Demodex Mites Treatment

Written by on August 24, 2007 in Demodex Mites, Ivermectin, What Causes Rosacea? with 274 Comments
demodex-mite

From: “Annette Anderson”
Date: Fri Nov 24, 2000 10:59 am
Subject: Effective treatment ?

Hi, I’m new to this group.

I sought you out to share a treatment approach with you that has worked for me very well, and since then has also helped a number of others.

I’m a family doctor in Canada; I was diagnosed with rosacea 2 years ago. My symptoms were deep-red flushing with any exercise,warm environment such as a hot shower, sunny day, also when crying ( PMS 🙂 ), alcohol etc. I looked awful, like Rudolf the red-nose raindeer. Of course I was prescribed Metrogel, took it faithfully, but wasn’t impressed. I didn’t yet have the papules or telangiectasias ( permanently dilated spidery arteries ), but I sure didn’t want to let it go that far. It was also getting worse rapidly. My doctor gave me the usual spiel, how rosacea is incurable, just avoid trigger factors, etc. Well, I was upset. I struck out on my own so to speak and hit the net. I found a lot of research articles on rosacea, including on medical mebsites for doctors only, such as “mdconsult.com” , where I found the most relevant ones. The first interesting article I came across was about several children with leukemia, who developed a rosacea-like rash ( as you know, rosacea is an “adult” disease ). Skin biopsies showed — you guessed it— huge loads of the skin mite Demodex Folliculorum. Alright, I just had to emphazise this. 🙂

They treated the kids with standard anti-mite treatment, permethrin, same we use to treat the mother of all mites, Scabies . The rash cleared. I thought, aha, gotta look at more articles like this. Turns out, there were quite a number of small, independent medical studies, where skin biopsies showed rosacea patients had a much higher than usual load of the generally benign mite demodex folliculorum ( I’ll attach some studies as examples ).

So, I tried the treatment on myself. I used Kwellada on my face ( not supposed to do this as per instructions on the bottle ” use neck down ” ). I worked out that a once – weekly application ( leave on 24 hours ) does the trick.

** Please note the complete treatment instructions following below .

After 2 months I noticed steady improvement, slow but very steady. First I thought, when it was all gone , I didn’t have to use the Kwellada anymore, but in the meantime I found out I still have to do it every 3 weeks or so for maintenance, usually as soon as my nose starts up again. I measured the intitial steps of improvement by how red my face would get after a hot shower. The intensity of the redness gradually diminished, and the total area involved contracted. First, it was the cheeks,forehead, chin and nose, lastly just the nose ( Rudolf ) , then that went , too. Basically, over a total of six months, all of the symptoms completely disappeared ! And stayed away, with the maintenance treatments, for the last eight months..

Boy, was I excited about this. I had proved my original theory. Well, not a new theory, according to those studies I mentioned, but I also haven’t heard of a regular patient with rosacea being treated for the mite problem, only for the secondary bacterial problem, with antibiotic ointments such as Metronidazole (Metrogel) etc. Then I started to try it out on my patients ( it seemed that all of a sudden nearly everyone had rosacea—–selective perception is an interesting phenomenon…). So far, it worked on all but one (total patients so far 21) . I have heard things like my patients’ hairdresser tried it too and had good results. Things like that. I always say, it might NOT work, but what have you got to lose ?

The treatment is simple, available over the counter (in Canada at least), cheap ( one bottle of Kwellada lotion, i.e. Permethrin 5% , lasted me exactly a year. ), and side effects are rare and minimal —permethrin for scabies can be used even on infants ! Getting it in the eyes is not fun, it burns like heck.

I have also found studies linking demodex to animals. One study was of a boy and his dog. The boy had a rosacea-like rash, and both he and his dog were heavily loaded with demodex. Treatment for both eliminated their problem. Since then I found out that most patients with rosacea get in close contact regularly either with their own cats/dogs or with those of friends and family. I don’t want to cause undue concern about pets, but I have to report my observations.
In any case it would probably not be too difficult to treat the pets as well, on and off.

I think it’s probably impossible to eliminate the demodex from one’s environment, just like it’s pretty hard to get rid of scabies forever, unless it was picked up on one’s travels .If it developed at home, it often recurs eventually.

Therefore I think that if the original treatment works, maintenance treatments are the way to prevent recurrences.

I would like to send my self-concocted treatment outline to you to review and possibly to try it out.

As I said there are no guarantees it will work at all, and side effects are always a certain possibility….but there’s not too much to lose. And I would be absolutely ecstatic if it worked for you, too.

I would like to ask you, that if you want to try the treatment, please fill out the questionnaire pre-treatment, as outlined in the following pages. I haven’t yet had time to think up the 6 months follow -up questionnaire, but PLEASE PLEASE PLEASE , if the treatment works for you, also fill out the 6-months follow-up questionnaire for me, I’ll send it some other time. I would like to gather these data and maybe eventually publish a summary of the results in a G.P. medical magazine. ( The big magazines like dermatology etc. only accept scientifically and statistically sound research studies, which I found out cost upwards of 50,000 $, which I can’t afford. Organizing a study through a research agency would take about 5 years to do !). Also, of course , I would really like to know about any side effects, or if it doesn’t work for someone, even when following the once-weekly treatment guideline. I am also interested in knowing if you have pets in your lives somewhere. That would be so very much appreciated.The icing on the cake would be “before” and “after six months ” close-ups of your face, with the eyes blocked out if you want. I would love some of those, if it worked, of course.

Good luck, I hope you’ll give it a shot. Remember, I’ll append some relevant articles at the end of this, to verify that I didn’t dream this up.

For the treatment outline I use in my practice, the “ingredients” are as follows ( I’m giving you the real names because you already know you have rosacea.

A = Kwellada shampoo
B = Kwellada lotion (5% Permethrin)
C = Sulfacet face cream or equivalent antibiotic cream

DR. ANNETTE ANDERSON, B.A., M.D.

FAMILY PHYSICIAN

(Address withheld for people outside my medical group)

RE: ROSACEA STUDY

I am looking for patients with a one year + history of chronic recurrent rosacea, for a small study (N=50) involving a new treatment method . The aim is to substantially reduce symptoms. There are no guarantees, but so far, positive results.

