Did the dermatologisttest for either fungal acne or microscopic demodex skin mites? These are 2 very often overlooked causes of acne. These skin conditions require different treatment than bacterial acne.

Fungal acne is common in humid environments. It requires treatment with anti-fungal medication.

The other possibility is the microscopic, demodex skin mite. They can cause long term skin problems for decades. You acquire them from your older family members. There is a possibility that some people are genetically more susceptible to getting demodex. There are several highly effective anti-parasitic treatments that work well to treat demodex skin mites.

Everyone over the age of 5 acquires the very common microscopic demodex skin mites. A healthy immune system keeps the population low. But if your immune system is low due to illness or stress these mites can become overpopulated. The mites eat oil. They can cause acne like symptoms, clogged pores, papules (bumps), pustules (die offs of dead mites). The skin may get dry and itchy. Issues with the mites can also appear anywhere on the body, scalp, back, chest, ears, etc. Dermatologist were taught incorrectly for 150 years that the mites were harmless. In the last 12 years eye doctors (opthalmologists) discovered that these mites can cause severe dry, red eyes, clogged oil glands. This is a condition known as blepharitis demodex or ocular rosacea. The eye doctors also noticed that patients with this condition also had large blackheads, and many had the symptoms of acne or rosacea subtype 2 (papules and pustules). Many old school dermatologists still have difficulty believing that the mites are a problem. The more knowledgeable dermatologists are aware of the damage the mites can cause and know how to treat the condition. Testing for demodex requires collecting a sample, putting it on a microscope slide and counting the mites to see if you have too many. The mites don't like light and crawl to the edge of the slide making counting them difficult. Because of that difficulty, some dermatologist will prescribe the oral treatment to eliminate the possibility of demodex as the cause of the skin problems.

If the cause is demodex there are several really good treatment options with anti-parasitic drugs:

1. Highly effective, inexpensive, 2 week treatment option using Oral Ivermectin and Oral Metronidazole. I was misdiagnosed with bacterial acne for decades. This treatment worked and is the only treatment that ever worked for me.The 2 drug combined treatment was published in a medical study in the May 2013 Journal of Infectious Diseases. Link below - cut and paste into browser if it doesn't work directly,or Google the link using the title:

Paper Title: "Evaluation of the efficacy of oral ivermectin in comparison with ivermectinmetronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum"

URL: https://www.sciencedirect.com/science/article/pii/S120197121201315X

2. Topical Treatment with Soolantra or Rosiver Cream (contains 1% Ivermectin). This treatment takes 16 weeks. Only effective on skin as it cannot be used to treat eyes. It's also more expensive than the shorter oral treatment.

The acne like conditions caused by demodex can appear to be cyclical. The mites live and die on a 2 to 3 week cycle. So the skin condition may seem better for a week or so and then the mites die. During a die off more pustules may appear. The pustules contain the dead mites.

On 6/26/2020 at 7:48 PM, ElaineA said:

The acne like conditions caused by demodex can appear to be cyclical. The mites live and die on a 2 to 3 week cycle. So the skin condition may seem better for a week or so and then the mites die. During a die off more pustules may appear. The pustules contain the dead mites.

Is there any easy way to identify if acne could be caused by demodex? My acne is very much cyclical, just as you describe and I've had it for many years. It mainly appears on my cheeks and jawline which is usually said to be common place for hormonal acne so that's what I've thought it to be but I don't know. I would happily go take a test against this if it is likely possibility

40 minutes ago, numberone said:

Is there any easy way to identify if acne could be caused by demodex? My acne is very much cyclical, just as you describe and I've had it for many years. It mainly appears on my cheeks and jawline which is usually said to be common place for hormonal acne so that's what I've thought it to be but I don't know. I would happily go take a test against this if it is likely possibility

A dermatologist can do the demodex test. They collect a skin sample, put it on a microscope slide, then try to count the demodex on the slide. They can collect the skin sample 2 different ways. 1. Do a light skin scraping. 2. Put a sticky glue on a microscope slide and place it on the skin, leave it for a moment and pull it off. Test 2 works similar to usinga pore strip. The mites do not like light and may crawl to the edge of the microscope slide. That makes the mites a little hard to count.

The link to a video shows how they do the slide test:

https://www.npr.org/sections/health-shots/2019/05/21/725087824/meet-the-mites-that-live-on-your-face

I had demodex and did have it along the jaw line.

A doctor can also test your hormone levels to see if they are too high.