Die you Demodex, die!

...I'm obviously not a Buddhist!

I had little sleep last night as I was very conscious of the mites moving upon my face.  It had me wondering if the Ivomec was not working for some reason.  I remembered that I'd left it out of the cupboard for a week in filtered sunlight while I was interstate for a holiday.  Could that amount of sunlight reduce the potency of the ivermectin in the solution?

I telephoned Merial and without giving too much away, I asked them if that amount of sunlight could effect the active ingredient.  After consulting with their resident vet, they assured me that it would be fine to "administer to my cattle".  I'm relieved to know that because I am only halfway through the 200ml bottle.

However, it does confirm that the mites are still not being effectively eradicated.

More research led me to a very interesting document: http://www.google.com/patents/US5952372 
Entitled: Oral administration or topically applying ivermectin in a dosage to eliminate demodex folliculorum mites from hair follicles in affected skin.

In short, William Robert McDaniel states that treating rosacea "with oral ivermectin in a regimen of 200 micrograms per kilogram body weight per dose for 2 or 3 consecutive doses at least 3 and not more than 7 days apart as the preferred regimen or, alternatively, topical ivermectin compounded to a 2% concentration by weight in a cream, lotion, or gel carrier vehicle is administered as an effective treatment for all clinical stages and signs of rosacea in affected persons."

My GP wrote me a script for Stromectol 3mg in December - based on my body weight I was to take 5 tablets.  Because of a miscommunication with the Pharmacist I took an incorrect dose of 4 tablets December 19th, 6 tablets January 17th and today I took the correct dose of 5 tablets.

Based on McDaniel's findings, I need to take my next dose in 4, 5 or 6 days time and could take my remaining dose again at 4, 5 or 6 days after that.  A detailed description is in the article (link above) but here's the reason why:  It "treats such rosacea patients with at least two doses timed so that between three and seven days separate the doses. Such spacing allows time for Demodex eggs to hatch into immature mites that are killed before they can mature into egg-producing adults. While two doses has been demonstrated to be quite effective, in unusual cases where absorption is impaired, as many as four doses at three- to seven-day intervals could be employed."

Today's dose was 2pm February 2nd.
My next dose should be 7th February.
My final dose should be 13th February.

...and then I'll need to assess the outcome.  

Today's pics show the evidence of mite's at work during the night.  Several red dots on my right cheek and a couple on my left.  Over the course of the day my cheeks became more inflamed looking.   It's a step backwards but it prompted me to do more research and thereby finding this wonderful document.  ...so I'm going to say it's really a step forward!

I'm lucky to have an open-minded GP.

My research of late has made me want to try oral Ivermectin (Stomectol) as a way of eradicating the demodex mites, or at least to rule it out.  Ivermectin is usually prescribed as a one-off treatment to cure scabies however demodex mites have a difficult life cycle to crack with eggs hatching within three days of being laid.  My thoughts are that more than one dose of it will be required.  

I made the appointment with my GP solely to discuss this issue.  It was interesting to note that she hadn't heard of demodex mites until now but was open-minded regarding what I was hoping to achieve and asked me how many courses did I think I would need to break the cycle.  I was unsure and hesitant to name a figure but she asked me if I thought 4 doses would be enough?  At this point in time, I'll take whatever I can get!  Since this is entirely experimental, I have no idea how often I should take doses for maximum effect.  I'm suspecting I should do it weekly and if I am getting good results, ask for another prescription.

I took my first dose yesterday but the pharmacist got the dosage wrong and only gave me 4 tables instead of the 5 tablets my GP worked out based on my body weight.  Eager to start, I took the dose during a meal and waited for any side effects but didn't experience anything - no nausea, no dizzyness etc.  I'll make sure I get the proper dosage next time.  It's not going to be a cheap exercise at $28 for 4 tablets.

I slept incredibly well last night and quite possibly it was the best sleep I've had in a long time.  It makes me wonder if my sleep disturbances are due to the nocturnal wanderings of the mite.  Perhaps I am having some success in diminishing their numbers?

Looking at the images, on my right cheek there is a large welt as a result of a deep and very painful infection.  It took 4 days to surface and looking at it, I think it will take several more to heal.  I'm not feeling defeated because this is the first pustular sore I have had since I started my routine in early December.  There have been other tiny infections which are closer to the surface resembling a whitehead but they heal quickly.  I'm assuming that over the next few days, if the Ivermectin is a success, I will end up with quite a lumpy sore face as a result of mass die-off - the infection will be due to the bacterium the mites leave in each pore as they decompose.

My left cheek, aside from having three tiny surface infections, is looking very good.  It gives me hope that by persisting with my TTO routine and in addition to regular washings alternating pyrethrin, permethin and benzyl benzoate should being results.