SooLantra has been approved by the FDA.

Reading that the FDA has approved an Ivermectin based cream to treat rosacea was like getting a Christmas gift from Galderma!

From what I have read, Ivermectin (the active ingredient in Soolantra Cream), has been reported to have both anti-inflammatory and antiparasitic activity.  Soolantra® (ivermectin) Cream 1% is found to be well tolerated with powerful results seen as early as two weeks with continuous improvement in patients with inflammatory lesions of rosacea.

Here is the Press Release from Galderma USA.

I can't imagine Soolantra will be available in Australia for some time but I had read in an initial report that the  new cream contists of ivermectin combined with Cetaphil cream (another Galderma product).  Having both a bottle of injectable (livestock) Ivomec (10mg/ml) and Cetaphil cream on hand, I mixed up a small batch to see what would happen.

I added 2 squirts of Cetaphil cream and 16 drops of Ivomec to a small stainless steel bowl and mixed them with a small metal spatula.  The two ingredients combined easily with no distinct separation.  I applied the mixture to my face, neck and decolletage.

Observations after 24 hours (3 applications):

• Face feels calm - not inflamed.
• Itching has diminished on face, neck and decolletage but seems more pronounced in my scalp.
• Small red dots have appeared across cheeks.  Particularly on the right cheek which is the side I sleep on.

My new routine will be as follows:
Twice daily TTO foaming face wash followed by hydrogen peroxide (3%) washed over any newly formed pustules (rinse with water after a few minutes) and then application of the home brew mixture of Cetaphil and Ivomec.

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.

Continuing the TTO routine.

I promised myself I would write here every day.  Maybe it will be more realistic if I post weekly instead.

Having continued with the routine of twice daily washing with a TTO based cleansing foam, followed by a generous application of a TTO based acne ointment, I have also been patting on 100% TTO on top of the ointment.  My skin hasn't looked so nice in years!  It's quite smooth and hydrated.

It's an odd sensation, but within minutes I can feel a ticking "movement" on my face.  I wonder if it is mites squirming to find a more habitable place.

The pimples and pustules are few and far between these days.  If I get one, zap it with a bit of Hydrogen Peroxide (applied with a cotton bud/Q-tip) and leave it there to dry out.

As you can see in the photographs, one side is worse than the other.  It's interesting to note that the worst side is the side I sleep on.

Itchy but not bumpy!

So itchy!  Aaaagh!

I'm feeling like I'm being eaten alive.  Mostly it's my body and scalp - in small patches on my face or throat.  I wonder if the TTO routine and pryrethrin is doing little more than just annoy the mites.  I'll take an anti-histermine and consider another course of action.

Regardless of the lack of calmness in my complexion today, my face hasn't developed any new bumps or pimples so I am going to view this as another positive advancement.  ...You can cover up redness with makeup but you can't disguise lumpy skin.

I was reading today about Ivermecton and also found some information regarding sulphur cream.  It might be time to have a chat with my GP to see if she has any thought regarding mite eradication.  Failing that, I'll go and see a vet!  

Another route I have considered as a "value add" is traditional Chinese medicine.  If the imbalances I am having are due to a lowered immune system, and my current diet (which isn't all that bad) can't rectify the situation, then perhaps some acupuncture can assist. 

Progress and some new ideas.

My skin was not as calm this morning.  I woke with a mild headache and delayed my routine for an hour or so.  I decided to take a steamy shower in the hope it would help with my headache.  Since the bottle of Pyrenel Foam was still where I had left it, I added it to a washer and lathered my entire body for a few minutes but used only the TTO Foaming Cleanser on my face.    

The itching sensation died off again.  If my rosacea is related to demodex mites, then it seems that they are not easily eradicated.  A regular application and perhaps some different insecticides will be required.

I searched for insecticides which use different active ingredients other than pyrethrin and came across scabies and body lice medications:

• lindane
• crotamine
• benzyl benzoate
• clotrimazole
• permithrin

Another visit to Chemist Warehouse!  I found a plain brown bottle on the bottom shelf labelled Benzemul Application (contains benzyl benzoate 250mg/ml).  I'll try this in a a few days time.

Another plain brown bottle I found was Hydrogen Peroxide 3%.  Mum (a nurse) always had a bottle of this at home when I was growing up.  As soon as it hits pus it fizzes and as a kid I always found it a little bit exciting to get the fizz on a skinned knee or sore.

And, I noticed in my photographs that I had some black pores at the sides of my nose and remembered a product I used to use called Biore Pore Pack.  Yes!  They still make them and I noted that they have extended their range into acne treatments as well.  

