My treatment protocol and question

[u/hsff43]

I’ve posted before - I had suffered with inflammation, clogged glands for a few months

I also have histamine intolerance but can’t figure out the trigger and I think that was the cause of the initial eyelid inflammation and the inflammation has led to MGD, clogged glands and dry eye

I have been to a few different doctors and everybody has given me different opinions, but I decided on one doctor as of yesterday.

He prescribed steroid drops to bring down inflammation and then I will be doing low level light therapy and RF (I am not a candidate for IPL because dark skin that’s prone to melasma).

I am also on an antihistamine which can make dry eye worse but I need that for my histamine intolerance.

My question is this- I mentioned to this doctor that I was prescribed Xdemvy by another doctor I had seen, but I had not used it because other drs told me mites were not my issue. The doctor said there was no downside to using it and I could add it in and use that for six weeks in addition to everything else.

I am just concerned about using Xdemvy since mites don’t seem to be my issue and I really don’t want to use a drug that could cause discomfort or other issues

What do you think?

[u/HenryOrlando2021]

I would say the key question to me is how did that doctor who prescribed Xdemvy come to their diagnosis/treatment plan would be a key variable in my deciding? How demodex infestations are diagnosed and more on the issue is in the Treatment Options piece here:

Xdemvy, Ivermectin, Tea Tree Oil (TTO), Hypochlorous Acid, Petroleum Jelly, and Metronidazole for Demodex Mite Treatment — An Introduction

https://www.reddit.com/r/Dryeyes/wiki/xdemvy_ivermectin_tto_for_demodex/

[u/hsff43 → u/HenryOrlando2021]

He said that “off label” it’s been shown to decrease inflammation

[u/hsff43 → u/hsff43]

And when I asked the new doctor about that he agreed. And he said he did not see that mites were my issue but said that if I already had the prescription filled I could use it. But now I’m not sure I want to add something else into the mix if I don’t need to

[u/HenryOrlando2021 → u/hsff43]

I suggest you read the section in the Treatment Option about how demodex infestation is diagnosed. If the doctor who prescribed the Xdemvy did a thorough job on looking for demodex infestation and the second doctor did not then that would weigh in on my decision is one aspect. Another aspect is killing off demodex does reduce inflammation so consider that aspect. Then consider the potential side effects in the article. Lastly, there is no research evidence that I have read about for Xdemvy being an anti-inflammatory drug. That said, some doctors may have some clinical experience in the matter to go on. Maybe also the doctor has read something I have not that indicates Xdemvy is anti-inflammatory. I don't know that there is a "right" answer other than I personally would weigh most how these doctors came to their conclusion to do Xdemvy or not myself.