One year on and still amazing results.

It's been a year since my last photographs and I thought it would be great to update you on my skin.

I have been less regimented with the scabies lotion (Quellada) over the last year - only using it for a couple of nights in a row when I get a breakout on my chin or in the nasal folds.

I haven't had any more laser treatment since I finished the course in early 2016.

My routine these days is very simple.  I keep my skin clean with a gentle cleanser (Cetaphil) and because I'm now 50 years old, I've been using a basic hyaluronic acid to keep the wrinkles at bay topped with Cetaphil lotion (to trap the hyaluronic acid in).

I always wear a hat when I got outside and I am mostly pretty good at remembering to apply sunscreen.

This probably really is my last post regarding my battle with rosacea.  ...maybe...

All the very best

Kate

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

Almost a year - comparison pics.

Almost a year since I started my personal war on demodex mites.  Here are the before and after shots.

Right Cheek 29 Nov 2014

Left Cheek 29 Nov 2014

Right Cheek 21 Nov 2015

Left Cheek 21 Nov 2015

My battle against Demodex Mites has been won!

It's really nice to know that people are reading about my journey!  Here's an update...

It has been almost one year and my skin has improved significantly.

Since getting the demodex mites under control using Quellada scabies lotion on a daily basis, my dermatologist has said to use it once a week.  Sometimes I forget and use it every couple of weeks when a small pimple reminds me to apply the lotion (paying particular attention to my sebum rich areas - the creases of nose and chin).

Morning routine at this time:
Cleanse with Cetaphil.
Zinc sunscreen with a tint OR I apply a mineral foundation if I am needing a made up look.

Evening routine at this time:
Cleanse with a micellar water to remove the sunscreen or makeup.
Apply Cetaphil lotion OR Quellada (once a week - I aim for Sunday evening)

The redness which remains is veins damages from the Demodex infestation.  To minimise the flare ups, I have had 4 sessions of IPL.  Initially the settings were low and bearable but each session is now dreaded as the operator has increased the pulse and focuses on my problem areas - on and around the nose and a couple of really stubborn veins on my chin.  I take two paracetamol before I go to the appointment but I doubt they do much to counter the shock of each zap.  I describe myself as pretty tough but I cried during my last session.

On average, it takes me around 3 days to recover from a session most of which consists of tender skin, one or two little bruises and swelling beneath the eyes.

I've got a routine I follow to minimise the discomfort.  As soon as I get into the car, I apply alcohol free aloe vera gel and turn the air conditioner on for an icy blast.  As soon as I arrive home, I very gently wash the sunscreen off my face (applied by the IPL operator as a matter of course) and apply Advantan cream followed by a layer of aloe vera.  I spend the next couple of hours sitting up on the bed, fanning my face with a hand fan and gently applying cold compress to particularly hot areas.

I stopped using the Solosite burn gel but only because as soon as you touch it, it sort of flakes off in blobs and was a bit messy.  I recommend that you don't go out in public with it on.  Other than that, if you have some on hand, go for it!

Within a couple of hours, I have the redness under control.  The skin feels very tender and remains that way for a few days.

I almost forgot!  Here's some exciting news for Australian rosacea sufferers!...  My dermatologist said that SooLantra will be here within the next month or so.  She said that although the Quellada has been excellent for me, she would get me a sample of SooLantra to try.  It will be interesting to see how much the SooLantra will cost here but it won't be anywhere near as affordable as the $25 a bottle I pay for Quellada.

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.

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!