It wasn't a cheap shopping expedition.  I needed shampoo as well and I don't usually purchase it from a chemist but Thursday Plantation has a TTO shampoo and conditioner so I added that to my pile of experimental goodies.

When I got home, I rinsed my face and applied the pore packs to my nose, cheeks, chin and forehead.  After around 15 minutes when they had dried to a crisp, I gently peeled them off.  Mostly the papers were clean but the nose paper was pretty gross.  I took a photograph but really can't bring myself to share it.  I did a second application for the nose and again, more grossness but that's all my nose can handle for one day.  

A google search regarding the use of hydrogen peroxide with rosacea brought me to a page where a mixture of the liquid with Baking Soda into a paste and applied to the face was getting results.  

...I know, I'm jumping all over the place with trying too many ideas at once but I'm eager to be rid of this redness.  You can tell I'm not a scientist!

Anyway, I mixed a toothpaste like concoction and caked it onto my nose, cheeks and chin.  It was a tingly, burning sensation but not unbearable.  The mixture was puffing slightly.  To keep it from falling off, I used the spoon to move it around.  Next time I'll add it and then lie down on the floor so it doesn't fall off.

I was feeling nervous about how my face would react to having the hydrogen peroxide on it.  I rinsed under running lukewarm water and my skin instantly felt very soft.  It was a little reddened but not uncomfortable.  A couple of spots had appeared overnight an I used a cotton tip to dab some undiluted hydrogen peroxide directly onto them.  They fizzed!  

I applied TTO antibacterial ointment and didn't get a chance to look in the mirror again for an hour or so but when I did, I was happy to see even calmer skin than I have for a long while.

Let's exterminate!

December 2, 2014

The itching sensation woke me up around 1am and I was so distracted by it I decided to do some more research regarding demodex mites.  In particular, their lifespan and how to eradicate them.  

The word pyrethrin stood out to me and I remembered seeing something like this in our medicine cupboard.  It was a bottle of head lice shampoo called Pyrenel Foam contained Pyrethrin and Piperonyl Butoxide.

At 7.30am, I was in the shower and used the Pryenel Foam as an insecticide.  It foamed beautifully in my hair and I used the lather to coat my entire body in foam.  I was careful to avoid my eyes but I applied it to the lower half of my face.  I stood in the shower (with the water turned off) and waited for 10 minutes before rinsing it off.

Perhaps it was overkill, but I then followed my morning routine of washing, blotting with paper towel, applying ointment and dabbing the pure TTO as needed.

Over the course of the day, I could feel a couple of new bumps forming low down on my right jawline and dotted the pure TTO during the course of the day.

For several hours I didn't experience any itching on my scalp or body but as the night fell, I started to feel like things were moving on my skin.  I will do the full body and hair treatment again in a few days time.

Feeling optimistic!

December 1, 2014

A confidence boost for me! So far, I have had calm mornings in a row.

Usually I wake up with quite inflamed looking cheeks. This tends to dissipate a little over the next hour or two. I tend to avoid looking in the mirror but today I had to keep checking to see if I was imagining an improvement.

White skin seems to be appearing within the red areas.

I continued my routine in the morning and again in the evening with the three products from Thursday Plantation and photographed my cheeks after the evening routing.

• Tea Tree Facewash for Acne 150ml
• Tea Tree Antiseptic Ointment 30g
• Tea Tree Oil Antiseptic (100% pure)

Facewash first. I wet my face over the basin and then spread two pumps worth over my face and into my brows (avoiding the eyes) and left it a minute or two before rinsing it off.

After rinsing, I blotted my face with two sheets of paper towel.

Generously applied the Antiseptic Ointment to my face.

Finally, I dotted some of my pimply bumps with the pure TTO.

Greeting the day calmly.

November 30, 2014

I woke this morning to relatively calm skin.  No new bumps had appeared overnight. 

I washed my face over the basin using the Tea Tree Oil cleanser (leaving it on for approximately 2 minutes before rinsing off under the tap) and blotting gently with paper towel to avoid cross-contamination.  Following this, I applied the TTO ointment and dabbed on the pure TTO on old bumps.

The calmness in my complexion remained until the heat of the day caused me to flush however, it was not as bad a reaction to the heat as I have previously experienced.

Periodically, I observed that while my face was no longer feeling itchy, my hairline was itching.  Am I imagining this?

The images below were taken that evening.

I readily researched rosacea.

November 29, 2014

I have 8 weeks until my next appointment and I am on a mission to present myself to her with a fresh face.

