Treating Demodex

Why Treat Demodex?

Demodex in small numbers don’t necessarily need to be treated, but when they are present in large numbers, i.e. an overpopulation or an infestation, they can cause significant, irreparable damage to your eyelashes and the glands in your eyelids, known as Meibomian and sebaceous glands.

In addition, Demodex can cause, or exacerbate, problems such as blepharitis, dry eye, styes, chalazia, recurrent eyelid infections, Meibomian gland dysfunction, ocular rosacea and “regular” rosacea (of your face).

Treating Demodex

There are two in office treatments that Dr. Muller can perform to eradicate 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, prior to treatment
Demodex, prior to treatment
After an in-office deep cleaning
After an in-office deep cleaning

*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.

In addition to the in office treatments above, all patients are given the following instructions for continued 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)