The premise of the study is that rosacea may be caused or aggravated by an over-abundance of a mite called DEMODEX FOLLICULORUM. This mite is a common organism found in skin follicles, but in some people it overgrows, attracting bacteria which cause inflammation and the symptoms of rosacea.

Typically, rosacea develops in several stages ( not all people with rosacea go through all stages) . These stages are:*

  • Flushing: periodic reddening of the face, aggravated by various trigger factors, such as hot showers ,emotional upset, alcohol, PMS, etc.
  • Inflammatory lesions: papules, pustules (pimples)
  • Edema may be present ( swelling over affected areas)
  • Telangiectasias may be added with time ( dilated blood vessels)
  • Ocular rosacea may occur (burning, stinging,tearing etc. of the eyes)
  • Rhinophyma may sometimes occur in the advanced stages in men ( red, swollen nose)

Rosacea is a clinical diagnosis, i.e. based on appearance and history alone.There are no blood tests to confirm or refute the diagnosis. It is important to see how the symptoms behave when the condition is treated appropriately.

So far, the assumption is, and experience seems to show, that rosacea cannot be cured, only controlled with creams or gels. These are typically antibiotic based, such as Metrogel (reg. TM). Sometimes,oral antibiotics are also used and can be quite effective for treating an acute flare-up. Of course, it is also important to avoid trigger factors.

However, this small study, (as other similar ones ), tries to illustrate that one should also attempt to treat for the mite DEMODEX FOLLICULORUM, in order to achieve better, and more lasting results. This concept is based on a review of some of the available literature/studies.**

Basically, it might seem that DEMODEX can overgrow, attracting bacteria in the process.It may be that certain substances such as lipases result in the release of irritant fatty acids, which in turn lead to the observed skin changes.

So far, the antibacterial-based treatments reduce the bacterial, but not the DEMODEX load. So, the underlying problem, the DEMODEX ,causes further flare-ups eventually, and the whole process repeats itself.

ABOUT THE STUDY:

  • Treatment is of a six months total duration.
  • Topical mite therapy is in the form of cream and shampoo, plus oral antibiotics if a heavy bacterial load seems to be present also.
  • Patients may continue own treatments during study.
  • Short questionnaires, time 0 and 6 months, in conjunction with office visits.
  • Patients are requested to supply a copy of the dermatology consult originally diagnosing rosacea.
  • Please, no patients with body-dysmorphic disorder, history of anti-social behavior, unstable psychiatric conditions, or severe self-image problems.
  • Please ask any interested rosacea patient to call my office to set up an appointment for the first visit/questionnaire.

Kind regards,
Annette Anderson, B.A., M.D.

* From: ROSACEA, a Guide For Physicians, Jonathan Wilkin,M.D.


ROSACEA TREATMENT TRIAL
Patient name: ______________________________
Patient’s GP: ______________________________
Date: ______________________________

QUESTIONNAIRE

* How long have you had rosacea? __________________________

* Did a dermatologist diagnose it, or confirm the diagnosis? Please provide a copy of the consultation letter from your GP’s
records.* Does anyone else in your family have rosacea?_____________________

* How much does your rosacea bother you, on a scale from 0 (not at
all) to 10 (unbearable)? ________________________

* Please list the factors that consistently seem to contribute to a
flare-up of your rosacea:______________________________

* Please tick off any factors you think might also act as triggers
for a flare-up ( if any) :
_____ hot rooms / hot showers / hot beverages
_____ caffeine
_____ alcohol
_____ sun/wind
_____ for women: PMS
_____ exercise
_____ dairy products
_____ emotional upset / crying
_____ chocolate
_____ spicy foods
_____ medications :(which ones)
_____ creams (which ones, eg. cortisone)
_____ natural herbs/supplements (which ones)
_____ cosmetics (eg. alcohol-based lotions, witch hazel, oil-based make-up… ,
which ones ______________________________

* Your rosacea usually consists of:

_____ generalized redness/flushing of the :
_____ cheeks
_____ chin
_____ nose
_____ forehead
_____ both cheeks and nose
_____ all of the above
_____ other
_____ redness/flushing plus pimples (papules, pustules)
_____ pimples only
_____ swelling over some areas of facial skin
_____ tiny, permanently dilated red blood vessels (telangectasias)
_____ eye irritation, such as intermittent burning, tearing etc.
_____ reddened, enlarged nose

* On average, how often do you get a major flare-up of rosacea?

* Which treatments ( creams or pills ) have you tried so far, and briefly mention the results:

TREATMENT RESULT

* Have you had any side-effects to these treatments?

* How effective have these treatments been in the reduction or elimination of your rosacea symptoms?

(a) not at all (b) somewhat effective (c) moderately effective (d) very effective

* Do you have any allergies?

* Are you willing to try another treatment for rosacea?

* This treatment is in a trial phase, i.e., has not yet been proven to be effective. There is no guarentee that it will work, although a number of people in my practice have tried it, and have had good results with it.

* The core ingredients used in the treatment are available over the counter. If you have allergies precluding you from using these ingredients, we might be able to find alternatives .

B) THE TREATMENT

OUTLINE

You will be asked to use three creams. ( Called for now “A, B, and C”. You will be advised of the names of these products upon receipt of the consultation report which diagnosed you as actually having rosacea, versus another skin condition. It is important for treatment success to establish the correct diagnosis.)

In order to improve the chances of success, I will suggest several additional measures, as outlined below. These are optional, but recommended.

TREATMENT PLAN

Choose a day when you are free from work or other obligations. You will need treatments A, B,and C . If you choose to follow the steps described as optional, you will also need laundry detergent, anti-mite spray, a plastic mattress cover, and a good vacuum cleaner.

1) In the morning, have a thorough whole-body cleanse.

2) Use A as a shampoo, as directed on the bottle.

3) Then, use B. Apply thoroughly to your face, neck, ears, and downwards to cover each inch of skin including feet and toes. Avoid mucus membranes, lips and eyes. Let dry for ten minutes, then put on clothes. Leave on for twenty-four hours.

Note: After several hours, you may note tingling or burning on your face in the distribution of your rosacea. This would feel worse when exposed to cold air. If needed, take two Tylenol tablets to decrease the discomfort. Try to persist with the treatment, unless the discomfort is severe (which has not happened to anyone yet).

4) Optional:

Wash all your clothes and bedding in as hot water as allowed by their labels.

Spray your furniture with an anti-mite/anti-scabies spray (available at any pharmacy)

Put a plastic mattress- cover on your mattress.

Vacuum your carpets thoroughly.

5) After twenty-four hours, wash off treatment B thoroughly, using a mild cleansing lotion (e.g. Cetaphil) , a mild soap ( e.g. Dove), or equivalent , not based on alcohol or witch hazel.

Towel off.

Apply treatment C to your face, covering every inch of skin including ears. On the rest of your body, you may use any lotion of your choice.

If your face feels quite dry and uncomfortable, after one hour you may apply a small amount of a high- quality moisturizer on top of C.

6) From now on, twice a day, wash your face thoroughly with warm water and a gentle soap (eg. Dove etc.), and then apply C. Leave C on during the day. Dab off any excess oilyness with a Kleenex. For women: you may apply a small amount of oil-free make-up on top of C, although it may compromise the treatment to some degree. (Unknown)

7) Once a week, repeat steps 3 ( this time, on the FACE only) and 5 for the rest of the six months ,or as long as needed , closely monitoring for side effects .

You may have noted some improvements in your rosacea after two months or so. Mostly, this would be noticeable through less frequent episodes of flushing, which might also be less severe. The dilated blood vessels in your face (which cause the redness) should slowly shrink further. This takes time!

The triggers you listed above may still cause flare-ups, but these should become less often and less noticeable as the blood vessels in your face keep going back to normal. It is still important to try and avoid these triggers, to let the blood vessels shrink. You might notice that the diameter of the total area involved is contracting.

In addition to the above, you might be prescribed an oral antibiotic to take, depending on the severity of your condition. This would be useful especially in the presence of a lot of pimples, which is the same concept applied in the treatment of acne. Acne also involves an overgrowth of bacteria, as in rosacea.


The significance of Demodex folliculorum density in rosacea. Erbagci Z – Int J Dermatol – 1998 Jun; 37(6): 421-5, Department of Dermatology, Faculty of Medicine, Gaziantep University, Turkey.Authors: Erbagci Z; Ozgoztasi O

BACKGROUND: Demodex folliculorum has been reported in rosacea in a number of clinical studies. As the Demodex mite is also present in many healthy individuals, it has been suggested that the mite may have a pathogenic role only when it is present in high densities. Moreover, some authors have proposed that a mite density above 5/cm2 may be a criterion for the diagnosis of inflammatory rosacea. In this study, the possible role of D. folliculorum and the importance of mite density in rosacea were investigated using a skin surface biopsy technique.

METHODS: Thirty-eight patients with rosacea and 38 age-and-sex-matched healthy subjects entered the study. With the skin surface biopsy technique, we obtained samples from three facial sites. We then determined the mite positivities, the mean mite counts in both study groups, the mean mite densities at each facial site and in the rosacea subgroups, and the mite densities above 5/cm2.RESULTS: The mean mite count in the rosacea group (6,684) was significantly higher than that in controls (2,868; p < 0.05). The cheek was the most frequently and heavily infested facial region. Ten rosacea patients and five normal subjects had mite densities over 5/cm2; the difference was not statistically significant (p > 0.05).

CONCLUSIONS: Rosacea is a disease of multifactorial origin, and individual properties may modify the severity of the inflammatory response to Demodex. We suggest that a certain mite density is not an appropriate criterion in the diagnosis of the disease; nevertheless, large numbers of D. folliculorum may have an important role in the pathogenesis of rosacea, together with other triggering factors.

Major Subjects:
.. Acne Rosacea / * Diagnosis / Pathology / * Parasitology
.. Facial Dermatoses / * Diagnosis / Pathology / * Parasitology
.. Mite Infestations / * Diagnosis / Pathology / * Parasitology


A study on Demodex folliculorum in rosacea. Abd-El-Al AM – J Egypt Soc Parasitol – 1997 Apr; 27(1): 183-95, Journal of the Egyptian Society of Parasitology, Author Affiliation: Department of Dermatology, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo.Authors: Abd-El-Al AM; Bayoumy AM; Abou Salem EA

A random sample of 16 female patients suffering from papulopustular rosacea (PPR) as well as (16) normal female healthy subjects as control group were adopted in this study to assess of Demodex folliculorum pathogenesis. It was done through determination of mite density using a standard skin surface biopsy 10.5 cm2 from different designated 6 areas on the face, and scanning electron microscopic study (SEM) as well as total IgE estimation. A trial of treatment using Crotamiton 10% cream with special program was also attempted. All subjects ranged between 35-55 years old. All patients with rosacea and 15 of the control group i.e. 75.93% were found to harbour mites. The mean mite counts by site distribution were 28.6 & 6.9 on the cheeks, followed by 14.5 & 3.0 on the forehead and lastly 6.8 & 0.8 on the chin in PPR and control groups respectively. The total mean mite count in patients was 49.9 initially and 7.9 after treatment. In the control group it was 10.7 & 10.6 respectively. The mean total IgE was 169.4 & 168.4 and 96.3 & 98.4 in PPR and control groups respectively Light and scanning electron microscopy revealed that all mites were pointing in one direction. Some of them were containing bacteria inside their gut and on their skin. After treatment 3 cases (18.75%) were completely cured, 10 cases (62.5%) gave moderate response while 3 cases (18.75) have no response. In conclusion, this study supports the pathogenic role of D. folliculorum in rosacea.

