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Thread: Desperately Need Help Fighting Demodex Mites

  1. #1
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    Default Desperately Need Help Fighting Demodex Mites

    I'm Male (33); do not have Rosacea or any symptoms at all.

    This May, I developed a Demodex mite infestation. I saw multiple Dermatologists in NYC that were unhelpful & unable to diagnose and suggest treatments. I finally got diagnosed by an Ophthalmologist, and realized the die-offs were occurring every 2.5 weeks, all the symptoms aligned, etc.

    Just prior to the Demodex infestation, I was on a medication that I later realized potentially causes adrenal suppression, and was in close contact with a family member who also has Demodex, though I myself never had issues with Demodex prior to this (had typical Acne that stopped over 5 years ago).

    For the last ~4 months, I've treated the problem pretty aggressively. Topically, I've used Cliradex & Ovante products for eyes, Grisi sulfur soap for body & scalp, DeLaCruz & NuStock sulfur for face, Hypochlorous spray for face, Permethrin for scalp, Selsun Blue & Denorex for scalp, Borax shampoo, Tea Tree Oil for face & scalp, Ivermectin 1% cream by Teva (soon to switch to horse paste). I also did the 2-week oral Metronidazole + Ivermectin course at the start of my treatment, and have taken oral Ivermectin weekly since then (so 10+ doses up until now).

    My breakouts are almost entirely on my forehead, scalp, and behind my ears. In terms of the number of breakouts I get each die-off period, I've managed to ~half the number (down to 5-6 new pimples each die-off period now), but they are still always there. Over the last month or so, I've treated the scalp pretty aggressively with Borax shampoo & undiluted Tea Tree Oil, and think I am experiencing a migration back to the forehead, where it all started.

    Another surprising thing is that even though the amount of breakouts have been at least halved since I started treatment, the pimples I am getting now on the forehead are deeper & puss-filled, whereas the initial ones in May where very surface-level and itchy, with no risk of scarring. I'm having trouble explaining this, as a reduction in mite population should lead to less severe breakouts (could it be that the 2-week antibiotic course altered the bacteria they carry with them, are the last remaining mites D. Brevis, and therefore cause deeper pimples, is the last batch coming from the scalp and transferring scalp bacteria to the face, resulting in worse breakouts, or are the last few ones travelling in batches and have nests?). The new pimples are always adjacent to the prior ones.

    In short, I'm running out of options and don't know what to do next.

    Has anyone with Demodex taken Moxidectin instead of Ivermectin (it's a stronger version horse paste often used for Scabies)?

    Anyone know of Dermatologists in New York knowledgeable in Demodex that could offer some help?

    Is it worth going to an Immunologist to try to see if I'm still immunosuppressed (have discontinued that medication 7+ months ago), and hence why I'm not fully responding to treatments?

    Any help/advice would be greatly appreciated.

  2. #2
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    Quote Originally Posted by Irao33 View Post
    I'm Male (33); do not have Rosacea or any symptoms at all.

    This May, I developed a Demodex mite infestation. I saw multiple Dermatologists in NYC that were unhelpful & unable to diagnose and suggest treatments. I finally got diagnosed by an Ophthalmologist, and realized the die-offs were occurring every 2.5 weeks, all the symptoms aligned, etc.

    Just prior to the Demodex infestation, I was on a medication that I later realized potentially causes adrenal suppression, and was in close contact with a family member who also has Demodex, though I myself never had issues with Demodex prior to this (had typical Acne that stopped over 5 years ago).

    For the last ~4 months, I've treated the problem pretty aggressively. Topically, I've used Cliradex & Ovante products for eyes, Grisi sulfur soap for body & scalp, DeLaCruz & NuStock sulfur for face, Hypochlorous spray for face, Permethrin for scalp, Selsun Blue & Denorex for scalp, Borax shampoo, Tea Tree Oil for face & scalp, Ivermectin 1% cream by Teva (soon to switch to horse paste). I also did the 2-week oral Metronidazole + Ivermectin course at the start of my treatment, and have taken oral Ivermectin weekly since then (so 10+ doses up until now).

    My breakouts are almost entirely on my forehead, scalp, and behind my ears. In terms of the number of breakouts I get each die-off period, I've managed to ~half the number (down to 5-6 new pimples each die-off period now), but they are still always there. Over the last month or so, I've treated the scalp pretty aggressively with Borax shampoo & undiluted Tea Tree Oil, and think I am experiencing a migration back to the forehead, where it all started.

    Another surprising thing is that even though the amount of breakouts have been at least halved since I started treatment, the pimples I am getting now on the forehead are deeper & puss-filled, whereas the initial ones in May where very surface-level and itchy, with no risk of scarring. I'm having trouble explaining this, as a reduction in mite population should lead to less severe breakouts (could it be that the 2-week antibiotic course altered the bacteria they carry with them, are the last remaining mites D. Brevis, and therefore cause deeper pimples, is the last batch coming from the scalp and transferring scalp bacteria to the face, resulting in worse breakouts, or are the last few ones travelling in batches and have nests?). The new pimples are always adjacent to the prior ones.

    In short, I'm running out of options and don't know what to do next.

    Has anyone with Demodex taken Moxidectin instead of Ivermectin (it's a stronger version horse paste often used for Scabies)?

    Anyone know of Dermatologists in New York knowledgeable in Demodex that could offer some help?

    Is it worth going to an Immunologist to try to see if I'm still immunosuppressed (have discontinued that medication 7+ months ago), and hence why I'm not fully responding to treatments?

