What Are Demodex Mites?

Author: Dr. Leigh Plowman (Optometrist)

Demodex Mites

Everyone has Demodex mites (also known as face mites) on their skin, but usually, they don’t cause any problems.

However, if you are already living with certain health issues, you may be more vulnerable to issues associated with these mites.

Let’s find out more about Demodex mites and what problems they can cause. We’ll also look at treatment and what you can do to prevent problems resulting from Demodex mite infestation.

What Are Demodex Mites?

Demodex mites are microscopic mites that live in hair follicles, generally on your face. They are too small to be seen by the naked eye, measuring only 0.15 to 0.4mm.

There are many different species of Demodex mites, but there are only two that live on humans:

Demodex folliculorum, which live in the smaller hair follicles like eyelashes. They consume skin cells.
Demodex brevis, which stay close to the oil glands in the hair follicles. They eat sebum, the oily substance produced by these glands.

When you are asleep, the mites emerge from your follicles to mate and then retreat to lay their eggs.

While this sounds alarming, Demodex mites are usually nothing to worry about as almost everyone has them and they don’t usually cause any harm. However, they can lead to skin or eye conditions in some circumstances.

What Problems Can Demodex Mites Cause?

When Demodex mites reproduce too quickly, they can become an issue for people who are immunocompromised or are already living with certain conditions.

This can trigger a condition called demodicosis, also known as Demodex folliculitis. This is actually an umbrella term for all the issues caused by Demodex mites.

You may be vulnerable to demodicosis if you:

Are an older person — the number of Demodex mites you have increases with age
Have other skin conditions like common rosacea (a different condition from the rosacea of demodicosis)
Use itch-relieving treatments such as hydrocortisone cream
Are undergoing chemotherapy
Take immunosuppressant medication — for example, after a transplant
Have an immunodeficiency disorder such as AIDS or leukemia

What Are the Symptoms of Demodicosis?

The symptoms of demodicosis can appear suddenly and tend to affect the skin or the eyes.

For the skin, you may notice the following symptoms:

Burning
Itchiness
Redness
Pustules
Roughness
Scaly skin, like eczema
Sensitivity
A white sheen on the skin

When Demodex mites affect the eyes, they can trigger a condition called blepharitis or inflammation of the eyelids.

This in itself includes the following symptoms:

Dry eyes
Red, irritated, burning or itchy eyes
Excessive tears
Blurred vision, which comes and goes
A feeling that there is something in the eye (foreign body)
Sensitivity to light
Brittle eyelashes and/or eyelash loss
Scaly eyelids
Eye infections
General eye or eyelid irritation

Demodex mites may also cause other eye conditions:

Meibomian gland dysfunction — when the meibomian glands on your eyelid edges don’t produce enough oil or produce oil that is of poor quality
Dry eyes — this is when your eyes don’t produce enough tears or they dry up too quickly, resulting in itchy, red, sore or watery eyes
Styes — lumps or swelling on the edge of the eyelid
Chalazions — lumps or swelling under the skin of the eyelid
Ocular rosacea — inflammation of the eyes with symptoms such as redness, itchiness and a burning sensation

What Should I Do If I Think I Have Demodicosis?

If you recognize one or more of these symptoms and think you have demodicosis, go and see your doctor.

They can carry out tests — for example, skin scraping or biopsy — to give you a diagnosis.

You may wish to consult a dermatologist if you have skin symptoms or an optometrist or ophthalmologist for eye symptoms.

What’s the Treatment for Demodicosis?

You may be offered a lotion, cream, gel or wash to be applied directly to your skin containing a pesticide to kill Demodex mites. Examples include Ivermectin (also known as Soolantra) and salicylic acid.

If your eyes are affected, you may be offered treatment to soothe the symptoms and advised to gently clean your eyelids daily with a solution containing tea tree oil.

How Can I Prevent Demodicosis?

You can’t prevent Demodex mites from living on your skin — they are just one type of organism that lives on or in the human body, and they don’t usually cause any problems. It’s only when they get out of control that you might notice uncomfortable symptoms. But by following a good skin and eye care routine, you can reduce the chances of being affected by demodicosis. This is what you can do:

Avoid heavy skincare products that may clog your pores.
Instead, look for products labeled “non-comedogenic,” which don’t block the pores.
Exfoliate to get rid of dead skin cells at least once a week.
Wash your face twice a day.
Keep your lids and lashes clean.

What else can I do to prevent Blepharitis?

Bacteria on our face and eyelids vastly outnumber Demodex. Bacteria commonly cause Blepharitis, Meibomian Gland Dysfunction and Dry Eyes.

Bacteria produce enzymes that chop up the oil in our normal tears. The result is soapy, irritating debris and clogged oil glands.

Avenova is a gentle eyelid cleanser that kills bacteria on the eyelids and face. Avenova helps Blepharitis, Meibomian Gland Dysfunction. Patients say that it feels refreshing to spray on closed eyes. Avenova plays an important part of my recommended routine for patients.

Avenova can kill bacteria associated with Demodex and has been shown in lab studies to

Keeping on Top of Demodex Mites

It’s good to know that Demodex mites don’t usually cause symptoms for most of us.

But if you do notice issues affecting your skin or eyes, consult your eye doctor or specialist for treatment to relieve the symptoms.

Keeping on top of your skin and eye hygiene is a great way to reduce the risk of issues associated with Demodex mites.

And the very fact that you have read this article means that you have the knowledge to recognize the symptoms of demodicosis and know when to reach out for help!