Common interventions used for Demodex infestation include metronidazole-based therapies, permethrin, benzoyl benzoate, crotamiton, lindane, and sulfur. Short courses of metronidazole taken orally have shown efficacy in reducing Demodex density.
Demodex Mite Treatment
The most commonly used treatment for demodicosis is a medication you apply to your skin called metronidazole. Other treatments include: Permethrin.
Evidence-based methods that are effective in treating Demodex blepharitis include oral ivermectin and TTO lid scrub. In a previous study, 6 mg of ivermectin taken orally twice daily at 2-week intervals reduced the average number of Demodex mites in chronic Demodex blepharitis.
In this case a single oral dose of 200 μg/kg ivermectin effectively led to substantial clinical improvement within 1 month. Repeated skin scrapings remained negative for Demodex mites. The 10-year history of the use of oral ivermectin to control onchocerciasis indicates that it is a safe drug.
It does so relatively quickly and with long-lasting effect, while also inhibiting adult female worms from releasing additional microfilariae. Dermal microfilarial loads are generally reduced by 78% within two days, and by some 98% two weeks after treatment.
Ivermectin, both oral and topical, has been effective in treating rosacea of various subtypes.
Most people have Demodex mites on their skin. You don't need treatment unless the mites grow out of control and cause symptoms. Treatment for a mite infestation usually involves a cream, gel, lotion or wash containing an acaricide. An acaricide is a pesticide that kills ticks and mites.
Ivermectin kills the Demodex, and when it dies, so do the bacteria.
The most effective and commonly used treatment agent for Demodex is tea tree oil. Tea tree oil is currently the go-to in-office and at-home treatment option for Demodex. Terpinen-4-ol – a terpene with antimicrobial, antifungal, antiviral, antiseptic, and acaricidal properties – is the active ingredient in tea tree oil.
I recommend washing sheets and pillowcases in hot water and drying with the hottest possible dryer setting to kill the mites that might otherwise jump from bedding to faces. In some cases, it might even help to get new pillows. Patients might also consider not using makeup for a week, and discarding their old makeup.
Of all the treatment options investigated, tea tree oil has been shown to be the most promising option for killing Demodex mites (Liu 2010). Tea tree oil therapies may be more effective as they are known to have antibacterial, antifungal, and anti‐inflammatory properties (Liu 2010).
Tea tree oil: The best treatment overall, according to 2020 research9. Topical permethrin: Can reduce the number of mites when used for two weeks10. Cliradex wipes: Contain 4-Terpineol, the key component of tea tree oil; use around the eyes for six to eight weeks.
A doctor may recommend treatment with creams such as crotamiton or permethrin. These are topical insecticides that can kill mites and so reduce their numbers. The doctor may also prescribe topical or oral metronidazole, which is an antibiotic medication.
Topical ivermectin can also have an anti-inflammatory effect. Research shows both topical ivermectin and oral ivermectin are effective at reducing rosacea symptoms. Compared to metronidazole cream, an antibiotic often used to treat rosacea, ivermectin cream provided greater relief.
If you can keep the follicles and lashes clean, the Demodex usually won't go into the lash follicle, he said. Regular lid hygiene can help with this, including using warm saltwater soaks, BlephEx, and agents like ivermectin.
Tea tree oil treatment
We know that the best treatment for demodex is tea tree oil. Tea tree oil is merciless against the mite. It comes in pads, ointments, soaps, shampoos, etc. We have noticed it is also effective against rosacea.
Too many Demodex mites can cause uncomfortable symptoms that may include: Itchy or burning eyes, especially in the morning. Swollen eyelids. Crusty eyes.
Because the immune system does not mature until 12 to 18 months of age, a dog with demodectic mange may have relapses until that age. In addition, dogs with suppressed immune systems may be susceptible to relapse.
EFFECTIVENESS. Ivermectin cream will produce clearing or almost clearing of rosacea lesions in 40% to 80% of patients with moderate to severe symptoms after three months of treatment (number needed to treat [NNT] = 4 to 5).
More specifically, oral ivermectin in a regimen of 200 micrograms per kilogram body weight per dose for 2 or 3 consecutive doses at least 3 and not more than 7 days apart as the preferred regimen or, alternatively, topical ivermectin compounded to a 2% concentration by weight in a cream, lotion, or gel carrier vehicle ...
Tetracyclines, specifically doxycycline, are the most commonly prescribed antibiotics for rosacea. Other antibiotics that can be used include macrolides, commonly azithromycin, and rarely, metronidazole.
Demodex is contracted and spread by either direct contact or dust containing eggs.