Demodex are tiny mites that live in the hair follicles and oil glands of human skin. Although they are present on most adults, an overgrowth can cause symptoms. Here is an overview of Demodex mites, how to tell if you’re infested, and what to do about it.
What are Demodex mites?
Demodex are a genus of tiny mites that live in or near hair follicles of mammals. There are more than 100 species of Demodex mites, but only two types live on humans:
- Demodex folliculorum – Lives in the hair follicles
- Demodex brevis – Lives in the sebaceous glands connected to the hair follicles
These mites feed on dead skin cells and oils (sebum) in the hair follicles. They are generally harmless organisms and most adults have some living on their skin. However, large numbers can cause irritation.
What causes a Demodex mite infestation?
It’s normal to have small numbers of Demodex mites living in your hair follicles. But an overgrowth can occur, causing symptoms. Some potential causes include:
- Weakened immune system – Makes it easier for mite populations to grow
- Hormonal changes
- Poor hygiene
- Use of oils on the skin
- Skin conditions such as rosacea, eczema, blepharitis
- Genetic factors
Intense itching and inflammation develop when large numbers of mites get into the hair follicles. The movement of the mites also causes irritation.
Symptoms of Demodex mite infestation
Possible symptoms associated with having too many Demodex mites include:
- Itching, burning skin
- Redness and inflammation
- Rash or bumps, especially on the face, eyelids, or neck
- Flaking, crusty skin
- Eye irritation, redness, feeling like something is in your eye
- Vision changes or blurry vision
- Blepharitis (eyelid inflammation and irritation)
- Rosacea symptoms like facial redness, flushing, and visible blood vessels
- Rough, dry skin or scaly patches
The mites themselves are too small to be seen with the naked eye. But infestations can cause visible skin abnormalities, rashes, redness, and irritation.
Risk factors
You may be more prone to getting an overgrowth of Demodex mites if you have:
- A weakened immune system from an illness or medication use
- Blepharitis
- Rosacea
- Eczema
- Dry skin
- Age over 50 years
- Use facial oils
- Poor facial hygiene
- Genetic susceptibility
How to diagnose a Demodex infestation
To check for too many Demodex mites, your doctor can perform a skin scraping, tape test, or biopsy:
- Skin scraping – Using a scalpel blade, your doctor scrapes a small amount of skin where mites may be lurking. This sample is examined under a microscope for mites.
- Tape test – A piece of clear tape is applied to a patch of suspicious skin, then examined under a microscope.
- Skin biopsy – Involves numbing an area of skin, then using a tool to collect a tissue sample. This can then be analyzed for Demodex mites.
Your doctor is likely to take a sample from your face near nose or eyes if you have symptoms there. They may also examine your eyelashes for signs of mites.
Demodex mite treatment
If you have an overgrowth of Demodex mites, treatment aims to kill and remove the mites while managing inflammation. Options may include:
- Medicated creams/gels – Prescription topical medications contain ingredients like crotamiton, sulfur, or ivermectin to eradicate mites.
- Tea tree oil – May help kill mites when applied to affected skin in small amounts.
- Face wash with salicylic acid or benzoyl peroxide – Can remove dead skin and oils where mites live.
- Antibacterial face washes – Reduce bacteria on skin that can cause inflammation.
- Warm compresses – Can soothe itchy, irritated skin and eyes.
- Antibiotics or anti-inflammatory drugs – Systemic or topical medications reduce redness, swelling, and inflammation.
- Improved hygiene and skin care – Gently wash face twice daily, avoid oils on face, use non-comedogenic moisturizers.
It may take a few weeks for treatments to fully clear a Demodex mite infestation. Your doctor may have you use medicated cleansers or creams regularly for up to 6 weeks.
Home remedies
Some natural remedies may help supplement medical treatment for Demodex mites, including:
- Apply diluted tea tree essential oil. It has antiseptic and anti-parasitic effects.
- Use honey masks. Honey has antimicrobial properties and can reduce inflammation.
- Scrub face gently with raw oatmeal. It acts as a gentle exfoliant.
- Apply aloe vera gel. It’s soothing and healing for skin.
- Take probiotic supplements to support immune function.
- Use a warm washcloth on the eyes or face to ease symptoms.
- Take omega-3s like fish oil to reduce inflammation.
Always check with your dermatologist before using oils or natural remedies. Some can irritate the skin or eyes.
Prevention tips
You can reduce your risk of problematic Demodex mite overgrowth by taking these preventive steps:
- Wash your face twice daily with a gentle cleanser.
- Avoid using oils and thick creams on your face.
- Shampoo hair regularly.
- Avoid makeup before sleeping.
- Don’t share face washcloths or towels.
- Replace pillowcases frequently.
- Clean makeup brushes and applicators.
- Manage any skin conditions like rosacea.
- Treat blepharitis if present.
Controlling mite populations involves regular hygiene to remove dead skin cells and excess oil where they thrive. Keeping skin healthy can also limit overgrowth.
When to see a doctor
You should make an appointment with your family doctor, dermatologist, or ophthalmologist if you have:
- Ongoing redness, irritation, or inflammation of facial skin, eyelids, or eyes
- Itchy skin, swelling, or rash that doesn’t resolve
- Flaking skin or dandruff that doesn’t respond to shampooing
- Recurring blepharitis
- Symptoms suggestive of rosacea
- Eye symptoms like irritation, burning, blurry vision
A doctor can examine your skin and eyes to help determine if Demodex mites are involved. They may collect a skin sample to check for mites under a microscope.
Conclusion
Demodex mites naturally occur on adult skin. But when populations spike, they can cause irritating symptoms like itching, redness, and skin inflammation. Suspect an infestation if you have recurrent blepharitis, rosacea, or unexplained facial itching. See a doctor for an evaluation. Proper treatment and prevention measures can help manage overgrowths of Demodex mites.