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bloopz

Reliable (Western) Study - Demodex

Edit: English isn't my mothertongue, I'm german...Just to make sure that my credibility isn't affected by possible language mistakes, etc.

Hello,

I just read some threads in this forum about demodex as a cause of acne and I believe that it's sad that so many people dismiss the theory about demodex because the people who present it mainly do it in a way that makes the theory seem questionable. One of the things I study is philosophy of science which deals with the goals, methods and basics of scientific research. So I actually do know how to filter and how to separate reliable from unreliable sources!

This is reliable western science:

http://www.sciencedirect.com/science/article/pii/S120197121201315X

Also note: There really are no reliable numbers (some sources claim 90%) on how much acne (and acne related) diseases are caused by demodex. But it's definitely the majority.

Read this link before you go on reading and make up your mind first. Otherwise you probably won't have the basis to believe in the essence of the demodex-theory.

If you somehow find it logical, I'm sure you will get information for yourselves. So no need for me to write anything specific about demodex since I just could be another idiot spreading dubious theories. Just this much: Demodex aren't bad per se. Most people who have no skin conditions at all have them.

It is a fact that Demodex exist and that most people (even people with completely healthy skin) have them. For most people they are nothing bad at all.

However, Demodex become a problem if their population on one's skin increases extremely. A probable cause for an extreme increase of demodex population is a high sebum-production since demodex live off sebum.

A probable reason for the effectiveness of isotretinoin on acne is that isotretinoin reduces the production of sebum dramatically and therefore eliminates the basis of existence for demodex.

A possible source for this (it's in german but if you really want to know if I'm speaking truth you can translate it): http://www.enzyklopaedie-dermatologie.de/login/n/h/944_1.htm

See also what wikipedia says ( https://en.wikipedia.org/wiki/Demodex ) : Older people are much more likely to carry the mites; about a third of children and young adults, half of adults, and two-thirds of elderly people are estimated to carry the mites.[10] The lower rate of children may be because children produce much less sebum.

So, children do not only produce "much less ebum", they are also much less likely to carry demodex (and if they do, they only have small amounts). Now, what do children not have? Right, acne.

I am aware that these explanations are far away from being scientifically airtight but since there isn't too much research about demodex from reliable scientists one has to work with the available sources and somehow try to inerpret and connect the information out of these sources. And that's just what I briefly did here. Anyway..just get information yourselves and remember the first link I posted, it speaks for itself. ( http://www.sciencedirect.com/science/article/pii/S120197121201315X )

I have two motivations for this post:

1. I want to help other sufferes.

2. I want the knowledge about demodex to be spread. The treatment options that are available today are good but it's always off-label use since there are nearly no medicaments specifically created to eradicate demodex.

The only chance to create more information about demodex and therefore to create reliable research in western pharmaceutical companies, universities, etc. is to call attention on this substantial topic for dealing with acne. Go to your doctors, show them the study from sciencedirect.com and ask for that treatment. Make your doctors realize the relevance of demodex. Only they have the basic medical knowledge to really understand demodex and create attention on medical symposiums, etc. This is the basis for possible new treatment options for demodex and therefore acne.

(Of course the idea of reducing the sebum production is even more substantial. Therefore it's right to do research on this but since the reason why a high sebum production causes skin problems [demodex] still isn't recognized in western medicin as it should be there is still much work to do.)

Best regards,

Andre

Edited by bloopz

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Andre - nice to have some real research on this site! I love a good philosopher of science! My research specialty is the philosophy of education, so I am perhaps not as good at this as you, but I did notice a logical issue in your argument that I am wondering about.

You use children as an example of how fewer mites = less acne. However, you also mention that the majority of elderly people do have these mites (a lot of them too!), yet this is also a population that generally has less acne and less sebum. HMMMMMMM?

Have you tried ivermectin or any other parasite killer? There are many stories on the ol' interwebz of people with severe rosacea and acne like symptoms being totally cured from this, but SO LITTLE real research. It is very curious.

