Get to know who is crawling over your eyelids at night. 

  Your bedmate Demodex

What are you doing all wrong in treating this infestation?

Be Empowered through understanding

  • Are you wondering what this parasite is doing in your eyelids?
  • What are your options to eliminate the infestation?
  • Why are your wipes not working? What is the best strength of treatment? 

Hi, I'm Dr Colin Parsloe. I consider myself to be a Professional patient - I work as an Ophthalmologist but live with Dry Eye Disease. I have been studying, treating and teaching on Dry Eye Disease for many years.

After reading this blog you will have an Overview of the options: You can download the PDF where we reviewed products offered by a pharmacy according to price per wipe and put them into the relevant categories. 

There are 65 various types of these parasites. Here we are focusing on Demodex Follicularis and not Bacterial Anterior Blepharitis. We cover this bacterial anterior blepharitis in a different post available here. Demodex have 8 legs! Yip just like spiders their distant cousin. They live on the surface of our bodies (ectoparasite) including in our follicles of the hairs on our face, armpits, chest and elsewhere. 


Demodex Follicularis is particularly fond of the face, especially in the eyelashes and eyelids. It has been implicated as a causative factor in patients with Rosacea.  An estimate by the National Rosacea Foundation is that there are up to 18 times more Demodex parasites in patients with rosacea than patients without rosacea.


We are going to provide some basic background information on this fascinating topic of  Demodex


We will review the principles behind cleaning with Tea Tree oil.

Our focus is on commercial cleaning products in the form of:

  1. Wipes
  2. Cleansers

Demodex is considered by some to be a part of the normal skin organisms, especially as we age. 

A study by Junemann showed that Demodex parasites were present in 25% of 20-year-olds, 30% of 50-year-olds and 100% of patients older than 90 years.

They have an enzyme that helps humans not to get certain bacterial infections.
They feed on debris, skin cells, oils and bacteria.


Demodex infestation

Background information

One of the main triggers for me to consider a patient has Demodex is that their symptoms seem to be worse when waking, they may also have brittle lashes and lashes that either turn the wrong way and rub on the eye or they just fall out. There can be large areas with no lashes. 


There are other signs including red eyelid margins. They have a classic cylindrical build-up of debris at the base of the lashes. I have had people complaining of a crusty build-up and thickening of their eyelids.


On their own they cause a mild inflammatory reaction that may be helpful to develop a background defense mechanism. However when they die they cause a more severe form of inflammation.
It is thought that some people may have a hypersensitivity to Demodex.

They are mobile and can crawl around your eyelashes and face at night. They can crawl at around 8-16 mm per hour. During an 8 hour sleep that is some 6-12 cm.


They do colonise your bedding, clothes and hair follicles on the rest of your body. 

Lifecycle

I am often asked if it is contagious. My answer is usually that they do spread between people living close together. Especially if they share make-up or towels, other personal items and they are found in bedding including pillows.


Mating takes place in the follicle opening and 15 - 20 eggs are laid inside the hair follicles or oil producing glands.


Baby Demodex hatch after 4 days and it takes around 7 days to mature into an adult. Female Demodex tend to stay inside the follicle while the male will wonder about looking for a mate. They prefer to be out and about in the dark (while you are asleep) and then retreat to the follicles in the light. They feed on the skin of the follicles, oil from the glands and the folds of your skin. They move around 2 centimeters per hour, they can roam quite far in one night. 


They can survive for around 3 - 4 weeks before dying and decomposing in the eyelash follicle.

When food is abundant then the number of Demodex increases significantly. This is where the problems arise.

Preventative treatment:

  • Do not share personal items
  • Consider bathing and washing your face with a tea tree oil bath soap
  • Regularly change your make-up products especially items such as mascara
  • Ensure that you wash off all your make-up every evening
  • Wash your bedding regularly at a high heat setting
  • Use dust mite pillow covers or replace your pillows regularly
  • Consider a few drops of tea tree oil in with your washing
  • Adding tea tree oil to your hairbrush or comb after cleaning them. 

Treatment  - Tea Tree Oil:

Treatment is aimed at removing their food supply - debris, oil and old skin cells.

This can be achieved with regular eyelid wipes without any Tea Tree Oil.


Using a thick ointment over the lashes at night (Vaseline?) to smother the parasites.

It also seems to reduce their reproductive activity.

You may come across advice to use 4% pilocarpine gel - please proceed with caution. 


Secondly at treating the Demodex directly with Tea Tree Oil. We need  to balance the strength of the Tea Tree Oil with the ability to tolerate the treatment. Tea Tree Oil stings the eye and is uncomfortable to use. 


It has been shown that 50% tea tree oil once a week for 3 weeks had a significant impact on the number of Demodex mites found.


5% tea tree oil wipes used daily also showed the ability to eliminate Demodex. Re-infestation levels will be high.

Lower concentration wipes do help to remove debris and are better tolerated. 


Treatment also includes cleaning of bedding and clothing.

We have reviewed the cost of Demodex wipes and cleansers in our PDF - free to download at the end of this post.

The results come from a review of a European online pharmaceutical company specialising in eye care. 

 

Price per wipe varied between $0.26 to $1.80

50% Tea Tree Oil

Although effective Tea Tree Oil is very painful and can result in damage to the eye if it gets onto the surface of the eye.


50% Tea Tree Oil must be applied by an Experienced Eye Care Specialist in their office or practice and must not be used at home unsupervised.

 

There is a commercially available solution they will have access to. 

In treating Demodex your aim is ultimately NOT elimination of all the parasites, rather your aim is to reduce the number of parasites down to a healthy level.

Wipes 

These vary from a 5% concentration to <1% concentration. 

The higher the concentration the more effective the wipe but the more irritating to the eye. 

Cleansers

All the cleansers had less than 1% concentration of Tea Tree Oil.

Do not Delay - download the PDF review now!

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