Do you think it is something related to alimentation? For example, do you restrict your daily diet?
I’m not sure about it. The lesions occur randomly in time, but sometimes there suddenly is a big worsening/breakout without a clear cause, which makes it easy to point diet as the cause of the worsening.
A healthy diet may help and drinking enough water, but simply switching to a healthy diet isn’t going to solve the problem by itself. (At least not for me.) Maybe there is some hidden thing in the diet that causes problems, like an allergy or intolerance, but finding it and determining whether it causes problems, probably required a lot of repeated trial-and-error.
Maybe sudden unexpected worsenings can be caused by the demodex life cycle. For example, if a region on the skin had a dense population of demodex, and if that population has the same synchronized life cycle, than they may die all at once, causing an unexpected worsening. Not sure if this is possible, but if it is, then it could explain breakouts.
But I think that external stimuli may cause worsenings. For example, I helped a friend a few months ago with his house. The house was dusty, and was recently treated with toxics to remove wood worms, also treated with toxics to remove a bee nest outside (of which a bit of toxic came inside) that day, wood saw dust, physical exercise, and the usage of skin irritating glass wool like material, and wearing tight eye goggles and mask, and they had cats (for which I’m allergic). Sounds like a really bad environment, but it sounds worse than it was when being in it. But it did cause the worst breakout I had this year, the next day. Not sure which of these stimuli caused the breakout, maybe it was just the tight eye goggles and mask, which maybe pressured demodex causing a breakout.
The difficult thing is that if I really want to know the cause of the breakout, then I have to try it again (a couple of times) with some things isolated. Like wearing the eye goggles and a mask the whole day, or being in a dusty house with cats etc.
I think multiple things are involved. Demodex could be one of them, but since almost everybody carries demodex, demodex by itself doesn’t explain the problem. Genetics could also one of them. Also bacteria. Maybe allergies. etc