Major Subjects:
.. Acne Rosacea / Drug Therapy / * Parasitology
.. Mite Infestations / * Complications / Drug Therapy
.. Mites / * Growth & Development / Ultrastructure

Additional Subjects:
.. Adult, Animal, Antipruritics / Therapeutic Use, Female
.. Hair Follicle / Parasitology / Ultrastructure, Human, .. IgE / Analysis
.. Insecticides / Therapeutic Use, Microscopy, Electron, Scanning
.. Middle Age, Toluidines / Therapeutic Use

Chemical Compound Name:
(Antipruritics); (Insecticides); (Toluidines); 37341-29-0 (IgE); 483-63-6 (crotamiton)


 

Demodicidosis in childhood acute lymphoblastic leukemia; an opportunistic infection occurring with immunosuppression. Ivy SP – J Pediatr – 1995 Nov; 127(5): 751-4, Author Affiliation: Department of Pediatrics, Children’s National Medical Center, Washington, DC 20010, USA.Authors: Ivy SP; Mackall CL; Gore L; Gress RE; Hartley AH

We report demodicidosis in 11 children with acute lymphoblastic leukemia and a mildly pruritic, erythematous papular dermatitis that developed in areas rich in sebaceous glands. Dermodex eruptions were safely and effectively treated with 5% permethrin. Proliferation of commensal parasites of the skin, Dermodex folliculorum and Dermodex brevis may be an opportunistic infection of the skin in the immunocompromised host; the expected abrogation of cell-mediated immunity secondary to lymphocyte depletion predisposes some children given chemotherapy for leukemia to mite proliferation.


1. Bonnar E, Ophth MC, Eustace P, et al. The Demodex mite population in rosacea. J Am Acad Dermatol 1993;28:443-8.
2. Hoekzema R, Hulsebosch HJ, Bos JD. Demodicidosis or rosacea: What did we treat? Br J Dermatol 1995;133:294-9.
3. Shelley WB, Shelley ED, Burmeister V. Unilateral demodectic rosacea. J Am Acad Dermatol 1989;20:915-7.
4. Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol 1993;128:650-9.
5. Mateo JR, Guzman OS, Rubio EF, et al. Demodex- attributed rosacea-like lesions in AIDS. Acta Derm Venereol 1993;73:437.
6. Ashack RJ, Frost ML, Norins AL. Papular pruritic eruption of Demodex folliculitis in patients with acquired immunodeficiency syndrome. J Am AcadDermatol 1989;21:306-7.
7. Dominey A, Rosen T, Tschen J. Papulonodular demodicidosis associated with acquired immunodeficiency syndrome. J Am Acad Dermatol 1989;20:197-201.
8. Banuls J, Ramon D, Aniz E, et al. Papular pruritic eruption with human immunodeficiency virus infection. Int J Dermatol 1991;30:801-3.
9. Sahn EE, Sheridan DM. Demodicidosis in a child with leukemia. J Am Acad Dermatol 1992;27:799-801.
10. Dominey A, Rschen J, Rosen T, et al. Pityriasis folliculorum revisited. J Am Acad Dermatol 1989;21:81-4.
11. Jimenez-Acosta F, Planas L, Penneys N. Demodex mites contain immunoreactivelipase. Arch Dermatol 1989;125:1436-7.


Demodex and Eye Disease

Blepharitis. Demodex folliculorum, associated pathogen spectrum and specific therapy, Demmler M – Ophthalmologe – 1997 Mar; 94(3): 191-6, Augenklinik, Universitat Munchen., Demmler M; de Kaspar HM; Mohring C; Klauss V

Original Title: Blepharitis. Demodex folliculorum, assoziiertes Erregerspektrum und spezifische Therapie.

Demodex folliculorum has been demonstrated with an elevated frequency in patients with blepharitis, and is thought to cause therapy-resistant blepharitis. This paper presents the germ spectrum of patients with blepharitis and demodex and discusses the efficiency of a specific therapy.

METHODS: In all, 3152 cilia from 139 patients with blepharitis (38% blepharitis, 44% blepharoconjunctivitis, others) and 108 persons with quiet eyes were examined for demodex. Smears n = 125, from the conjunctive of symptomatic patients were investigated for bacteria, 3 weeks of therapy with mercury ointment, 2%: Lindan, cortisone (prednisolone, dexamethasone, hydrocortisone, fluorometholone) or antibiotics after antibiogram (gentamicin, kanamicin, neomicin, erythromicin, ofloxacin, polymyxin-B, colistin) followed in all Demodex-positive blepharitis patients (n = 41).

RESULTS: Demodex was found in 52% (62/139) of patients with chronic blepharitis, as against 20% (3/15) of those with acute blepharitis (statistically significant difference, chi 2-test, alpha = 2.5%) and in 29% of quiet eyes (statistically significantly less, alpha = 2.5%, chi 2-test). Gram-positive cocci were isolated from 79% of 57 Demodex-positive patients with blepharitis and 72% of 68 Demodex-negative patients anaerobes in 39% and 37%, gram-negative rods in 11% and 3% (statistically significant difference for gram-negative rods, alpha = 5%, chi 2-test). Of the patients with Demodex, 25% apparently had no more parasites after mercury ointment, 2% (n = 8 ) and lindan (n = 5) and 15% after cortisone and antibiotics (n = 13). (The best and statistically very significant results (alpha = 1%) were those obtained with mercury ointment, 2%, and lindan: t-test for connected spot checks).

CONCLUSIONS: Gram-positive and gram-negative bacteria grew more often in patients with Demodex. Demodex seems to be a mediator of chronic blepharitis; we recommend that mites be sought in cilia of chronic blepharitis patients. Mercury ointment, 2% and lindan proved efficient for specific therapy, the main problem being the laborious application and toxicity.

Major Subjects:
.. Blepharitis / * Diagnosis / Drug Therapy / Etiology
.. Mite Infestations / Complications / * Diagnosis / Drug Therapy

Additional Subjects:
.. Administration, Topical,
.. Anti-Inflammatory Agents, Steroidal / Administration & Dosage
.. English Abstract, Female, Human, Lindane / Administration & Dosage
.. Male, Mercury Compounds / Administration & Dosage, Middle Age
.. Prospective Studies

Chemical Compound Name:
(Anti-Inflammatory Agents, Steroidal); (Mercury Compounds); 58-89-9 (Lindane)


Okay, that’s enough for today. Please let me know what you think about this.
Annie

Followup Email

From: “Annette Anderson” <andersona@telus.net>
To: “Rosacea-Support” <rosacea-support@egroups.com>
Subject: Unsubscribe please/Bye
Date: Fri, 1 Dec 2000 11:53:17 -0800

Hi,
I’ve enjoyed my stay here.

