How can a patient manage the worm-like lesions on the face and upper extremities that appear after taking the tablet Ivermectin?

Question

Hello doctor,

I have had a cyclical facial rash, seborrheic dermatitis, and rosacea for one and a half years. My dermatologists had ruled out fungal and bacterial infection and prescribed the tablet Ivermectin. After taking the tablet, I developed lesions on my face and upper extremities that have a worm-like appearance. I also have small black spots on my face and upper extremities. I had swelling and bruises on my left and right foot before taking the tablet. My biopsy report showed moderate inflammation. I used the Metronidazole ointment. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Demodex mites are present in healthy individuals and may have a pathogenic role only when present in high densities. It may clinically not be apparent, but it may multiply rapidly under favorable circumstances, leading to the development of different pathogenic conditions. Demodex may also act as a vector of transmission of various infections from one area of the body to another or between individuals by its potential to ingest and transport various microorganisms found in its niche. Fungal infections are very common in this mode of transmission. I suggest you take the following preventive measures:

Cleanse the face twice daily with a non-soap cleanser.
Avoid oil-based cleansers and greasy makeup.
Exfoliate periodically to remove dead skin cells.

The mites may be temporarily eradicated with topical insecticides. I suggest you take the following medications (consult a specialist doctor, discuss with them and take medications with their consent):

Crotamiton cream (Geraniol, Citronellol, Coumarin, Benzyl alcohol, Benzyl benzoate, citral, D-limonene, Eugenol, and Linalool).
Tablet Albendazole 400 mg once daily for three days
Tablet Ivermectin 12 mg once a day for three days.

Answer 2

Hello,

Welcome back to icliniq.com.

I suggest you take the following medications (consult a specialist doctor, discuss with them and take medications with their consent):

Tablet Allegra (Fexofenadine) once daily for 15 days.
Tab Singulair (Montelukast) once a day for seven days.
Mometasone 0.1 % cream once daily for seven days.
Ammonium lactate (12 %) cream once daily for seven days.

I suggest you undergo a stool test and blood test.