Eyelash mites are tiny parasites that live in or near the hair follicles of mammals. Demodex folliculorum and Demodex brevis are two species of eyelash mite present on human eyelashes.
Demodex infestations may occur on the face, including the cheeks, the nose, the chin, the forehead, the temples, the eyelashes, and the brows.
Other areas of infestation include the balding scalp, the neck, the ears, the penis, and the buttocks. Demodex folliculorum more commonly occur on the face.
This article covers the causes, symptoms, and treatments associated with eyelash mites.
Demodex mites are parasites that live on the skin of their human hosts.
People can acquire eyelash mites by coming into close or direct contact with another person who has them. The affected person may have larvae or adult mites that can spread to other people.
People can also acquire eyelash mites from dust that contains eggs.
According to one 2014 study, Demodex mites are not limited to any ethnic group. That said, they commonly occur on the skin of:
- Aboriginal people
- Caucasian people
- Inuit people
- Maori people
- Nigerian people
However, experts do not fully understand the prevalence of Demodex infestations, especially that of eyelash mites.
Some populations may have a higher chance of infestation, including medical staff and students who have frequent contact with the public.
People with eyelash mites may not experience any symptoms. Eyelash mites occur in healthy people, so the infestation may go unnoticed unless the mites multiply rapidly.
Some researchers suggest that Demodex infestations can develop due to an imbalance in the immune mechanism.
Skin conditions that develop due to Demodex mites are grouped under the terms demodicosis or demodicidosis.
Experts have demonstrated that eyelash mites may cause a variety of conditions affecting the front of the eye, including:
- changes to the eyelashes, such as loss and misalignment
- basal cell carcinoma of the lid
Blepharitis refers to inflammation of the eyelids. People with blepharitis may experience:
- blurred vision
- a feeling of heavy eyelids
Conjunctivitis refers to inflammation of the membrane that covers the eyeball, which is called the conjunctiva.
Keratitis refers to inflammation of the cornea.
According to one study, an infestation of Demodex mites on the eyelashes and sebaceous glands of the eyelids can cause madarosis, or eyelash loss.
Eyelash mites cause inflammation of the hair follicle, which leads to edema and eventual easy epilation of the eyelashes. Eyelashes may also become brittle and fall off.
Since eyelash mite infestations are often asymptomatic, many people will only seek treatment when the mites multiply in greater numbers. Demodex infestations are underdiagnosed and undertreated.
The treatment goal with Demodex blepharitis is to exterminate the mites. To do this, a doctor may suggest:
- better eyelid hygiene
- 1% sulfur ointment
- 1% mercury oxide ointment
- pilocarpine gel
- iodized solutions
- warm compresses
- intense pulsed light
- tea tree oil
According to some research, tea tree oil might be the only agent for killing Demodex mites. It may have antibacterial, antifungal, and anti-inflammatory effects that help treat the issue.
Inflammation of the eyelids can lead to inflammation of the conjunctiva. This is known as blepharoconjunctivitis.
Typical treatments for conjunctivitis — including antibiotics, antivirals, and lubrication — may be ineffective in treating blepharoconjunctivitis due to Demodex.
In a small study of 12 participants with blepharoconjunctivitis, unresolved infections responded after a short course of tea tree oil.
Eyelash mites may also affect the cornea and cause Demodex keratitis. Some research has shown that tea tree oil can eradicate eyelash mites and reduce eye surface inflammation.
In this study, the participants applied tea tree oil at 50% concentration for lid scrubs and 5% concentration for lid massages.
Other treatment options may include:
- crotamiton cream
- permethrin cream
- topical metronidazole
- oral metronidazole
In severe cases, such as in people with HIV, oral ivermectin may be effective.
Eyelash mites only live on the human hair follicle. They do not cause problems when present in low numbers.
To prevent blepharitis, blepharoconjunctivitis, Demodex keratitis, and other conditions associated with eyelash mites, researchers recommend the following preventive measures:
- Cleanse the face twice per day with a non-soap cleanser.
- Avoid using oil-based or greasy facial products, such as cleansers and makeup.
- Remove dead skin cells on the face with periodic exfoliation.
To prevent acquiring eyelash mites, people should avoid close contact with others who have them. Eyelash mites pass from host to host through contact with hair, eyebrows, and the sebaceous glands on the nose.
This measure may be challenging, however, as infestations are often underdiagnosed or misdiagnosed. Therefore, a person may not know that they have acquired the mites.
Eyelash mite infestations commonly affect the eyelid. They typically go unnoticed.
If the mites begin to multiply, however, people may experience symptoms of infestation. Blepharitis, conjunctivitis, keratitis, and other eye conditions may be associated with the presence of eyelash mites.
Experts recommend hygiene tips to prevent the multiplication of eyelash mites.
If symptoms do occur, several treatments may help. However, according to some research, the most effective treatment for eyelash mites may be tea tree oil.
People who think that they might have eyelash mites should speak with a doctor before using tea tree oil on their eyelids.