I was very sorry, though, that Rachelle had a very bad reaction to the
treatment I proposed, although she did say she’s very sensitive to start with.
Something good may have come out of this as she found a wonderful protocol of
natural ingredients to attack the mite. If one has a choice, of course, natural
treatments are always preferable.

Unfortunately I can’t keep up with reading all my messages from you and others,
so I’ve done “my hit and run “. As I am free of any and all rosacea symptoms
now, I’m concentrating on my other area of interest, insulin resistance.
If any of you would like to write to me about my area of special interest,
Demodex folliculorum and rosacea, please write to
andersona@telus.net

Good luck to all of you and thanks for the great ideas.
Annie

More Information

For more information see how to kill demodex mites and also ocular demodex, tea tree oil as a treatment.

For those interested in eliminating Demodex, do check out Soolantra – a recently approved topical treatment for rosacea that contains 1% ivermectin.

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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274 Reader Comments

  1. sunnyroxanne says:

    Hi everyone. I love this blog. It seems like we’re all in the same boat and none of the doctors want to help us. I was reading about a zapper on another blog and they said that it kills parasites. Has anyone ever tried this to kill the mites? Thx for any info.

  2. Elena burashnikov says:

    Dear Mrs. Annetee Anderson
    I have severe Resaca. Already tried several expensive drugs including Metrogel, Cultivate, Finacea, Atralin…nothing really helps, but actually I was afraid of any side effects and did not use them faithfully.
    I live in the United States and would like to know if I can buy Kwellada somewhere here in USA and try your treatment. Unfortunately my dermatologist never offered me the test for Demodex.
    Are you still doing the study for Rosacea and how is your skin now?
    Thank you
    Elena

  3. George Hajdu says:

    I have Demodex over 3 month now, and looks like to me almost impossible to read them off! I Was using Nix cream with nearly zero result! In this moment I am using Benzil Benzoate, in 32 % cream mix over 1.5 week but I still have Demodex, OK much less but it is still there, looks like to me some of them just don’t care of any poison or medication… My whole body is full of red dots and perks, I am looks like some one after a huge mosquito attack! I know if it something out there, what is will help me, but i am not very happy so far with any result! I will try using your medications, like the Kwellada family products, I will be very happy if I will have any positive result!
    Sincerely: George

  4. michele smith says:

    i was diagnosed with rosacea. I struggle every day with it . today i went to a allergist
    he said my main allergy is dust mites. now i have been thinkin possibly i have demodex rosacae Dr. never said he could do a test. i have alot of redness and broken veins which i hate. Any suggestions thanks michele smith

  5. Kathleen Emmke says:

    This article is enlightening to say the least. I have been diagnosed with blepharitis and in the last 6 months have been battling a condition that I believe is Rosacea. Long time ago a used to have dogs, but my eye condition had been developing for years before it was ever diagnosed. I also have a chalazion on one eyelid and I have to wonder if this might possibly be related also. One of the first things my eye doctor told me to do was to wash my eyelids with baby shampoo daily, which I have now done for years. I had to give up any eye makeup several years ago also as it made the condition worse.

    Now in the last 6 months my nose, cheeks and chin are beginning to have all the symptoms or Rosacea and it is truly embarrassing and disheartening when I am trying the best I can to use the best cleansers and makeup, to no avail.

    I am going to look into your program for tea tree oil and the regimen you have written of here, but would like to know if I can get any further assistance or if your study is still open.

    Thank you for your help.

    Kathleen

  6. Megumi says:

    Kathleen…

    Do not try the tea tree oil. It doesn’t go well with Rosacea skin. Or atleast test it on a small area first. I tried using products with tea tree oil in it. It aggravated my rosacea skin and dried it up

    Megumi

  7. karen fischer says:

    I would like to participate in your study. I have been diagnosed with rosacea for 4 years. It drives me nuts. I also have occular rosacea. I have wondered if mites could be playing a role. It would be great if you could help me. Please e mail me back. Thank you very much
    Karen

  8. George Hajdu says:

    Dear Annette Anderson!
    I am wondering if you are real, or only just a SALES DIRECTOR for KWELLADA? People are asking here serious questions, but not any answer or suggestions coming from a expert as you are? I think all this DEMODEX and Rosacea problems coming from a chemical unbalance in the body, what is can cause some kind of diet, or certain medications what people are taking? Nobody can get suddenly a DEMODEX over population on their body, with out some health related disturbances! I believe, you can splash on your self all the KWELLADA wonders, for a hefty high cost, and just soon you stop for a day or two, all those little creatures are back with a vengeance? How about if we all start check it out, what changes we made in our life since we have our DEMODEX AND ROSACEA? Or something we just destroyed in our immune system, what ever is responsible for producing the anti bodies for above problems? Please be serious and start helping people, with the right medical suggestions!

  9. Sc'Eric says:

    OMG–SUCCESS!!!

    Annette & Bo’nana~

    I took your comments regarding tea tree oil and applied them to something I’d already been toying with: CASTOR OIL!

    I’ve had a scaly rash on my face (a butterfly rash) since July. High-histamine foods and barrel-aged wine and spirits definitely contribute to flare-ups. And I’d been starting to lose faith that I’d ever look and feel normal again.

    For the past month, I’ve been using castor oil to help moisturize my face, hoping that its antifungal properties might help address any microfloral overgrowth. And it showed some minor success, but typically only lasted a few days before my face would flare-up again.

    This past SATURDAY night, however (and thanks to your comments), I mixed up equal parts TEA TREE OIL and CASTOR OIL–perfect because they do not repel one another like with water or alcohol. I applied very cautiously to my eyebrows, eyelids and to every part of my face that was effected by the scaly rash. I made sure to KEEP MY EYES CLOSED for at least 10 minutes while the oil soaked into my skin. [Trust me: DO NOT OPEN YOUR EYES while the tea tree oil is near your eyes!] I then blotted the remainder with a clean paper towel and went to bed a few hours later.

    When I woke up, my face showed DRAMATIC improvement. I then decided I would apply again using the same technique on MONDAY night. Tuesday, again showed marked improvement… almost to the point that you couldn’t tell there’d been any scaling at all. And with the light scaling that still remained, I figured I’d try one more session to address that last bit of flare-up.

