Update after two years.

Overall my dermatologist is pleased with the results however she can still see evidence of demodex activity on my face particularly around my nasel folds and chin and she reminds me to keep using the scabies lotion regularly as maintainence.  This is evident in the images below, as a couple of small pustules.  

My face looks a little flushed in these shots and it's due to a couple of reasons.  One reason is that we are now treating the strong veins around the nose and over the chin with a new laser called Genesis.  We are also going over the cheeks to close off the veins to remove the background redness.  

This new laser is very effective and the downtime seems to be less than the previous laser.  While it is so much more targetted, it is also very much more painful and I'm only on a moderate setting.  I haven't had to resort to a stressball until now, and behind my goggles I am weeping with pain.

Unlike recovery from the previous laser, the recovery is less like a surface burn but more of an interior swelling so my past strategies of quickly cooling the skin does not apply.  In fact, there's really nothing I can do but be gentle for a couple of days and not let my husband near me with his beard stubble which feels like a thousand daggers.  

The second reason for the flushed appearance could be due to anti aging products recommended by my dermatologist which can both cause flushing.

I'm still getting into the routine but basically it's using a Vitamin C topical serum in the morning with 50+ sunscreen over the top and at nighttime, a very low percentage Retinol topical with Hyaloronic Acid serum over the forehead and cheeks and the scabies lotion around my nasal folds and chin.  I couldn't afford the topicals sold by my dermatologist but have purchased very similar products from The Ordinary which are almost a tenth of the price.

At this point, I am very confident in my skin.  My complexion is generally clear and even.  ...and not bad for nearly 51!

PS.  At long last I got a sample tube of SooLantra and used all 10mg of it over the course of 5 nights (just around my problem areas).  It was okay.  No reaction, no nothing really.  The Cetaphil base it consists of makes it easy to apply and lightly moisturising.  My feeling is that the Quellada or Lyclear is just as good and at a fifth of the price.  I was glad for the opportunity to test it out though!

 

My rosacea has been beaten so this is a final update...maybe?

I saw my dermatologist last Thursday.  She has told me that she doesn't want to see me for the next 18 months.  Hooray!  I like her a lot but the consultation fee is something I don't particularly enjoy paying.

Her advice is to continue using the Quellada Scabies Lotion just once a week as a maintenance against the demodex mites.  She said I could use the Lyclear but I reminded her that I was a bit irritated by the formaldehyde in the cream although once a week as maintenance would not be an issue for me as it was when I was using it daily.

She said that there is no need to switch to SooLantra.  It does the same job and the Quellada is 70% less expensive.

My advice to anyone who has found my page:

• Ignore my earlier posts and go straight to using a dedicated scabies treatment - either Lyclear or Quellada.  Use it every evening and eventually the demodex mites will be eradicated.

If you can afford to, use SooLantra.  I would imagine the preparation is very gentle on the skin although I have not had the opportunity to try a sample.

• Only once the mites have been eradicated will it be worth assessing the damage to your skin and determining a course of repair as in IPL (Intense Pulsed Light).

• The science is here to support it and dermatologists the world over now agree that the pimple and pustule rosacea is caused by demodex mite infestation (or over-colonization) so don't be afraid to broach this subject with a dermatologist. It is interesting to note that ophthalmologists came to this conclusion a lot earlier linking blepharitis and occular rosacea to demodex mites.

• Don't fall prey to companies (or individuals) with outlandish claims of a magic cure.  There are a lot of people making a lot of money because of rosacea.  If it sounds too good to be true, avoid it!  When I was experimenting in my earlier posts, I was enticed to try a bit of pseudo-science (apple cider vinegar, hydrogen peroxide, undiluted tea tree oil etc) and I am the first to admit that the feeling of desperation can override usually good common sense.  

Finally, be kind to yourself and be gentle on your skin.  Don't be sad about the damage, the skin has a remarkable ability to repair if you gently (and patiently) help it along.  

Right side of face. May 17, 2016

Left side of face. May 17, 2016

Best wishes

Kate

Still battling the demodex mites but winning!

Since my last post, I saw my dermatologist and was recommended to try IPL (Intense Pulsed Light) to reduce the redness in my cheeks, nose and chin where the veins are damaged.  

I had my first session 4 weeks ago at the dermatologist and am due for my second session tomorrow. 

