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Demodex Mite Research Covered at AAD Annual Meeting
The role of Demodex mites in producing the chronic skin inflammation (redness), papules and pustules seen in rosacea was recently canvassed at the 72nd annual meeting of the American Academy of Dermatology.
Dr. Frank C. Powell, consulting dermatologist at Mater Misericordiae Hospital in Dublin, Ireland, noted that the mites are most prevalent in the same areas of the face most commonly affected by rosacea.
Although Demodex may be found in healthy skin the concentration of mites has been found to be far greater in the facial skin of rosacea patients (see Forton reference below).
According to Dr. Powell "in rosacea patients something causes the mites to proliferate, possibly triggering an inflammatory response."
Papules and pustules seen in rosacea are known to not be the result of Propionibacterium as they are in acne.
Demodex infest follicles and pores where they feed on the skin's oils (sebum) and dead skin cells.
Cleansing can reduce the accumulation of oil and dead cells to make the skin less hospitable to infestation by Demodex, however it is important not to dry or otherwise irritate the skin in the process.
A regular double-cleansing protocol of Rosacea Pre-Cleansing Emulsifier followed by the Rosacea Anti-Inflammatory Foaming Cleanser or Rosacea Oil-Free Purifying Gel Cleanser can thoroughly purge skin without destabilising it.
Forton FMN. Papulopustular rosacea, skin immunity and Demodex: pitioriasis foliculorum as a missing links. Eur Acad Dermatol Venerol. 2012;26:19-28.
Abstract: Papulopustular rosacea (PPR) is a common facial skin disease, characterized by erythema, telangiectasia, papules and pustules. Its physiopathology is still being discussed, but recently several molecular features of its inflammatory process have been identified: an overproduction of Toll-Like receptors 2, of a serine protease, and of abnormal forms of cathelicidin. The two factors which stimulate the Toll-like receptors to induce cathelicidin expression are skin infection and cutaneous barrier disruption: these two conditions are, at least theoretically, fulfilled by Demodex, which is present in high density in PPR and creates epithelial breaches by eating cells. So, the major pathogenic mechanisms of Demodex and its role in PPR are reviewed here in the context of these recent discoveries. In this review, the inflammatory process of PPR appears to be a consequence of the proliferation of Demodex, and strongly supports the hypothesis that: (1) in the first stage a specific (innate or acquired) immune defect against Demodex allows the proliferation of the mite; (2) in the second stage, probably when some mites penetrate into the dermis, the immune system is suddenly stimulated and gives rise to an exaggerated immune response against the Demodex, resulting in the papules and the pustules of the rosacea. In this context, it would be very interesting to study the immune molecular features of this first stage, named "pityriasis folliculorum", where the Demodex proliferate profusely with no, or a low immune reaction from the host: this entity appears to be a missing link in the understanding of rosacea.
Rosacea May Be Caused by Mites — New Scientist.
Bacteria From Mites Might Be Responsible For Rosacea — Huffington Post Healthy Living.
Author: Peter Wilson.
Reviewed: Wednesday, December 16, 2015.
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