    Long story short, I was so exhausted WEDNESDAY night that I forgot. It’s now Thursday and I am now going to apply what I hope to be my last treatment of TEA TREE OIL + CASTOR OIL.

    One note however: I think next time I would use 2 parts CASTOR OIL to 1 part TEA TREE OIL.

    GOOD LUCK EVERYONE! If I have a recurrent flare-up, I’ll let you know!

  10. Sc'Eric says:

    ps. You can use a cotton ball to apply the oil to the effected areas.

  11. Frances says:

    For over two years I’ve been fighting demodicosis on my cheeks. It started with a few red bumps which then spread all over my cheeks. The treatment the dermatologist gave me consisted of 2% boric acid compresses on my cheeks daily, Rozamet cream at night (Rosacea therapy cream in our country-Croatia), through the day Zu-Cn cream (Uriage). At the beginning I had also Doksiciklin antibiotics. I was sent to the hospital laboratory and twice was diagnosed Demodex folliculorum and Pittosporum ovale positive on my cheeks and nose. The third time, 2 months ago, the results turned out negative.
    It would be wonderful if my state was really better and improving, but my cheeks are not well, I notice that my face is now reddening more frequently with a blush that persists on my face more than before (I allways blushed easily but as soon as the stressful situation would pass my face would get normal), I also tend to blush more easily in hot/cold situations now (cold wind, hot office), before this was also the case but as I stated it would soon pass, now it persists much longer so it happens that throughout the day I’m more red than not in my face. The dermathologist prescribed me the same therapy for six more months but didn’t think it would be wise to treat my scalp or skin that I suggested since the lab results came negative.
    My questions are: what is Your opinion, is it possible that the lab results came negative and that it still developed into rosacea?Would it be safe for me to treat my scalp and body as well, since my scalp itches for more than 20 years but I’ve allways been treated with shampoos for seborrheic dermatitis (with no results), and my skin also itches (also treated for dry skin conditions). I have a very fair, sensitive skin, prone to skin diseases, also the capillaries on my cheeks are very visible. I blush very easily.
    Is the demodicosis transmittable from human to human and from human to cats?Two months ago I got a cat, she is very healthy and has no skin conditions but I’m worried that she might catch demodicosis from me!Since you stated that there allways (in your opinion) is a connection between rashes on humans and demodicosis on pets, can it be that pets get demodex from humans too, although demodex folliculorum is a human mite, and demodex gatoi is a cat mite.
    Thank you very much in advance!Frances

  12. David Bourke says:

    I thank Dr. Anderson for her most informative post.

    However, I must beg to differ with her statement on demodex in the environment. I’ve had generalised demodicosis for almost three years now which has driven me to the brink of suicide since it’s classified as delusional.

    Consequently, I’ve done nothing but extensively research these mites over that time. According to ALL the research papers and articles I’ve read, demodex mites live only in the skin. The only ones that emerge onto the skin’s surface are male mites looking for females to impregnate, and virgin females seeking a new site to make a home. They have sharp abrasive claws specially adapted to prevent them from falling off our skin.

    If they are dislodged from the host in a dry environment, they will die in a few hours.

    In a moist environment, however, like a damp towel, they can live for up to 60 hours. Other research papers estimate environmental survival times of 24-38 hours. They do not lay eggs anywhere else but inside our skin.

    Here’s just one example:

    http://demodexsolutions.com/default.asp?faq.asp~mainFrame

    They are, after all, arachnids, and although chemically very hardy insects, are physically as delicate as any tiny spider, and possess a very thin exoskeleton.

    If you visit my website – http://www.delusionalinsects.com – you can find a lot more details, including my own story, plus some non-pharmaceutical treatments I’ve just discovered which work very well indeed.

    Be warned, however, that my horrific experience has soured me completely on conventional medicine, doctors, and dermatologists, and I’m not the least bit shy about saying so.

  13. missnz says:

    Thank you for your post,

    I don’t have rosacea, but do have itchy scalp (due to mild psoriasis) with a VERY itchy face. When it gets really bad my entire body itches from head to toe in every area with absolutely NO rash. Doctors have no clue. I find that it is worse when I am run down, and can somewhat control it by using a .1%ww Betamethasone lotion on my scalp every day, but that is futile when I am run down and not sleeping enough.

    Do you think I might have the Demodex mite? And would you recommend that I use the Kwellada lotion and / or shampoo you suggested?

    I am at a loss now and have been doing internet research for ages and this is the most relevant thing I have come across.

    Appreciate your help,

    missnz 🙂

  14. S. Farmer says:

    I had similar symptoms… figuring it had something to do with the demodex mite I started using Face Dr. (Rejuvinating Soap)… all the pustules and papules now stay away – I use every other night now for maintenance)… $25.00 year cost.
    It contains sea buckthorn oil with the mites don’t like!
    It really does work wonders!
    (Used every day until everything was under control. The first 3 weeks were awful because everything was coming to the surface… after that…. everything has been comparatively wonderful)

  15. Kathleen Emmke says:

    I had read that tea tree oil helps this condition, but you are not supposed to use it full strength, so I went looking for a facial cleanser that contains tea tree oil. I found Home Health Facial Gel with tea tree oil in it at our local health store. It has worked wonders! My face is clearing and starting to look more like myself again. I started to see a difference immediately and after approximately two weeks of use, you can hardly tell there is an issue. This product can also be found online along with the moisturizer from the same company.

    I hope this helps someone as I understand how upsetting it can be to deal with this problem.

  16. GAgirl says:

    All above — I have been suffering with this problem of the demodex monsters for months. I finally have found something that is working (since no docs would help me). I use epsom salt and organics yellow vinegar and bath in it since the demodex fall off my face and seem to bite my arms and legs. I also put some lavender and ecalyptus oil (health food store) in the water, just shake drops in. I also take the vinegar and oil and wash my face with it.

    I am also using Hyalauric acid serum which really is helping on my face. You can get this at Vitacost.com online.

    I am finally getting some relief and my red spots seem to be shrinking. They even went in my hair it got so bad so I wash my hair in the vinegar solution too. hope this helps.