The head dermatologist came to inspect my face before the session and she said that I had done a great job of reducing the mites but they were still evident around my nose creases and on my chin. I realised that I hadn't been focussing on those areas since it was the pimples and pustules on my cheeks which had been causing me the most concern.  Since then I have paid particular attention to the chin and nose creases and there has been a nice improvement. 

During the session, the zapping was uncomfortable particularly around the base of the nose and nostril flaps.  I figured that if I don't make a fuss it will be over faster so I gritted my teeth and tried to focus on my breathing.

The following four days were spent being very gentle on my skin and using a thin application of Advantan cream (daily) and regular applications of Aloe Vera gel to soothe the burning feeling.  I found some Solosite gel in the cupboard and it was nice but if it was touched after application it was a bit messy to deal with.  

After my skin felt calm again, I continued with my current demodex mite eradication.

Currently I am using Quellada lotion once a day.  The best time to apply it is in the evening just as the mites are starting to emerge.   

You may recall, I was using Lyclear with great results but after a couple of months I noticed discomfort most likely from the preservative (formaldehyde).  My dermatologist said to use whichever feels the best.  Most people wouldn't react to the amount of formaldehyde so it's a matter of trying it.  The Lyclear is certainly easier to apply.  The Quellada is wetter and therefore takes a bit longer to work into the skin.

Here are the latest images of my cheeks.

It's been a while between updates.

I met with my dermatologist in February and while she was up to date with information regarding the approval of SooLantra in the US, she was not supportive of me using Ivomec.  

"Too strong, too strong!" she said.  

I am inclined to disagree based on how my skin was responding and improving but I'm not a dermatologist. In hindsight, I think that the tea tree oil products were too strong but used less often and for particular reasons will continue to have their place in my routine.

My dermatologist started me on a Permethrin 5% scabies cream called Lyclear Dermal Cream.  

From the patient information leaflet: "Lyclear Dermal Cream contains butylated hydroxytoluene (E321) and formaldehyde which may cause local skin reactions (e.g. contact dermatitis), or irritation to the eyes and mucous membranes (lining of the nose, mouth and genital areas)."

I commenced twice daily usage (February 10th) and mostly my skin has responded very well with only two significant skin eruptions.  The skin generally appears smooth.  Flushing episodes are less common and abate sooner than in the past.  

My rosy complexion remains but that is due to the many broken capillaries across my cheeks and around my nose and will have to be addressed by future laser treatment.  I am able to disguise this by applying a mineral foundation (or a tinted sunblock) but am careful to wash it off as soon as I can.

The demodex mites continue to inhabit my pores but in fewer numbers these days.  I can feel the tingly, itchy feeling here and there on my face and in my hairline after the sun has set.  It serves to remind me to apply the Lyclear cream before I go to bed.  There have been a few occasions, that when the itching feels more aggressive than usual, I apply the Ivomec fluid and after that has dried, I apply a layer of Lyclear over the top.  

My current routine is as follows (and is dependent on how my skin is feeling at the time):

Morning (if showering).
 - Wash with TTO foaming cleanser OR with Cetaphil cleanser. 
 - Apply Lyclear Dermal Cream.

Morning (if not showering).
 - Dampen cleansing pads with micellar water (currently using Suisse Micellar Water because it was on special!). Discard and use a fresh pad to finish.
 - Apply Lyclear Dermal Cream.

I wear a hat when I go outside but if a sunblock is needed, I use a tinted 30+ by Invisible Zinc.  I don't like the shininess but the colour helps to disguise my broken capillaries.

Evening (if not showering).
 - Dampen cleansing pads with micellar water. Discard and use a fresh pad to finish.
 - Apply Lyclear Dermal Cream OR if there is obvious mite activity (bumps/itching) apply Ivomec (allow to dry) and then apply Lyclear Dermal Cream on top.

Evening (if showering).
Wash with TTO foaming cleanser OR with Cetaphil cleanser.
 - Apply Lyclear Dermal Cream OR if there is obvious mite activity (bumps/itching) apply Ivomec (allow to dry) and then apply Lyclear Dermal Cream on top.

My application of Ivomec fluid topped with the Lyclear has so far not exceeded more than once weekly.  I have used it as "booster" when I can see that there are bumps forming.  I apply it at nighttime because that is when the demodex mites are active.  

In additions, I recently started taking vitamin D3 and vitamin B but not specifically for this issue. 

The two pics below are a vast improvement on what I was dealing with late November 2014.  My right cheek (bottom image) has always been the worst effected.  It's the side I sleep on. 

My next appointment with the dermatologist is in June.