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Demodex mites are little bugs that can infest your eyelashes, eyelash follicles and eyebrows. These mites are nocturnal, coming out of your eyelash follicles at night to eat, mate and lay their eggs. Their life cycle is typically 2 to 3 weeks.

Demodex Illustration
Demodex Mites Live in Eyelash Follicles and the Glands in Your Eyelids

If your eyelashes are infested with Demodex you may experience “dandruff” in your eyelashes, redness or irritation of your eyes and/or eyelids, and occasional itching; while some people experience no symptoms at all.

Demodex mites can cause irreparable damage to your meibomian glands, making it important to quickly diagnose and treat the infestation.

Infestations of Demodex are readily diagnosed by Dr. Muller using her microscope to examine your eyes, eyelids and eyelashes.

Once diagnosed, the following steps should be taken:

In addition to what you will be directed to do at home (see below), there are two in office treatments that Dr. Muller can perform to hasten the eradication of your mites:

1 - A BlephEx treatment which thoroughly removes debris and other remnants of Demodex while dramatically reducing the number of adult mites and cleaning the biofilm* from your eyelids. Dr. Muller places a topical anesthetic on your eyes and eyelids, then uses a medical device with a high-speed rotating sponge soaked in an eyelid cleanser containing tea tree oil to clean and exfoliate your eyelids. Most patients report the treatment “tickles”, i.e. it is not uncomfortable. When a Blephex treatment is performed immediately before a manual debridement (below), the Blephex treatment increases the effectiveness of the manual debridement by increasing the penetration of the medical grade tea tree oil into the eyelash and eyebrow follicles.

2 - A manual, deep cleaning eyelid and eyebrow debridement is performed by Dr. Muller, combined with the use of a highly concentrated medical grade tea tree oil cleanser. The highly concentrated cleanser applied during this in office medical treatment is not available for home use and is the most effective way to kill both the adult mites and their larvae.

The above two treatments facilitate the most effective and the most rapid eradication of Demodex mites, leaving your eyelids clean and healthy.

Demodex pre and post Deep Cleaning
Photo A Above:
What Does Demodex Look Like?
If you have Demodex mites it looks as if you have dandruff in your eyelashes

Photo B Above:
Clean eyelashes and eyelids following a deep cleaning in our office

*A biofilm is a slimy, sticky film of bacteria that coats the surface of the eyelids. A biofilm is composed of a well-hydrated matrix of bacteria and their glycocalyx, a sugary coating that allows cells to adhere to and communicate with each other. The eyelid margin—with its moisture, nutrients and warmth—is the perfect environment to cultivate a thriving bacterial biofilm.

Instructions for at home treatment:

Wash all sheets, pillow cases, and towels in hot water and dry with the “high” dryer setting.

Discard all pillows.

Discard all old makeup and refrain from wearing makeup until the mites are eradicated.

If you sleep with a partner, he or she must be evaluated for Demodex.

Purchase and use tea tree soap for your face, and tea tree shampoo for your hair.

Purchase wipes and foam containing Tea Tree oil and cleanse your eyelids twice each day using them. You can choose from any of the following:

  • Blephadex Demodex Cleansers (< 3% tea tree oil)
  • Oust Demodex Cleansers (1% tea tree oil)
  • Cliradex Demodex Cleansers (4% terpinen-4-ol, an isolated component of tea tree oil)

Live demodex seen in our office upon examination, using our microscope, of an eyelash from one of our patients

Live demodex from another patient as seen in our office using our microscope