Demodex and Rosacea
Demodex folliculorum are microscopic mites that live naturally in the hair follicles of most adults. In individuals with rosacea, these mites are often found in much higher numbers, and it's believed they may play a role in the inflammation of papulopustular rosacea.
How to know if mites are a factor
If you have papulopustular rosacea (the subtype with red bumps and pustules), it is highly likely that an overgrowth of Demodex is contributing to your rosacea. The mites and the bacteria they carry can trigger a strong immune response in susceptible individuals.
Treatments that target demodex
Several treatments work, at least in part, by reducing the Demodex population. Topical ivermectin (Soolantra) is the most direct and effective treatment, as it is an anti-parasitic agent, however it likely has other anti-inflammatory properties as well so does not only work through its action on demodex. Other treatments like sulphur-based cleansers or creams also have anti-Demodex activity. Oral ivermectin is sometimes trialled in very severe, resistant cases.
How can I help
I see patients in person in central London. An in person consultation allows me to examine the skin directly including features that are difficult to capture in a photograph such as 3-dimensional changes and textural change. This is the better option where the diagnosis is uncertain, where previous treatment has not been effective, or where a procedure is being considered. For more straightforward conditions such as acne and rosacea a remote consultation with clear photographs can be a good option.
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