I have been struggling with this for a little less than a year now. I am a 27 year old female and never really struggled with acne besides the occaisional break out here and there during my menstral cycle. I have gone to numerous dermatologists and all came to the conclusion it was acne, which I can tell you it is unlike any acne I have ever seen or experienced before. The spot will begin to itch and then turns into a clear liquid blister. When it ruptures it will ooze the clear liquid and then slowly crusts over into a yellow crust like substance. They range in size, the largest I’ve had is probably a little smaller than my pinky finger nail. I’ve been on numerous medicines/antibiotics you name it. Most recent the doctors had me on doxycycline. I’ve been on it for a month and haven’t seen any noticlable difference. I’ll post some pictures of some of the ones I’ve had. It is really starting to tear me down emotionally and mentally… not to mention financially and I don’t know what to do anymore. I have a derm appointment next week I am going to beg and plead for soolantra because nothing else has worked and it seems people have had success with that. I also ordered sudacrem online and that should arrive in a week or so. I don’t have insurance, does anyone know if soolantra is super expensive? At this point I’ll shell out anything but I’m just wondering how hard it’s going to hit my bank account. I just can’t believe we are all struggling like this and no doctor or dermatologist has ever heard about it! I’m beyond frustrated and upset I’m just trying to stay positive but it’s really hard. And I’ve only been dealing with this for a year, props to you all who have been going through this much longer. I will keep you posted on what my dermatologist says next week. (PS - all of these photos have been over a few month time span. But I did currently just wake up with one this morning)

Welcome to the forum and thank you for sharing your photos and situation.
Your skin problem looks like the classic typical problem that this forum is all about, so you’re on the right place.

I don’t know much about the costs of Soolantra in the US (I assume?). Maybe @misfit108 can tell you something about it? If I remember correctly, someone said something like $200 for a tube of Soolantra. But you can use it for like 3 to 6 months.

If your dermatologist doesn’t want to provide Soolantra, than you could try to show him this: What does it look like? (photos) and tell him/her that a lot of people on this forum have the exact same unknown skin problem and a lot of them used Soolantra with success.

Soolantra is a moisturizer containing the medicine ivermectin, the primary/active ingredient. Some people have just ivermectin from a topical animal/horse product with success. It can be much cheaper (and without prescription), although it may be safer to use Soolantra. For more info, see: Does yours spread? and Cattle medicine is more potent

Topical ivermectine may cause a bad reaction on some people, which is supposed to be a temporary breakout. So you may want to start with it slowly. For more info, see Bad first reaction

I have also used doxycycline for like 1 to 3 months, but it didn’t do anything to the lesions.

Your skin also looks dry/prone. Dry skin may be more prone to the problem than hydrated skin. So you may also want to try: Skin hydration
(It probably isn’t going to remove the problem, but this moisturizer could reduce itch and reduce the occurence of new lesions a bit.)

Can I post your photos in this topic? What does it look like? (photos)
So that people can compare it with their skin problem?

Hi, hon. You’ve got what we got, so know that you’re not alone. A lot of us have been through the same hoops as you. Doctors don’t know/don’t care enough, so they just try different antibiotics. Many years back some doctors experimented on me with plague antidote. They like to just ‘guess’ at things. Soolantra will very highly likely be your ticket to managing this stuff. No one likes paying for it. Even if you have insurance, insurance doesn’t cover it. I don’t remember how much I paid last time, but at the least it was $350. You have to weigh if you want to get your life back or not. Also, when I first started Soolantra the first tube was $20 or something like that. They had some voucher on their main website at that time. Not sure if that’s still available or not. Soolantra is a small tube, so if you slather it all over your face, it won’t last you more than a few months. Once I got things under control (2-3 weeks,) I was able to apply every other day. And I only put a little bit between my eyebrows and down the sides of my nose where the cheeks crease into the nose. Honestly, just a dab of soolantra the size of a single cheerio is enough to cover those regions. And my whole face stays clear from just covering those three spots. I don’t know what will work for you, but I wish you luck and we are here for you. We all have the same thing and you will never find a doctor who knows what it is or can do more for you than give you antibiotics and do pointless tests or claim its impetigo.

I’ve had good success with sulfur cream. But the reality is, you have to get away from what ever is upsetting your skin. My triggers are stress (yay!), sweating, and sugar. So I know if I down something sugary, by the next day (if not sooner) I’m going to have an outbreak. It all starts in your intestines!