  17. Frances says:

    I bought the Tea tree oil shampoo and face lotion, it doesn’t do well on my resacean face skin, and it isn’t of much help for my scalp(reduces the itching the first 5 seconds I apply it on), after that it doesn’t do any real good to me.
    PLEASE DOES ANYONE KNOW A GOOG SHAMPOO TO TREAT THE DEMODEX MITES?
    Everyone is suggesting good products fr face and body, but I don’t find anything about the shampoo. Please help!Thanks!

  18. Frances says:

    GAgirl, please could you tell me can yellow vinegar be replaced with apple cider vinegar?Have you tried that option as well, maybe?

  19. Teresa says:

    I am in Australia and would like to know if the study is still continuing. I went to see my doctor today about my rosacea and he advised me of this site and the study. My only problem area is my nose but the last few months it has become worse with developing sores and and swelling on some parts of the nose. I’m sick of having to apply thick make-up every day to cover it up and looking like Rudolph!

  20. Al Cronin says:

    I do not have a bad case of Rosacea, although after reading your article I realized I experience many of the symptoms from time to time.
    My concern is that I have a great sensitivity to mites and have been iritated by them for many years. I tried to talk to my dermatologist about demodex mites and he scoffed at the thought. He eventually took a scraping from the back of my neck and agreed there were mites present. He prescribed Permethrin cream which I use occasionally. I try to keep my hair cut short. The problem is they just keep coming. I mean I feel them on my ears, my neck, my forehead and up my nose. I keep my nose hair cut also. Three years ago I had shingles around one eye and although it appeared to all go away, I occasionally get twitches and I swear there are mites in that eyebrow.
    I cannot sit on upholstered furniture either in my home or elsewhere. I use foam pillows and a special mattress cover.
    I welcome any suggestions to help with the mite problem. I am 70 YO and need some relief after all the years I have been bothered by these meanspirited creatures.
    Any suggestions will be appreciated. Thanks

  21. Sharon Sadler says:

    Please could you help me I’m sure I have the Demedox mite on my scalp as all the syptoms are there, and I am starting to get patterned baldness which is very upsetting and constant itching.
    Please could you perscribe me what to do.

    Yours faithfully

    Sharon

  22. David Bourke says:

    Quote: “Every pre-med student is ultimately asked the question: why do you want to become a doctor. Inevitably, they all give the same, banal answer: I want to help people.”

    That’s from a REAL doctor who treats Lyme Disease.

    Here’s how much Dr. Anderson, the author of this article, wanted to help people:

    On Fri Nov 24, 2000, she published this piece detailing her “study.”

    On Fri Dec 1, 2000 – ONE WEEK LATER – she resigned from the group and terminated her “study” after one member showed an adverse reaction.

    Here’s an extract from her resignation message: “As I am free of any and all rosacea symptoms now, I’m concentrating on my other area of interest, insulin resistance.”

    Translation: “I’m all right, Jack. The rest of you can go hang.”

    She has not been heard from since.

    She also refers to demodex as “benign.” Oh, really? Externally and internally, demodex carry dangerous bacteria, fungi, and viruses (including HIV/AIDS). The fungus they harbour in their gut to enable them to digest food directly attacks the human immune system.

    Benign? No, the word the good doctor is groping for here is “commensal.” Which means the mites benefit, and you don’t. And it is a scientific fact that changes in its chemical environment can cause an organism to alter its lifestyle from commensal or symbiotic to parasitic.

    Eleven years later, people are still pleading for help here on this thread. It took me 18 months before I realised that I was NEVER EVER going to get anything from the medical community other than a delusional diagnosis. No scrapings, no blood tests, no immune system tests, no tests for underlying illnesses, no allergy tests – nothing but an eyeballing and a history-taking. And once the sensation of crawling was mentioned, bingo – you’re psychotic!

    Oh, you may get the odd doctor who’ll prescribe a topical pesticide like permethrin, ivermectin, or malathion. But the problem with this is that pest-killing companies (and doctors) have been using these for so long and so freely that insect pests have now become resistant to them. Which is exactly how medicine managed to destroy the most powerful tool in its own arsenal – antibiotics.

    Biology 101: any organism under threat will either die out or evolve to cope with that threat.

    The bottom line is that you’ll get no cure from medicine. If you’re very, very lucky, you MAY get an open-minded doctor or dermatologist who MAY prescribe something to help you manage the problem. In other words, treatment. At a cost. But no cure.

    Of course, you’ll still get the odd would-be medical careerist or butterfly mind alighting on the problem every now and again. Until it eventually dawns on them that mites just don’t make glamorous medicine.

    The ONLY real help I’ve received for my demodex nightmare came from a natural healer with an extensive professional background in research chemistry , a supremely courageous and inventive Las Vegas woman, and a bunch of other extraordinary “ordinary” people.

    Not one single doctor or dermatologist among them.

    You can find that help documented here:

    http://www.delusionalinsects.com

    By the way, the Lyme doctor’s blog can be read here (and it’s a real eye-opener):

    http://lymemd.blogspot.com/2010/02/evidence-based-medicine-critical.html

    Final word: medics like Dr. Anderson are about as useful to humanity as a chocolate fireplace.

  23. Kate says:

    Al Cronin and Sharon have you tried tea tree oil shampoo? This is supposed to kill the mite. You can also use the actual oil on your scalp for severe conditions. Sharon, I suggest you do this as you said you have patterned baldness. I would also suggest looking at your diet. I had an incredibly irritated scalp and itch with no rash all over my body, and am just trying out a low salicylate diet (found in most fruits, processed foods etc) and have cut out Aspartame (artificial sweetner) and so far have seen an improvement, but it is early days yet to tell if that is the problem. Every one is different and I hope you find what works for you.

    All the best,

    Kate.

  24. Kate says:

    Al Cronin and Sharon have you tried tea tree oil shampoo? This is supposed to kill the mite. You can also use the actual oil on your scalp for severe conditions. Sharon, I suggest you do this as you said you have patterned baldness. I would also suggest looking at your diet. I had an incredibly irritated scalp and itch with no rash all over my body, and am just trying out a low salicylate diet (found in most fruits, processed foods etc) and have cut out Aspartame (artificial sweetener) and so far have seen an improvement, but it is early days yet to tell if that is the problem. Every one is different and I hope you find what works for you.

    All the best,

    Kate.

