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Demodeciasis Treatment

Case report of a 34 yo man with proven Demodex-Rosacea who was treated with 200 mg/kg ivermectin with subsequent weekly topical permethrin. The protocol  showed impressive treatment efficacy.
See pdf of article: Download Demodeciasis Ivermectin

Topical Ivermectin for Rosacea

"The etiology of papulopustular rosacea (PPR) is not well understood yet appears to involve both the innate and adaptive immune response in addition to possible infestation with Demodex mites. Current treatments for PPR consist mainly of antibiotics. Ivermectin cream 1%, a new topical treatment for PPR, possesses both anti-inflammatory and anti-parasitic properties. After 12 weeks of treatment, subjects treated with ivermectin cream 1% had significantly greater reductions in PPR symptoms and enhanced disease-related quality of life improvements compared to subjects who received vehicle. Furthermore, PPR symptoms continued to improve with prolonged treatment (40 weeks). Ivermectin cream 1% offers a multi-pronged approach to combat the complex pathophysiology of rosacea."  Full Text Ivermectin 1% Cream for Rosacea. Gita Gupta, MD, et. al.

This recent article was written by researches who are deeply in the pockets of Big PhRMA, however, topical Ivermectin may still be worth trying.  It is unlikely to be covered by drug plans.  On GoodRx Soolantra will run ~ $300 for 30 grams. 5% permethrin cream is also available and is much less expensive.  It is similar to ivermectin but is a higher percentage and may prove more irritating.  Dr. Yoon Cohen writes: "Permethrin and Ivermectin are both paralytic agents that block different ion channel. Permethrin is a synthetic pyrethrin that disables nerve cell Na+ transport channels in parasites resulting in paralysis. Ivermectin blocks glutamate-gated chloride channel resulting in paralysis. In my personal experience, permethrin 5% cream was not that irritating. If patients find 5% cream too strong, we could try permethrin 1% lotion. The only problem with permethrin would be with patients who have allergy to sesquiterpene lactone allergens (Chrysanthemum, ragweed, sunflower, artichoke, arnica, daisy, marigold plants) as there is cross react with permethrin." Dr. Cohen thinks "topical ivermectin may have a role for some individuals who cannot take topical permethrin or oral ivermectin, but it wouldn't be the first go-to drug for sure....although you see more and more of free Soonlantra samples around in clinics these days."

There are ways to save on Soolantra but it is very complicated.  See: Soolantra Savings and Support (and let us know if you can make out heads or tails from the site).

Recent ad for Soolantra gets the award for the most unpleasant drug promo ever!