Getting new crusts every couple of weeks makes testing very difficult. In my case I was getting them on daily basis (about 1 per 2-3 days, usually small, sometimes large). But I do think that you may detect/see them more often when using a bright white led flashlight. In my case, small ones are difficult to spot under normal bathroom lighting conditions, the color of the lesion often doesn’t contrast enough to clearly see them, but when using a bright led light, I see them immediately.
I have experience with both sulfur soap and (pure) neem oil. I was using these:
I used this combination and shortly (few days to a week?) after starting it, I got a breakout that made me quit using these. Note that a breakout may actually be a sign of healing, but it may also be a sign of worsening. The breakout could also be by chance, so I can’t make any hard conclusions out of this experience. If I had to guess, I would suspect the sulphur products to be the cause of the breakouts, I got the breakout after increasing the use of the Sulfur Ointment, I think. Maybe I used it too much, because the Sulfur Ointment may also give a scrub effect.
When it comes to practicality, neem oil and sulfur ointment aren’t fun. Sulphur has a rotten egg smell, especially the ointment, and this smell is difficult to get off. I have also used ZZ-Cream before (also a sulphur based product), and it’s smell got in my bedding sheets, and I could smell on my sheets even after the first couple of high temperature washes.
The smell of neem oil is even worse. (Neem soap is probably a lot milder.) Neem oil is very sticky and water-resistant, difficult to wash off the skin. And the taste is very bad, when it reaches my lips. Also, there hardly is any scientific backup to support the use of neem oil. Those that support/promote neem oil simply say that demodex doesn’t like neem oil, I can understand why…
About Soolantra, yes, I can still recommended it. In my case, it gave quick results and it’s easy to use (no bad smell etc). There is some concern that Soolantra is simply suppressing the lesions by it’s anti inflammatory properties, but in my case, when stopping with it, the results seem to last longer than I would expect from only anti inflammatory. Although in my case I can’t make good conclusions, because it was recent, and I also recently used oral anti-biotics due to a bad throat infection, which also seem to have improved my skin. (Although I suspect the throat infection wasn’t bacterial but glandular fever/infectious mononucleosis.)
The current best known treatment for this disease can be found here: