like demodex and therefore it's perfectly normal that permethrin makes it worse at first, as it kills off the mites. This stage can last even for 2 weeks, but then you should get better gradually. Permethrin cream should be only applied once a week, because it can be irritating for the skin and it can be also absorbed systematically.

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    Thank you so much, I truly hope it gradually gets better.

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    It will.

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    Hello,

    Although I have not used permethrin in four days, my skin condition now looks worse than it ever has.
    Has anyone experienced a similar reaction to the product? It is scary to look at and very painful.

    MariaSt, what made you think it was demodex? Thank you.
    Attached Images

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    I said that it looks like demodex, because your "rash" and your red pores are characteristic. If you want to confirm this or sthg else, you can go to a microbiologist and perform skin scrappings, cultures,etc. You can also try an ivermectin cream instead of permethrin, because it's less irritating.

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    Hello,

    I had a similar thing when I had a flare up months ago but with more extent areas. It was caused by a moisturizer (who apparently feed the yeast) + stress + self esteem down.
    It seems that you maybe have also dermatitis sebboreic (who often coexist with rosacea/demodex).

    Be careful to what you apply on your skin. Some cream make it worse.

    Does it burns?

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    There were no flakes before permethrin.

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    Hello,

    Thanks to you both for your message.

    Yes, it is burning.

    Before I started permethrin, I used Crotamiton for about two weeks and noticed much improvement. Then, one day, I decided to shave my beard and the pustules and redness came back a few days later. Although I have been regularly placing the cutting head in boiling water in order to disinfect it, can it be that my electric shaver is also infested?

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    Quote Originally Posted by atlas222 View Post
    Hello,

    Thanks to you both for your message.

    Yes, it is burning.

    Before I started permethrin, I used Crotamiton for about two weeks and noticed much improvement. Then, one day, I decided to shave my beard and the pustules and redness came back a few days later. Although I have been regularly placing the cutting head in boiling water in order to disinfect it, can it be that my electric shaver is also infested?
    Is your electric razor totally nickel-free? Allergy to nickel is very common.

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