Commentary by:

Professor Marcello Monti

Head of the Dermatology Unit at Humanitas and Professor of Dermatology at the University of Milan

The skin on our face is inhabited by thousands of harmless microorganisms known as skin mites.Their presence has been associated with a particular skin disease known as acne rosacea, which is not to be confused with rosacea or couperose. What is the role of these skin mites? – Professor Marcello Monti, head of Dermatology at Humanitas Hospital – responds to this question.


“Demodex folliculorum, also known as face mites, appear in greater quantity on the skin of individuals with acne rosace, which is an inflammatory disease of the skin. It results in small pustules and redness of the face, characteristics that are similar to both ordinary acne and rosacea. However, the reason for this proliferation is not known. The individuals on which this proliferation of mites may present itself do not have immunodeficiency problems, but perhaps they may have gone through extremely stressful periods that have lowered their skin's immune system.”


How is acne rosacea treated?

“The treatment aims to reduce the presence of these mites in the follicles. An anti-parasite medication known as ivermectin or creams made ​​from salicylic acid and sulfur are used” says the professor.


(For further information, click here: Acne- “natural” therapies do not work) 


Face mites, such as Demodex follliculorum, do not have anything to do with rosacea, which is characterized by the appearance of redness on the cheeks and forehead. “Rosacea is a form of permanent vasodilation of the vascular components of the skin. Treatment involves a skin stimulation technique (needling) with which balance of the blood vessels can be restored.”


Often, symptoms of acne rosacea linked to vasodilation may still affect the individual even after the pustules have disappeared: “In this case, it acts as if it were a common rosacea. You may also be prescribed vasoconstrictors but with a warning on possible side effects: “In fact, vasoconstrictors act on the symptoms for a short period of time, around 5-8 hours. They reduce the redness of the skin but it still tends to reoccur. Furthermore, with prolonged use, rosacea may even worsen.”


(For further information, click here: Acne: lamps that can treat skin conditions?)


For indivuduals with rosacea, it is  not recommended to expose oneself to the sun. In cases where sunlight is inevitable, it is recommended to use high-protection sunscreen creams.  “The sun can also be beneficial – explains Professor Monti – probably because it stimulates the skin to better develop its components. Limited exposure to sunlight may improve the course of rosacea while sunscreens do nothing but "intoxicate" the skin further,” he concludes.


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