Medical Studies on Rosacea patients positively diagnosed with demodex, rosacea and/or SIBO

[ElaineA]

Medical studies on treatment for patients with Demodex diagnosed as Rosacea, Demodicosis or Demodectic Rosacea.  The first 3 articles identify patients with positive demodex overpopulation.  The 4 article identifies rosacea patients with SIBO.

The gold standard test for SIBO is the endoscope test.  A thin tube is inserted through the mouth, through the stomach and into the small intestine,  A fluid sample is collected from the small intestine and cultured for bacteria or fungus.  Based on the clear scientific results of this test, a very specific diagnosis can identify the bacteria or fungus causing the skin issues.  Once the underlying microbe(s) are identified, the doctor can choose the best treatment to successfully clear the skin condition.

1.  Patient misdiagnosed with bacterial acne and treated with Accutane.  Initially the treatment appeared successful BUT the patient quickly relapsed after treatement with Accutane ended.  Identification of overpopulation of demodex skin mites and treatment with Oral Ivermectin cleared the patients skin.   Follow up not performed so the patients long term treatment success is unknown.  SIBO diagnosis not mentioned.

Accutane will temporarily reduce the population of demodex by greatly reducing the oil they eat, starving the population down.  Once the Accutane is stopped, the mite population frequently rebounds.  The Accutane just treats the symptoms.  It doesn't kill the demodex.  A rebound after Accutane happened to the patient in this medical study - treatment with Oral Ivermectin cleared up his skin:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5489393/

2.  Treatment of 12 year old with demodicosis for a year.   A single dose of Oral Ivermectin cleared her skin.  Initially the patient was treated with doxycyclin which appeared to help during the first round of treatment.  Doxycyclin was not effective the second time it was tried.  A single dose of oral ivermectin cured her skin condition.  Long term followup not mentioned.

https://jamanetwork.com/journals/jamadermatology/fullarticle/1784334

3.  2013 Medical study comparing the treatments using Oral Ivermectin alone versus Oral Ivermectin + Oral Metrondiazole.  The authers could not explain why Oral Metronidazole improved the patients outcome.   Subsequent scrutiny indicates that Oral Metronidazole is highly effective against at least 2 of the bacteria that cause SIBO.  Oral Metronidazole is 99% effective at treating Bacteriodes and Eggerthella Lenta.   While the patients in 2013 were not tested for SIBO, it is likely that for many, SIBO was causing the immune system malfunction that allowed the demodex to become so overpopulated.  Treatment with Oral Metronidazole cleared the SIBO allowing the skin to heal.  The Oral Ivermectin doses killed the overpopulation of demodex skin mites allowing for faster healing.

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

4.  Interestingly, it was reported in JAMA in 1985 that Oral Metronidazole was highly efffective in treating rosacea:

https://jamanetwork.com/journals/jamadermatology/article-abstract/545882

5.  Use of Rifaximin in the treatment of rosacea.  Rifaximin is a very expensive antibiotic.  Rifaximin is highly successful at treating some types of E Coli.  However, to successfully treat other types of SIBO bacteria, a different antibiotic should be used.  NOTE:  SIBO was diagnosed in many of these rosacea patients.  However, the actual bacteria causing each patient's SIBO was not identified or reported.  Rifaximin is not the best antibiotic to treat some types of SIBO bacteria.  For effective clearing of SIBO induced Rosacea, the correct antibiotic needs to be selected based on the actual bacteria causing the patients SIBO.

https://www.jaad.org/article/S0190-9622(12)02330-4/fulltext#:~:text=Of the patients with SIBO%2C 28 were treated with rifaximin,and SIBO reported marked improvement.

 

Edited July 20, 2021 by ElaineA
Corrected typos.