Do you eat dairy products(milk, cheese etc)regularly ? I've seen many examples where women have been able to eliminate acne just by removing dairy/gluten/refined sugarfrom the diet. American standard diet is one of the reasons why people developall these food sensitivities, as not all of us have good genetics that would allow usto poison our bodies for decades without any consequences.

Find a dermatologist who knows how to test you for microscopic Demodex Skin Mites.Demdex can cause acne like symptoms.The skin mites eat oil.The condition may respond initially to antibiotics or anti-fungal drugs since the demodex can track bacteria or fungus around the skin and back down into the pores and oil glandswhen they come out to mate at night.

Demodicosiscan be cyclical, since demodex live on a 2-3 week cycle.When they die they create pustules that look like acne pimples. That can be confused with hormonal acne by doctors who only do visual exams. That is why it is important to find a doctor who will actually test for demodex or at least is willing to treat the possible condition. They have to take a skin sample and manually count the mites under a microscope. The skin sample is collected by either a very light skin scraping or better a sticky microscope slide pressed to the skin for 1 minute (like a pore strip). Regrettably, not all dermatologists are as knowledgeable about demodex as others.Demodex were first discovered on human corpses in 1840 and thought to be harmless.They are until they get overpopulated.Overpopulation can start when the immune system is down due to illness or stress.

I had problems with demodex for decades.It was misdiagnosed by 4 board certified dermatologistsas bacterial acne.The last one reviewed my records and said "gee maybe its hormonal".It wasn't hormonal for me either.None of the many antibiotics, retinoids, or prescription benzoyl peroxide products ever worked.Minocin did seem to help at first.

Symptoms may include some or all of the following:blackheads, papules, pustules, folliculitis, scalp acne, body acne, blackheads in outer ears, telangectasias (broken capillaries), red eyes, dry eyes, your skin may or may not be red, it may be worse cyclically due to the mites dying on their 2-3 week life cycle.

Print out a copy of the following medical article to take to your doctor.My Family Practice doctor prescribed it for me. He knew that I had skin problems for years. I took the 2 week, 2 drug oral treatment described in this paper.It worked - nothing else ever worked.The medical journal articledescribes a properly done medical study on treating demodex:

"Evaluation of the efficacy of oral ivermectin in comparison with ivermectinmetronidazole combined therapy in the treatment of ocular and skin lesions ofDemodex folliculorum"

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

This 2 drug oral prescription treatment uses 2, safe, inexpensive generic drugs:Oral Ivermectin + Oral Metronidazole.Cost with insurance copay about $13.03 USD or about $52 cash USD full retail.Taking both oral drugs provided far better clearance of the mites than taking Oral Ivermectin alone.

Prescription Treatment options

1. 2 week full body Oral Treatment (best and fastest)Oral Ivermetin (in 2 once a week doses based on body weight) + 3 times daily dose of Oral Metronidazole.The first dose of Oral Ivermectin kills the current adults.The second dose a week later kills any new mites from the eggs that have hatched.Oral Metronidazole as it breaks down in the body creates 5 metabolites that are believed to create a bad environment for the demodex.NOTE: Topical Metronidazole gel does not work - you have to take the oral drug to get the metabolites to kill the mites.

2.Topical (Expensive and slow):Soolantra Cream (1% Ivermectin) - Soolantra Retail costs up to %500-$600 per tube.May be muh cheaper with insurance copay.Takes 16 weeks of nightly use.Due to expense if you have body or scalp symptoms this will not likely be a cost effective solution.Best for milder cases isolated to the face.

Over the Counter Support Options:

1. Use a clean towel every day. Demodex can live on a wet towel for up to 54 hours. Demodex die at 58 degrees C. So washing towels and bed linens in an automatic clothes washer and dryer should eliminate the mites from towels and bed sheets.
2. Wash face at night before bed with a commercial Tea Tree Oil based face wash (Desert Essence, The Body Shop and the eye eco brand are all good).
3. Spray face after washing at night with Hypochlorous Acid Spray ( Heyedrate or Occusoft, both are good). Let dry before using face serum and/or moisturizer.
4.Ivermectin Horse Paste (1.87% Ivermectin) available from Amazon for about $5 for a small tube.Stronger and cheaper than Soolantra.People have reported good results with this more cost effective option.Use at night - that is when the mites are active.
5.Intense Pulsed Light Treatment (IPL) - IPL has been shown to kill the mites.The mites don't like light.