  25. Candius stearns says:

    I have had rosecea for several years and over the last 3 month use IPL laser treatment. I have seen a hugh improvement with the laser treatments will post before and after pictures once the afters have been taken.

  26. jim says:

    I had bought this chinese-made product a few years back…It showed improvement, but the instant I had done using the product, the scrawling feelings came back all over my body.

    The product is not cheap, but i may buy it again…They have a host of other product, but cost a lot..Up to $70..

    If anyone have cure for demotex, please post it here…I can’t stand of having insect walk all over my body…Although I’ve become use to it, it really freaked me out once i realize what was scrawling on my body.

  27. Gayle Stevenson says:

    Milk of magnesia pushes the demodex mites out of the pores. It is a laxative. I was getting rosacea, first on my face, then my stomach and then my legs. It was burning and hurt. Nothing helped cure it. I could only decrease the rosacea some. I put on the milk of magnesia and, like a miracle, my skin cooled and I saw the demodex mites and their stuff all over my skin. I washed it off and reapplied the mom. Today is the first day I have used it, but I think I may be back to my old self soon. Hope this helps.

  28. jim says:

    Milk of magnesia??….I have never heard of this milk before..is it like the natural milk?

  29. jim says:

    Do you drink this Milk of Magnesia or do you apply it on your skin??

  30. Mike Marca says:

    The electric has not destroyed any hair yet, and it does work. You can always just use it for areas where you do not care about destroying hair. When I use it for my eyebrows it takes about one to two days before more mites take over. At least I am bringing down the population. Mike

  31. Mike Marca says:

    So you say that they turn up their noses for Milk of Magnesia? It’s worth a try. Maybe it makes them constipated. Ha.

  32. jim says:

    electric?..What are u talking about mike?

  33. Gayle Stevenson says:

    I’m still using the milk of magnesia and the heat, rosacea, is almost eradicated. I’m still getting stuff out ofmy pores but my skin is beautiful again. I was so sad about having the ugly, thick skin with small sores on it. My face
    Ooks like I was sunburned and looks tanned with peeling skin I can feel but not see. After I apply the mom, I let it dry and then wet it again and get more demodex mites out.
    I am amazed at how many are in my skin all over.

  34. Gayle Stevenson says:

    Note: I still have to use listerine in my ears. I can feel them when they are coming out. I put tissue over the listerine and leave in about 30 min or more.

  35. jim says:

    Gayle, i thought the M.O.M was something you’re suppose to drink?

    Can you help me and tell me where i buy this M.O.N and the listerine

  36. David Bourke says:

    @Gayle Stevenson – many thanks for the fascinating info on Milk of Magnesia.

    I’d be very grateful if you could tell us how to use this, how often it should be applied, how long it’s left on for, and the treatment duration. You also mention “heat” – I don’t understand this reference.

    Also, which variety of Listerine?

    Thank you in advance for this vital information.

    @jim – Milk of Magnesia is a laxative. When you use it as one, you drink it. However, here it’s used “off-label” as a topical skin application, like a moisturiser or skin cream. You can buy Milk of Magnesia (MOM) and Listerine in any pharmacy, and possibly even in a good supermarket (well, the Listerine certainly).

  37. Gayle Stevenson says:

    I mentioned Listerine [I use the off brand, Equate, with mint in it] in the ears and Milk of Magnesia [I use the off brand with the same ingredients, Equate] for the skin. I am still new the these mites, so I still am experimenting with these products.

    I don’t know why, but it seems the mites travel to a certain part of my body, stomach, face, legs. I feel the crawling sensation, then the area begins to get hot and my skin begins to burn like a sunburn. The process takes about an hour or more. A washcloth with clorox helped but did not stop the burning. I apply Milk of Magnesia on the area and it instantly cools.

    There are two types: 1) cherry, which has citric acid in it and drys clear and does not dry out the skin so much. I like this one best and 2) the original mom, which becomes powdery when it drys and causes the skin to feel tight even after it is removed.

    I apply the mom where ever I feel an itch and massage it in until the itch stops. I rinse my hands often and massage the water and mom together until the debris, which comes out of the pores, stops coming out. I sometimes apply hand sanitizer, [I use Germ-x] over the mom and this causes the debris to come out of my pores even more. I constantly apply, rub, rinse, apply, rub and rinse until the itching stops and until I have no more debris coming out of my pores. Then I apply one last time and leave the mom on overnight.

    When the skin is dry, I massage into the skin a thin coat of vaseline, or jojo oil, or coconut oil, anything pure. The mom seems to work better when I use it after I have previously apply oil on the skin. On my face, I will do the mom treatment, wipe with a cooled washcloth cooked in the microwave for 2 minutes, apply an oil and gently massage my face where I feel debris coming out of the pores and then wipe again with a clean wash cloth which has been cooked in the microwave. I try to always keep something on my skin to protect it.

    With the Listerine [or off brand Listerine], when I feel the crawling sensation coming out of my ears, I pour some in and put tissue over it to keep it in. I leave it in as long as I can, sometimes 3 minutes, sometimes 30, depending on how much time I have.

    I want to add that I used the cherry mom on my dog, who got terrible flakes from a neighbor dog with which she mated. I wet her hair, added mom and rubbed it in. I left it on overnight and rinsed her in the morning and blow dried her hair. I saw many small black dots on her skin. She was not healed over night but the flakes were much less. I have only begun this treatment on her.

  38. David Bourke says:

    @Gayle Stevenson – thank you very much indeed for providing such clear and extensive details on the Milk of Magnesia and Listerine treatments.

    I wonder if you’d mind if I put this information up on my website under the title of “Gayle’s Milk of Magnesia Remedy.”

    http://www.delusionalinsects.com/styled-23/styled-26/index.html

    Thank you once again.

  39. Sandra Beckman says:

    Adding my thanks, Gayle. I looked up topical use of Milk of Magnesia on the web and learned it’s a time-honored treatment for acne too. It dries the oily sebum that causes the eruptions. I’ve put it directly on the dermititis I have on my scalp today and will let everyone know if it helps. Feels good, anyway. Thanks again.

  40. Jake says:

    @Francis I think you better get a new practitioner. Do a search on wikipedia for Pittosporum. You will find it is a tree and I’m sure that you don’t have trees growing out of your skin.

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