It’s a good assumption, but I am zero stress and I don’t eat sugar. I cut out bread, rice, fruit. I eat nuts, meat and veggies. It hasn’t helped me one bit. What works for some doesn’t always work for others.

So I’ve been on soolantra for about 5 days and I don’t know if I’m experiencing the die off or a really bad reaction. I use ceraVe facewash and lotion each morning and then at night wash my face with ceraVe again and then apply the soolantra. Each morning I have woken up with a new lesion on my face, forehead, cheek and now the side of my nose. I usually never really got a lesion on the top of my nose (only near my nostrils really) but now my nose is covered in tiny little lesions. My nose, around my mouth, my cheeks and my forehead look absolutely awful. It’s hard to keep going with the soolantra and I don’t know if I’m doing more damage than good. It seems everyone has had good experiences with soolantra. With my luck of course this doesn’t work. I’m back in a hole again and don’t know what to do. Even worse than before, because now if this doesn’t work for me what will? I will try and post pictures

Here’s more info about bad reactions: Bad first reaction

You could try to do one of the following, or a combination of these:

  • reduce the application frequency, for example skip a few days
  • reduce the amount per application
  • reduce the area on which you apply it
  • combine Soolantra with a moisturizer to reduce the concentration of Soolantra

You could also try to apply some Soolantra on a different part of the skin, just to see if your skin reacts negatively to it, such as on the arm.

I had a mild breakout, also with some very small lesions or small bumps when starting with Soolantra, but it wasn’t as bad as medium lesions. But my situation was/is a bit difficult to compare/understand, because I was recovering from a very bad topical steroid withdrawal breakout. Some other people also reported mild initial breakouts from Soolantra, but the one from the topic above from @One345, was bad and it’s unclear what her situation is now.

Maybe it’s best to stop for some days, until you skin is at least back to the state it was before Soolantra.

Did you use Cerave before you started with Soolantra? If so, what was your daily facial regimen before Soolantra?

some of us have gone through that. For me, it took about two weeks. Expect some die off. After two weeks, things calmed down for me and I’ve been alright for 2 years now. If the demodex theory is to be believed, you’re laying nuclear waste to demodex and your skin is attempting to clean up the residue.

I’m going to keep going with it. I mean my face already looks terrible so what the heck why not continue to try and really target these suckers (if it is demodex). I was reading on the rosacea forum about a zz cream. Has anyone tried that before?

My routine was pretty simple before. I pretty much used ceraVe products since they are gentle. I previously used panoxyl, it’s got benzoil peroxide in it, it got to be a tad drying if I used it everyday. So that’s why I got ceraVe as the panoxyl was waaaaay too much for my face. A previous dermatologist told me to use it thinking it would help this issue :roll_eyes: which it did not, in fact it probably made it worse since it was so drying.

I have used ZZ Cream (Zhongzhou Zinc oxide ointment) a couple of years ago. But I didn’t noticed an improvement. ZZ Cream is from a Chinese company called Demodex Solutions:
They also sell other products. There also is a European version: https://www.demoderm.de/

The product has sulfur in it, which gives a rotten egg smell, which is difficult to wash off the skin. So the smell may be noticable for like two days after washing it off, but I may be confusing this smell issue with sulfur soap that I have also used.
When applying it on the skin, it temporary feels a bit cold, which could be caused by the menthol in it.
My first ZZ Cream (little jar) contained a hair in the sealed area of the cream, which suggest that the production process could be better.

About the ingredients:

main ingredients, Sulphur, Zinc oxide and Menthol, the ointment contains many different Chinese herbs to make the ointment as effective as possible. This is why the Zhongzhou Zinc oxide and sublimed sulphur ointment (ZZ Cream) is much more effective than pure sulphur without the danger of burning of the skin.

The Ointments formula is protected by a Chinese state patent, some of the ingredients are: Zinc oxide, Sublimed sulfur, Menthol, Boric acid, salicylic acid, Chinese medicine herbs, and the base which is a complex formula on his own.