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Have you tried ivermectin or any other parasite killer? There are many stories on the ol' interwebz of people with severe rosacea and acne like symptoms being totally cured from this, but SO LITTLE real research. It is very curious.

First of all (also regarding you're other question) I should generally mention that I don't have too much knowledge about acne (at least not as much as some ppl in this forum probably have). I did have acne (without treatment one would probably have to call it severe, with treatment it looked more like a mild - moderate form of acne) but that was manageable by using an isotrexin-ointment. The main reason I busied myself with Demodex, etc. was because a severe blepharitis and dry eyes which were caused by it.

I did the exact therapy which is described in the study I posted. What I definitely know is that the ivermectin-metronidazol treatment had an amazing effect on myblepharitis and acne. (Btw: The Zongzhou ointment from demodexsolutions.com seemed to work for me. However, I am not totally sure about that. But if in dobut: I would advise it since I imagine it to be senseful to complement the oral ivermectin-metronidazol-therapy with local treatment even though the posted study doesn't indicate that this would be necessary [except in the rosacea cases in which the demodex-amount could be reduced but not eradicated]).

I did notice a logical issue in your argument that I am wondering about.

You use children as an example of how fewer mites = less acne. However, you also mention that the majority of elderly people do have these mites (a lot of them too!), yet this is also a population that generally has less acne and less sebum. HMMMMMMM?

1.

The premise for accepting the demodex-theory is that there must be other (unknown) factors than sebum-production which benefit/influence the increase of demodex (I once read something about immune weakness as a possible cause but that’s just speculation. Maybe it also has something to do with the sebum-composition…). Otherwise it wouldn’t be explainable how demodex-infestation can cause all these different types of problems (acne, rosacea, seborrhoic dermatitis, blepharitis, etc.)

Also, the sebum-production of rosacea patients is often completely normal even though the idea that demodex could play a role in rosacea is much more popular (just google it) than it is regarding other diseases.

In contrast to the fact that rosacea patients mostly do not have abnormal sebum-production there are many sources claiming the effectiveness of isotretinoin on rosacea…

There simply are many unanswered questions.

But note this: Yes, you’re right, elderly people generally do not have much sebum. However, skin conditions like rosacea or seborrhoic dermatitis tend to occur respectively worsen in old age. (At least that’s what my sources tell me, not sure how accepted this claim is.) Following the demodex-theory this does make sense as the mite-population increases in old age.

Generally one has to accept that the knowledge about demodex and it’s possible (I believe probable) role in triggering many skin related diseases is fragmentary. Just another example: I’ve read sources that told me high amounts of the mite itself would cause immune reactions. However, there are many sources claiming that the problem isn’t even the mite itself but the bacteria that it carries in its body which are released when the mite starts to die/decompose. ( for example: http://www.newscientist.com/article/dn22227-rosacea-may-be-caused-by-mite-faeces-in-your-pores.html#.Ux3eac6uRdk )

2.

  1. I’m of the opinion that people shouldn’t consider valid studies and research a necessary condition for their actions. Concerning medical treatment this means that I think it’s the wrong way to completely evaluate the sense or nonsense of theories and possible treatments by the amount and validity of available research. There are so many accepted treatments for all kinds of diseases about which the medicine doesn’t even know how it works. And btw…take a look at the psychology: Daniel Kahnemann himself (nobel prize winner) claimed that he expects a scientific catastrophe as more and studies on which substantial theories were based reveal as not being reproducible even though some of these theories were believed to be true for decades… I hope I won’t be misunderstood: Science and therefore also medicine needs to be based on a strict scientific codex that includes all these widely known aspects about the need for valid studies, consistent theories, etc. BUT: I believe that it’s no good to only argue by using (supposed) scientific facts and to always require for studies, studies, studies. If you do that you actually are not using the methods of valid science in a constructive way anymore but you are hiding behind the unfulfillable require for total security. (I’m not even specifically referring to you as you’re question makes complete sense. However, while reading some random threads in this forum I somehow got the impression that there often are two different ways of argumentation: 1. No scientific base at all 2. scientific certainty above everything)

One could think that I lost track but my general point is that I don't see any reason to not give the ivermectin-metronidazol therapy a try. Two different doctors told me that there really aren't any considerable risks about this therapy and the things I've read myself only confirmed these statements. Why not just try it? Especially regarding people who are actually considering treaments with extreme possible side-effects like an accutane-therapy (or even the ones taking antibiotics in a long-term use).

