Demodex "die-off"

Would anyone like to share their personal experience with die-off symptoms after using Soolantra or another Ivermectin treatment? I feel I am currently experiencing this die-off reaction but I can’t be sure if that’s what it is or if it is just my skin reacting badly to the treatment. My symptoms are small red circles all over my face after treatment. They do not form any real oozing lesions. It just looks red and irritated.

I cannot tell reliable experiences about it, because right before starting with it, I stopped using a topical corticosteroid.
I used this topical corticosteroid and stopped using it after a few months, which gave me a very bad breakout. I started with Soolantra at the peak of that breakout, so a die-off reaction maybe wasn’t noticeable because I was already in a breakout period. But it seemed that Soolantra quickly reduced itch, and maybe gave a very mild breakout with small and relative quick restoring lesions. Maybe a bit reddened skin, but I’m not sure about this reddening. If there was reddening in my case, than it was (I think) only temporary during maybe the first days or week after starting with it.

I started using Soolantra one week ago. I apply it at night, right after washing my face, and then apply extra virgin coconut oil over top of it after waiting 5-10 minutes. In the morning, I wash my face again and only apply the EVC (Extra Virgin Coconut).

Over this first week, I’ve removed all restrictions on my diet except that I don’t really like sugar that much. My skin is almost completely normal because of Soolantra. I have gotten an occasional whitehead, but they have been small and absolutely no oozing at all. Or so minimal, the crust has been barely bigger than a grain of sand. I did get one or two red splotches that I assumed would break out, but that same day the redness faded and the splotch disappeared.

I am not taking anything else in conjunction with Soolantra, other than a B Vitamin complex which I always take.

It is possibly what you’re experiencing is die-off. If you are using tea tree oil, then its even more likely its a die-off effect. I think its important not to try too many different things at once. I highly recommend using just coconut oil or a mild moisurizer like cerave or cetaphil. If you make it a month where you find Soolantra is working for you, then start experimenting with tea tree to see if your face can handle it. I used tea tree and jojob for a few months and it tore my skin apart. I could never get through the die-off phase.


I have been using Soolantra for over a good month now and i didn’t have any ‘die off’ situation. It took 2/3 days to work and since then i have not had a lesion! I put it on first thing every morning after a shower and most nights don’t wash my face unless i have been the gym. I can’t really say i notice it on my skin once its soaked in either (15mins) so i don’t mind keeping it on in public.

The only negative thing i have to say about it is that it has given me some blackheads on my cheek nr my nose that i never had before, but its a very small price to pay compared to what i was going through before!

Got a derm appointment at the end of Feb to see whats the next step… continue with Soolantra or stop and see what happens! I have a feeling it will come back sooner or later without the cream.

Regarding die-off, I notice that I do get raised, red areas from time to time. Before Soolantra, these would have continued to grow bigger until they burst open and started weeping into the dreaded yellow crust. Today, one of these little mountains sprang up but thanks to Soolantra it didn’t stay raised and inflamed for very long. Eventually, it shrank down to almost flush with the rest of my face. I don’t think anyone would notice the site except for me. I’m very impressed with Soolantra so far. Reactions are happening on my skin, but the weeping and oozing stage has been totally removed from the process. Whoever they paid to invent this cream did it right. But can they offer us a groupon or something to save on the cost?

Do you use the Soolantra everyday or do you dab it on any spots that look like they may be a problem?

I put it on after a shower or washing my face. I spread over the areas where I have outbreaks, which is almost all of my face except by my sideburns. I let it soak in for a few minutes, and then apply extra virgin coconut oil as moisturizer afterwards. I’ve finally gone to discuss this with my dermatologist, and starting next week I’ll taper down to using every other day. I’m going to see how far out I can go without breakouts. So, no I don’t just use it as breakouts occur but as a preventative measure.

I hope the Invermectin is working for you. One thing I want you to know, when you get your first prescription of soolantra the first 12 prescriptions should only cost you $25-$50. Mine was $25. The derm will most likely give you a little booklet that gives you 12 prescriptions at that price. Even without that, you can just download the coupon for the website. But if you get Invermectin to work just as well as soolantra, more power to you.

Hope you are seeing some positive results.

Misfit I am seeing great results! I wish I had the nerve to post my photos I took over the last two weeks. Drastic change. I had a lot of red weird irritated areas. No real oz zing. Just what I call “angry” skin. It’s gotten much better now. However I was a little let down this morning when I developed a small oozer on my chin. But I attribute it to being lazy with my ivermectin formula. From what I have read it seems it is best to keep on with it religiously for quite some time. Just how long is debatable. I am going to stick with this for a month and if I still think I need to see a dermatologist again I will. If I get the Soolantra I will definitely use the coupons you spoke of. I’m going broke with all these treatments

I know exactly what you mean by ‘angry skin’. I was still getting this when I first started with Soolantra, but not any more. However, I did develop a cold sore over the past two days. I don’t expect Soolantra to help that, as that’s a different thing altogether.

I think you do have to keep using it religiously at first. I’ve been doing every night. Now I’m going to do every other night. If that works for a while, I will drift out to every 3 or four days. I’ll keep spacing it until I start to ooze again. Trial and error is the only way to find out how often you will need it.

As always, good luck.

And good luck to you as well. Keep us posted.