    Any help/advice would be greatly appreciated.
    I feel your pain. I had this too. Misdiagnosed by 4 board certified dermatologist for decades. Finally turned into a roaring bad case of ocular rosacea / blepharitis demodex. Based on the symptoms I think that I did have BOTH demodex folliculorum and demodex brevis. I did the 2 week Oral Ivermectin + Oral Metronidazole treatment which worked for me. Some doctors do prescribe this oral treatment for 4 to 6 weeks. I never tried the Moxidectin treatment.

    Demodex do seem to get overpopulated when the immune system is down. That is what happened to me. I had a severe virus at age 11.5 years. The skin problems never went away or responded to bacterial acne meds. It might be worth seeing an immunologist. Sorry I don't know any doctors in the NY area.

    Are you using a clean towel everyday? The mites can live on damp towels for up to 54 hours. The mites die at temperatures above 59 degrees Celsius. So washing towels and bed sheets in warm to hot water and drying in automatic laundry machines should kill them. Also make sure that anything you put in your hair like hats, bandanas, head bands, etc are cleaned frequently.

    You can also use the Cliradex wipes for the face as well as the eyes. The stronger Horse Paste may help as well. Horse paste is cheap enough to treat your scalp too. Put it on the scalp at night and wrap a towel around your head. Wash it out in the morning. The 1% Ivermectin based topicals help but much more slowly than the oral full body treatment.

    One other thing I did that helped my face was a super intense homemade tea tree oil mask. WARNING: This mask may dry or severely irritate the skin and is NOT recommended for people with sensitive skin - it would be too harsh. I mixed 50% tea tree oil with 50% grape seed oil to dilute it. This is the strongest strength of tea tree oil that should ever be used - Tea Tree oil is intense and in most products is diluted to a strength of a most 5%-10%. I just mixed enough of the oil to coat my face and left it on for 30 minutes - if it burns too much wash it off immediately. It takes 4 minutes for pure tea tree oil to kill the adult mites. If you can stand it for at least 8 minutes it can help.

    One other trick is to use the Desert Essence Tea Tree Oil ointment (5% Tea Tree oil) on your face at night. It is thick like vaseline so it makes it difficult for the mites to get out and mate. The tea tree oil hopefully kills them before they get back down in the pores.

    Nothing is known to kill the demodex eggs. The last ones laid should take about 3 days to hatch. Then about 5-6 days to mature to adults before they start laying eggs too. That is why all treatments have to be continued long enough to kill the adults off and then when the next batch of eggs hatch, to kill of the next generation of mites.

  3. #3
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    Your treatment should kill all mites. Go to a derm or a doctor is the best advice. See if you could have any other problems like Staph infection or gram negative folliculitis.

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    Quote Originally Posted by Manufc View Post
    Your treatment should kill all mites. Go to a derm or a doctor is the best advice. See if you could have any other problems like Staph infection or gram negative folliculitis.
    Thanks. The breakouts still mostly occur every 2.5 weeks, which would imply it's still Demodex that's not fully gone.

  5. #5
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    Quote Originally Posted by ElaineA View Post
    I feel your pain. I had this too. Misdiagnosed by 4 board certified dermatologist for decades. Finally turned into a roaring bad case of ocular rosacea / blepharitis demodex. Based on the symptoms I think that I did have BOTH demodex folliculorum and demodex brevis. I did the 2 week Oral Ivermectin + Oral Metronidazole treatment which worked for me. Some doctors do prescribe this oral treatment for 4 to 6 weeks. I never tried the Moxidectin treatment.

    Demodex do seem to get overpopulated when the immune system is down. That is what happened to me. I had a severe virus at age 11.5 years. The skin problems never went away or responded to bacterial acne meds. It might be worth seeing an immunologist. Sorry I don't know any doctors in the NY area.

    Are you using a clean towel everyday? The mites can live on damp towels for up to 54 hours. The mites die at temperatures above 59 degrees Celsius. So washing towels and bed sheets in warm to hot water and drying in automatic laundry machines should kill them. Also make sure that anything you put in your hair like hats, bandanas, head bands, etc are cleaned frequently.

    You can also use the Cliradex wipes for the face as well as the eyes. The stronger Horse Paste may help as well. Horse paste is cheap enough to treat your scalp too. Put it on the scalp at night and wrap a towel around your head. Wash it out in the morning. The 1% Ivermectin based topicals help but much more slowly than the oral full body treatment.

    One other thing I did that helped my face was a super intense homemade tea tree oil mask. WARNING: This mask may dry or severely irritate the skin and is NOT recommended for people with sensitive skin - it would be too harsh. I mixed 50% tea tree oil with 50% grape seed oil to dilute it. This is the strongest strength of tea tree oil that should ever be used - Tea Tree oil is intense and in most products is diluted to a strength of a most 5%-10%. I just mixed enough of the oil to coat my face and left it on for 30 minutes - if it burns too much wash it off immediately. It takes 4 minutes for pure tea tree oil to kill the adult mites. If you can stand it for at least 8 minutes it can help.

    One other trick is to use the Desert Essence Tea Tree Oil ointment (5% Tea Tree oil) on your face at night. It is thick like vaseline so it makes it difficult for the mites to get out and mate. The tea tree oil hopefully kills them before they get back down in the pores.

    Nothing is known to kill the demodex eggs. The last ones laid should take about 3 days to hatch. Then about 5-6 days to mature to adults before they start laying eggs too. That is why all treatments have to be continued long enough to kill the adults off and then when the next batch of eggs hatch, to kill of the next generation of mites.
    Thanks Elaine, for the response and the advice. I will take into consideration the treatment aspects you mentioned that I have not yet incorporated in my routine.

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