Greetings,

Andre

Edited by bloopz

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I agree with this:

I believe that it’s no good to only argue by using (supposed) scientific facts and to always require for studies, studies, studies. If you do that you actually are not using the methods of valid science in a constructive way anymore but you are hiding behind the unfulfillable require for total security. (I’m not even specifically referring to you as you’re question makes complete sense. However, while reading some random threads in this forum I somehow got the impression that there often are two different ways of argumentation: 1. No scientific base at all 2. scientific certainty above everything).

I especially agree with the part where I'm not being specifically referred to, but also the other parts. Notice I didn't say "I like a good scientist" at the beginning of my last post. Ha ha ha!

I read a lot of feedback on a Rosacea forum from people who had participated in an ivermectin study, and the results they reported were pretty inconsistent. Not like - 'I tried it and I was cured!'

So it goes.

It is impossible to know what the f**k is going on. This is why I've committed myself to a life of complexivist indeterminacy.

And I'm sticking with my isotretinoin for now. If it fails, I will be more inclined to join your revolution.

Cheers.

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I read a lot of feedback on a Rosacea forum from people who had participated in an ivermectin study, and the results they reported were pretty inconsistent. Not like - 'I tried it and I was cured!'

1.

1-s2.0-S120197121201315X-gr1.jpg

Did you read the study carefully? In the rosacea-group the oral ivermectin (don't know if you're quoting studies that did oral or topical therapy) wasn't enough to eradicate the mites. The amount could only be halfed so there's no reason to expect people being cured by only taking ivermectin. As the study to which this graph belongs shows it is necessary to combine oral ivermectin and oral metronidazol.

Oh, and please note: I just found some posts in forums of ppl with roseacea who used oral ivermectin and said that it helped immensly but that it would only be a "a short-term solution to a long term problem" . It should be stated that people with a cured demodex related disease definitely have to use some ointment on regular base to prevent demodex from coming back which is very probable as many people out there (also many healthy) are infested (other possible risk factors are animals). demodexsolutions.com propses to use an ointment (of course theirs ) every second day to prevent reinfestation...I still do use Zongzhou creme from demodexsolutions sometimes but I generally prefer to put some ointment containing tea tree oil on my face every evening which seems to be enough to stay healthy and keep these mites from coming back.

2. Generally: You've got to differentiate between oral and topical treatment with ivermectin. The topical use is much more difficult and the chances of success are logically not as good as with oral treatment. One important reason for this is the fact that a topical face-only therapy has the risk that possible mites from other areas (for example hair/head) can easily reinfest the face of a person. (This is a fact.)

Look what I also found (supports my idea of complementing every demodex-therapy with oral medicaments with something topical):

A 32-year-old man presented with a chronic rosacea-like dermatitis of the facial skin and the eyelids. The skin disorder had been present for 4 years and was unresponsive to multiple previous treatment attempts. Skin scrapings and a histologic examination of a biopsy specimen from the affected area revealed the presence of numerous Demodex mites. The patient was treated with oral ivermectin and subsequent topical permethrin resulting in complete and rapid clearing of the folliculitis. We believe that this case supports the view that Demodex mites may be pathogenic when they are present in large numbers. Oral treatment with 200 microg/kg ivermectin with subsequent weekly topical permethrin showed impressive treatment efficacy in a case refractory to conventional treatment. http://www.ncbi.nlm.nih.gov/pubmed/10534645