Thanks to Google, these are things which I have found particularly interesting:

• Demodex mites are in proportionately greater numbers on rosacea affected skin.
• Tea Tree Oil is a highly respected antiseptic.  Demodex mites don't really like tea tree oil.
• You can ingest diluted borax which changes the preferred habitat for the demodex mite.
• Human insecticides can assist in temporary eradication.  
• Deplorable witch doctors are taking advantage of  rosacea sufferers who are at their wits end.  Human nature, I suppose.

The easiest way to start was to take a look at Tea Tree Oil (TTO).  Tea tree oil has been claimed to be useful for treating a wide variety of medical conditions...(source Wikipedia, Tea Tree Oil). It kind of sounds a bit witch doctor-ish but I've done a lot of reading and confident that what I've read so far about TTO in correlation with demodex mites and rosacea at least needs to be considered.

Chemist Warehouse has a range called Thursday Plantation and I purchased three products:

• Tea Tree Facewash for Acne 150ml
• Tea Tree Antiseptic Ointment 30g
• Tea Tree Oil Antiseptic (100% pure)

Facewash first.  I wet my face over the basin and then spread two pumps worth over my face and into my brows (avoiding the eyes) and it felt so cool I decided to leave it there for a minute before rinsing it off.  

After rinsing, I blotted my face with two sheets of paper towel.  My face felt fresh.

Next, I generously applied the Antiseptic Ointment to my face.  The coating left me glistening and felt nice.

Finally, I dotted some of my pimply bumps with the pure TTO.  Since it was on top of the ointment, the fact that it was undiluted didn't concern me.  

And I took a photograph of each cheek.

My sensitive skin.

November 2014 

After a long Melbourne winter, I came to the bleak realization that my rosacea symptoms were out of control.  Redness had increased, pimples and bumps were battled with on an almost daily basis and several spider nevi had left their jagged marks on my cheeks.  All evidence of the battle I was losing.  I was glad that my appointment with my dermatologist was approaching.  

I see a dermatologist primarily to have regular skin cancer checks.  Growing up in Queensland in the days when sun sense consisted of a smear of Pink Zinc across your nose and throwing your hat off as soon as Mum had disappeared into the house, and in my twenties having moved to Melbourne, I was using solarium regularly enough to combat the SADS.  Yes, of course there was vanity involved as well.  Tanned skin looks so healthy! Right?!  

During my first consultation with the dermatologist 2 years ago, she noted that I had rosacea.  Oh!?  I had no idea.  

I had, up until that point, concluded that I had very sensitive skin...and marketing had convinced me that it was special skin.  I spent a fortune over the years purchasing the latest products marketed at that skin type.  By thirty years of age, my bathroom cupboards were overloaded with products which I'd tried, tested and found lacking.  With no more room and even less gullibility, facials were now preceded with, "Please don't sell my anything today".  

For a while regular glycolic peels were helpful.  The burning sensation seemed to calm things down for a week or two and I found myself yearning for the burning and I was a good client.  I would pre-purchase my peels in lots of six.  I stopped yearning when the beautician put her prices up and I'd grown tired of hearing her boyfriend woes.  With her prices, she could afford to see a good psychologist instead of ear bashing a client.

Life and priorities changed when I landed a husband, got a mortgage and had a child.  I stopped worrying so much about what I looked like.  Did I let myself go?  I was too tired to consider that I might have and blamed my red cheeks and pimples on my tiredness.  In springtime, I would blame my red cheeks on hay fever coupled with tiredness.  

This winter, there was a definite shift in my psyche.  Tiredness had given way to self-consciousness. Knowing now that I had rosacea and knowing that people always attribute it to alcohol (and I'll admit, I do like a glass of wine or two), I started to hide from people - fearing they would judge me for my complexion.  I rarely left the car at school pick up and drop off times.  I made up excuses to avoid social gatherings.  If I didn't have a choice, I would take extra care in applying mineral foundation and powder to disguise my red and lumpy cheeks.  To draw questioning eyes away from my cheeks I would overemphasis my eyes and brows.  

The appointment with the dermatologist had come.  Skin check done.  Nothing to worry about.  Good.  "Your rosacea is very active", she observed.  And then she recommended trying a low dose of  roaccutane.  All I need to do is pass a liver function test and a cholesterol test and then I can get started.  She printed two pages of do's, don'ts, and side effects and said she'll see me in 8 weeks.

I'll pause for a second.  At my age, even a low dose is not something which will comfortably fit into my lifestyle.  For one, I am a mad keen gardener.  I'll potter about for hours digging, watering and planning (and wearing a hat of course) but also enjoying being outdoors.  Even low dose roaccutane makes you very sun sensitive.  

It's a commitment and I need to think about this further.