Hello Logan and Ian,

Unfortunately, in the study Logan cited, they never recounted the
demodex (if my memory serves correct) and thus it was a general anti-
inflammatory action of oral metronidazole that helped clear the
folliculitis. It was only one patient to so you must consider
that. Oral metronidazole has rarely been shown to have an effect on
demodex. It has several other actions that make it beneficial to
rosacea. Below is one of many abstracts on the ineffectiveness of
oral metronidazole on demodex. It also emphasizes that
demodicidosis is a distinct disorder from rosacea. Oral stromectol
is by far the best medication to combat demodex as proven in over
120 cases in 9 recent papers. I think there was full clearance in
95% of the patients studied.

Eur J Dermatol. 1998 Apr-May;8(3):191-2. Related Articles, Links


Unilateral demodicidosis.

A 45-year-old man presented with a unilateral, papulopustular,
rosacealike, chronic dermatitis which involved the left portion of
the forehead and the eyelids unilaterally. Many Demodex mites were
found in the follicles of the affected area. Topical crotamiton
cleared the lesions after an unsuccessful trial with oral
metronidazole. This observation provides further evidence that
demodicidosis is a condition distinct from common rosacea.

Regards,

Geoffrey
______________________________

Dr. Geoffrey Nase
Ph.D. Neurovascular Physiologist
http://www.drnase.com
______________________________




--- In rosacea-support@yahoogroups.com, ian <csciian@y...> wrote:
> Thanks for sharing the abstract, Logan. Unfortunately, I was just
> paraphrasing from a previous post by Dr. Nase... and I believe he
was
> pulling from a few abstracts that he was reviewing at the time.
> (Original message:
> http://groups-beta.google.com/group/rosacea/msg/a9fe36ae6e55469a)
What
> turned me on to the original post was the effectiveness of
> Stromectol/Ivermectin, the large number of positive results
reported,
> and even more the saftey of it ("not one major side effect").
>
> It's good to know that oral metronidazole is an option to use for
this
> as well. I think I may have even remembered low dosage Accutane as
being
> a theoretical helper with facial mite infestation (?).
>
> But then again, I'm not much of an expert on these things... I'm
merely
> a starving physics student. :)
>
> Ian
>
> loganruns73 wrote:
>
> >>If anything, a prescription of Stromectol appears to
> >>be one of the safest and most effective medications
> >>for ruling out mite involvement.
> >>
> >>
> >
> >Not really. See the abstract below.
> >
> >Logan
> >
> >
> >J Am Acad Dermatol. 2003 Nov;49(5 Suppl):S272-4.
> >
> >Demodex abscesses: clinical and therapeutic challenges.
> >
> >Schaller M, Sander CA, Plewig G.
> >
> >Department of Dermatology and Allergology, University of Munich,
> >Germany. Martin.Schaller@l...
> >
> >A 53-year-old man had a 6-week history of confluent erythematous
> >papules, pustules, and abscesses of the face initially limited to
the
> >right nasolabial fold. Histologic investigation revealed a
> >perifollicular infiltrate with lymphocytes, histiocytes, and many
> >Demodex folliculorum mites. A large number of mites were seen in
skin
> >scrapings. The skin manifestations progressed and persisted for
the
> >following 5 years and were unresponsive to numerous antiparasitic
> >treatments, including repeated oral administration of ivermectin
and
> >external application of lindane, permethrin, and benzoyl
benzoate.
> >Therapy with oral administration of 250 mg metronidazole 3 times
a
> >day for 2 weeks resulted in rapid and lasting recovery. Demodex
> >folliculitis remains a diagnostic and therapeutic challenge.
> >Antiparasitic therapies used against lice or scabies may fail in
> >control of D folliculorum mites. In the presence of clinical and
> >microscopic findings typical of Demodex folliculitis or
abscesses,
> >treatment failure with acaricidal agents does not exclude the
> >diagnosis. Oral metronidazole seems to work in the management of
this
> >chronic mite infestation.
> >
> >
> >
> >
> >
> >
> >
> >
> >