Edit:

I don't want to be ignorant as every disease is something really personal and subjective but I feel like I should remind you of something: All kinds of eye-problems are (for example according to acne.org) certain to occur as side-effects of oral isotretinoin, there also is the possibility of getting permanent dry eyes. People shouldn't underestimate this! I suffered from extremely dry eyes for about 1 year. The thing about eyes is that you use them all the time. Of course people suffer from acne but they have the possibility of forgetting the condition of their skin by doing sport, reading, working, watching films, etc. You simply can't do that if you have severe eye problems, it's always there. So..of course the use of isotretinoin is justificated if people suffer bad from their acne and decide to use it but everyone who does should not only be aware of the side-effects but of what some of the side-effects could mean for his/her life in contrast to "just" having acne.

Just needed to say that especially since I saw threads/posts of ppl in this forum which advertised oral isotretionoin really carelessly which I find a bit unreflected, even irresponsible. (again not referring to you, kim!)

Edited by bloopz

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I'm coming late to this but I wanted to share my experience. I'm in my late 40s and have had "acne" since I was a teen. I've been "successfully" fighting it with Differin gel and benzoyl peroxide, but it wasn't a cure. Just battling it back.

In the last year or two, it started getting worse on my back and I assumed it was possibly hormonal (perimenopause). But I noticed it was much worse on my left side and found that odd. I tend to sleep on my left and the thought had occurred to me that there might be a connection. I also had had eye involvement--had about five chalazia, the fancy name for cysts in the eye lash zone, one of which had to be removed surgically. The eye doctor was the one that suggested I see a dermatologist for possible rosacea because of the eye involvement. So I finally did and he said it wasn't acne, it was rosacea.

I've had the easy facial flushing since I was a kid and had suspected I might have rosacea, but I don't have a lot of redness like some people. My main symptom was papulopustular "zits," some on my face but as I said, mostly on my back recently.

He prescribed the topical sulfacetimide/sulphur wash. It was a definite improvement, however, I knew I had a systemic problem and felt like this was at best a good weapon but not a cure.

I started reading about the demodex connection, which apparently is especially linked to papulopustular acne, and followed some of the studies recently done.

After a lot of deliberation and research, I decided to try one of the protocols that seems to be working in some human studies. (Search "demodex ivermectin Metronidazole" and you'll find them.) I bought Ivermectin as a gel paste, the version that's actually designed to fight mites in horses, and I bought Metronidazole over the counter (it's for use in aquariums to fight infections in fish). I'm NOT suggesting you go this route. In retrospect, I should've gone back to my dermatologist and ask to be put on the protocol I was reading about but I was afraid to be told no and tired of years of suffering through this.

Once I started taking the meds, I continued to use the topical on my back and face. Interestingly, I had a MASSIVE breakout on my chest. (I took pictures to document it, if anyone wants to see them.) I've had the occasional "zit" on my chest before but nothing like this. They took weeks to heal, like these "zits" always do.

In any case, this was early April 2015. It's now late May 2015. I stopped the Metronidazole but still periodically take the Ivermectin, like once every 10 days. I'm almost completely clear. I have one to three remaining "zits" and that's it. I think the breakout on my chest was the mites moving to safer ground, i.e., moving away from my back where the topical was killing them off but then dying off en masse as the systemic medication kicked in.

So if this wasn't Demodex, it was definitely something that's been eradicated by the protocol I've been using. I'm 99.9999999% certain those mites were the cause, though.

From what I read, Ivermectin has a good safety record in humans, which is why I felt comfortable (eventually) trying it. But again, I really, truly, highly recommend you get with a willing dermatologist and get this checked out. It's worth it to rule it out, at least.

Me, I've still got some scarring to deal with, but I'm super happy to have the chance finally to wear a backless dress for once in my life, before no one will want to see my back in a dress again. (Except for my husband, gosh love him!)

Good luck on your journey.

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