Demodex mites were discovered in 1841 and are tiny little microscopic mites which live all over our bodies… all of us. This may seem gross but it’s not, it’s just part of our evolution and part of life. We never see them or know they are there. They eat our dead skin cells and for most of us never cause a problem. Many years ago, scientists discovered a connection between rosaceans and a higher population of demodex mites on their faces. Now they don’t know for sure if the mites are causing the rosacea or if the mites are there because of the rosacea, but either way, if you have Subtype II with red marks, papules, pustules, and enlarged pores, chances are you would improve tremendously by controlling the mite population on your face.
I must caution you that this type of treatment for rosacea is considered “controversial.” While many people, including myself, have amazing success addressing the demodex mite population on their faces, there are dermatologists and medical doctors who don’t believe there is any correlation between rosacea and demodex mites. The prescription medication Soolantra is meant to address demodex mites using ivermectin. Ivermectin is considered a reliable treatment of demodex mites, but it may take a while (up to 6 months) and doesn’t work for everyone. It is also very expensive. I was told it would not be covered by my insurance and it cost over $700. Since I did not have that kind of money to spend on a single tube of medication and the reviews were so-so, I opted to search for other alternatives. Please keep in mind that ANY demodex mite treatment works by killing the population of mites, and this will cause your rosacea to get worse before it gets better. Many people give up before giving the treatment a chance because of the week of die-off.
Since I am a chiropractor, I cannot recommend a topical “treatment” for your rosacea. That is the job of your dermatologist. However, I am telling you the product I used, because it did work for me. It does not work for everyone, and some of the demodex mite creams are not yet approved by the FDA. If you choose to try one of these options, you must do your own research, understand that your rosacea may get worse before it gets better (during the die-off period) and understand that your dermatologist may in fact advise against this form of treatment. The following resource is a collection of testimonials of rosaceans who had excellent results when they treated their skin for demodex mites: https://irosacea.org/forums/topic/8291-zz-cream-anecdotal-reports/.
That being said, there are a few different options for a sulfur based demodex treatment. I used ZhongZhou Cosmetic Cream by Demodex Solutions. I found out about it from the Rosaceagroup.org forum and was fascinated. A telltale sign of a demodex mite problem is that your skin will get better and then worse every 3 weeks or so. After starting ZZ cream, I noticed a difference in about three days. My skin stopped getting red bumps and the pores became smaller. My cheeks got smoother and the papules stopped. Over the next three weeks I continued to use it religiously and soon the sandpaper feel of my skin improved. The only issue I had with the cream was that it was extremely drying so I had to moisturize twice a day. If you choose to try a demodex mite treatment, be prepared to invest in a very hydrating moisturizer which DOES NOT have petroleum or mineral oil listed in the ingredients. If these products are in your moisturizer, the demodex cream will have difficulty penetrating your skin. The Arbonne SuperCalm Moisturizer with probiotics is my favorite brand to use.
The main ingredient in ZZ cream is sulfur which is what kills the demodex mites, or at least reduces the population. It also contains zinc, lanolin, menthol and Chinese herbs. If you are allergic to sulfur, lanolin or zinc, obviously you would need to find another alternative. I am not recommending the Zhong Zhou treatment to anyone without first trying other medications approved by your dermatologist. Many people have contacted me to tell me their dermatologist doesn’t know what demodex mites are, and isn’t familiar with Soolantra. Again, this treatment worked for me, but it will not work for everyone, and you will have to decide for yourself (with the help of your doctor) if this approach may be right for you.