Here are some treatment options for demodex skin mites. I did the combined 2 week oral therapy with Oral Ivermectin * Oral Metronidazole. It worked after years of being misdiagnosed with acne (bacterial) and "allergic conjunctivitis" and given quite a variety of useless antibiotics, retinoids and prescription benzoyl peroxide that didn't work. 8+ months after this treatment my skin and eyes are still clear - first time in many years. This oral prescription treatment was published in the May 2013 issue of the International Journal of Infectious Diseases. The combined 2 drug treatment was more effective than oral Ivermectin alone.Using the more effective 2 drug combined treatment (from paper) based on body weight for the oral Ivermectin:1. Two doses of oral Ivermectin one week apart. Each weekly dose is 200 micrograms Ivermectin per kilogram of body weight. My doctor rounded the dose up some since they tablets are 3 mg - that avoided having to break tablets. Worked out to 12 mg per dose for me. Take on an empty stomach with a large glass of water.2. Oral Metronidazole, 250 mg. three times a day for two weeks. Do not drink alcohol while taking oral Metronidazole and for 72 hours after taking the last tablet.I didn't have any problems with either drug. Although, the first dose of Ivermectin did make me sleepy. Got a great 2 hour nap out of it. Cost: With insurance copay just $13.03 or about $52 full retail. Here's some links to the May 2013 Journal of Infectious Diseases article:Summary of results:https://www.ncbi.nlm.nih.gov/pubmed/23294870Full Journal Article:https://www.sciencedirect.com/scienc...0197121201315XIt may be wiser to try the Ivermectin first instead of the Roacutane. Roacutane shuts down the oil glands which will reduce the oil eating mite population by starving some of them. But Roacutane will not kill all of the mites. A lot of people seem to have rebound problems after completing the Roacutane treatment. Roacutane also has a lot of serious side effects. Roacutane treatment takes months longer as well. Additional topical treatments effective against demodex skin mites:A tea tree oil facial cleanser and overnight tea tree oil moisture cream or tea tree oil ointment can also provide topical support to kill the mites, especially at night. The male mites come out on the skin surface at night to mate. Tea Tree oil can kill the mites or at the very least ruin their love life.Tea Tree Oil cleansers:1. The Body Shop Tea Tree Skin Clearing Facial Wash (liquid). Available from The Body Shop store or online, or Amazon.2. The Body Shop Tea Tree Clearing Foaming Cleanser. Available from The Body Shop store or online, or Amazon.3. Desert Essence Thoroughly Clean Face Wash - Available at Kroger, Sprouts, Amazon4. Tranquil Eyes 1% (or 2%) Gentle Formula Tea Tree Eyelid and Facial Cleanser by eyeEco - Available at AmazonTea Tree Oil Moisturizer or Ointment - 5% Tea Tree Oil is a good minimum1. Desert Essence Tea Tree Oil Skin Ointment - Available at Sprouts, Amazon2. Derma e Tea Tree and Vitamin E Relief Cream - Available at Sprouts, Amazon3. The Body Shop Tea Tree Night LotionWarning: Tea Tree Oil should never be used at full strength - it can burn and it can be toxic if ingested. It should be diluted with another carrier oil like grapeseed oil or castor oil to no stronger than 50% - even that may be too strong for sensitive skin. 5-10% is the strongest that most face washes or night cremes will contain.Hypochlorous acid sprays can also help. Hypochlorous acid is a mild acid and a natural antiseptic, the same as made by the human body in response to a cut or scrape. It kills mites especially in the nymph stage. (Heyedrate and Occusoft are 2 brands available from Amazon). Spray face and eyelids and let dry prior to putting on the nightly moisturizer/ointment. If your face feels itchy in the middle of the night, spray again. Borax Treatments:Borax DIY shampoo (1 TBSP of 20 Mule Team Borax (grocery store laundry aisle) per cup of hot water, mix in hot water and stir, cool and pour in a clean shampoo bottle) can also be used to wash hair and face. Borax shampoo is a no lather shampoos, use the same as you would any shampoo. Borax kills the mites. Demodex skin mites may also cause what appears to be body acne as well as tchy skin. The mites can make your skin itch - this borax soak will soothe the skin by killing the mites. Borax bath soaks can be very helpful in treating demodex that has spread to other parts of the body. Bath body soak below is for a standard 5 foot bathtub: 1. Start filling tub with pleasantly warm bath water. Do not make the water too hot as that can over heat you. 2. Add 1 cup 20 Mule Team Borax (available in the laundry aisle at most grocery stores about $5.50 per box). 3. Add 1 cup Dr. Teal's Epsom Salts (Coconut Oil version is good to aid skin moisture). 4. Swish water to dissolve the Borax and the Epsom Salts. 5. Soak for 30 minutes. Wash your hair and face too and let the solution stay on the face and hair while you soak. 6. Shower after soaking, rinsing hair too, conditioning hair if needed.