Not sure if I fully understand you. So you are basically waiting for the moment that you get a new lesion in the morning, and then go to a dermatologist the same day for a skin biopsy?
About the question whether you should wait for a biopsy or start with Soolantra without biopsy: from a scientific point of view, a biopsy would be very interesting, not just for yourself, but also for us (the other oozers). Because even if demodex is involved (what we currently think), it is likely that bacteria also play a role (carried by demodex as a vector). Only a well performed biopsy followed by good pathology will be able to tell the exact cause and the possible microorganisms involved or whether demodex (or it’s bacteria) is causing some kind of allergic reaction.
TV show “The Dr’s” discuss women with chronic, untreated skin condition shows a woman with skin problems in which a biopsy showed what was going on.
But I’m not sure if there is a risk of scars with a biopsy, so it’s difficult to give advice on this part.
Soolantra is likely only available on prescription. If you want to get it, you could try the following:
- Confirm at your pharmacy whether they have Soolantra available, otherwise your derm won’t be able to prescribe it.
- Not all dermatologists belief/know about demodex being able to cause problems. (This point of view will probably change now that Galderma has released Soolantra for the treatment of rosacea, which is primarily targeting demodex.) Some dermatologists may not know yet about Soolantra. In that case, you may have to convince your derm by showing scientific research and the existance of Soolantra. You could try by handing some studies from Demodex studies to your derm, one of them should be [Demodex] Papulopustular rosacea, skin immunity and Demodex: pityriasis folliculorum as a missing link from the dermatologist from Brussels.
Taking oral metronidazole and/or ivermectin should in theory make the treatment more efficient. Although both may cause side effects when taken orally. (I haven’t used them, but the others on Soolantra have.)
I think you have to take it at least 1 to 3 months, but hard to say.