In western countries, they aren’t able to hide ingredients under names like “herbs” and “formula on his own”, so the European version says:

Ingredients: Aqua, Stearyl alcohol, Propylene glycol, Glycerol, Stearic acid, Zinc oxide, Sulfur, Isopropyl myristate, Petrolatum, Glyceryl stearate, Dimethicone, Menthol, Sorbitan stearate, Polysorbate 80, Wheat germ oil, Azone, Salicylic acid, Sodium lauryl sulfate.

Active ingredients: Zinc and Sulfur

I though the main ingredient was sulfur, but now that I’m reading about ZZ cream again, I see an ingredient that this forum (and I personally) already know about: Zinc oxide (which is the main ingredient of Sudocrem): Sudocrem saved me!
“ZZ” stands for “Zhongzhou Zinc”, which may suggest that zinc is more important than sulfur. (Zhongzhou is an area in China.)

Not sure why I didn’t notice effects with ZZ Cream but did with Sudocrem. I did use Sudocrem in a more rigorous.

I have also used some other products from Demodex Solutions:

Xin Fumanling Cream: http://www.demodexsolutions.com/xin-fumanling-cream.asp?bc=no
which contains:

3% Metronidazole, Radix Angelicae Dahuricae, Radix Stemonae, And other herbs.

So it contains Metronidazole, which is an antibiotic that is able to kill some bacteria and single celled organisms. Other people on this forum have used metronidazole in oral form, but the effects are unclear, because they took it together with the application of Soolantra.

I didn’t notice a difference on my skin with Xin Fumanling Cream.

And I have used DS shampoo: http://www.demodexsolutions.com/ds-shampoo-demodex-removing.asp?bc=no
But it now has an “improved formula” and “& Body wash” added to the product name, so some ingredients may differ from what I have used.
Ingredients of the new formula:

Densefruit pittany root-bark extract, Light yellow sophora root extract, Cocamidopropyl Betaine, Ammonium Lauryl Sulphate, Climbazole, Citric Acid, Guar Gum, Fragrance, Glycerin, Purified Water etc.

I have used it only on my scalp, as an addition to my regimen at that time.

How are you doing now, any improvements?

Soolantra is a godsend. So you guys know I was dealing with the aftermath of first trying it. All I have to say is just keep using it. My face broke out horribly the first two to three weeks of using soolantra. But by the fourth week it pretty much all subsided. I have gotten one in my nose (weird I never got one actually like in, in my nose) maybe that’s where my demodex is living (or like some people have said staph?) but other than a very very small one on my chin it’s been pretty tame. If you are reading this and come to this site and are experiencing similar cases, try soolantra! It’s not 100% just yet but it’s at least a 70% difference. I started soolantra, use about a pea or half a pea size amount, on April 22nd and it’s now May 23rd and so for so good. But, it is expensive. I don’t know what I’ll do when I run out of my bottle I think 45g was $600 US but I went on their website and found a savings card and the first bottle was $75. Since it’s getting better I’m going to take the advice I’ve read on here and use less just around the zones that usually break out. I will keep y’all posted

I am glad your skin has improved @kcr. I have started using Soolantra 3 days ago and my skin is currently reacting so bad. I keep getting oozing lesions but knowing that your skin improved after a short term bad reaction is reassuring. Hopefully mine will improve soon and I finally get rid of these nasty oozing lesions.

Hey mz66, sorry you are experiencing a bad first reaction but all I can say is keep going with it. You don’t have to use too much, just a pea size or smaller amount. I still have a ton in my first tube. I was applying it every night but I have sometimes forgotten to apply it and skipped a day or two and it still keeps it at bay. In the last few months I may have had one or two that has popped up but they are nothing in comparison to the ones I was getting before soolantra. I will attach a photo of my face now and you can compare it to the ones I’ve posted earlier. It is like day and night and I cannot be happier. Keep going with it and keep us posted!


@kcr Awesome. Really pleased for you. @mz66 Keep going with the soolantra. I’m pretty sure you will see improvement in 3 weeks. Let us know how you get on.

Hi. I have recently had the same condition. A hard lump under the skin that is begging to be squeezed as they are painful. Once squeezed a never ending amount of clear fluid leaks out and then tiny bubbles form and get squeezed and then crust over. They do ooze. I then applied the cream as attached in photos and it almost cleared it up overnight. After two weeks they, maybe ten or more are red marks on my skin with only 3 still red and tender. Bottom half of my face only around my mouth and jaw bone.