Demodex associated blepharitis is a very common condition seen worldwide. Blepharitis is a chronic condition that affects the skin at the margin of your eyelids. Symptoms include itching, pain and soreness, redness, swelling, foreign body sensation and “dandruff” buildup on the lashes. Blepharitis can be caused by a number of different things one of which is Demodex.

Demodex is a mite (technically it is an obligate human ecto-parasite) that lives on the skin of just about every human being. Under high magnification it kind of looks like one of Godzillas foes and immediately causes a person to itch just thinking about it!

The structure of the demodex mite. Front view and rear view. Demodecosis. This little critter lives in and around your sebaceous glands. Picture makes you itch doesn’t it…..

Demodex lives in and around sebaceous glands. Sebaceous glands are responsible for secreting oil and are located mainly around hair follicles. These little monsters are found on your face, ears, back, eyebrows, eyelids, and any other oily area. Under certain conditions such as increased oil secretion states (teenage years) they throw a party and cause an infestation which leads to redness and irritation (Demodicosis).

Demodicosis, called demodectic mange or red mange. Cross section of the skin with mites. Close-up demodex through magnifying glass

Demodex numbers increase as we get older and can begin to infest the eyelids leading to a type of blepharitis and dry eye. When the oily secretions at the base of the eyelashes thicken it creates flakes and particles. Demodex feeds on these flakes and particles and will begin to overgrow and cause in infestation. These flakes are difficult to see in the mirror but are obvious under the microscope as you can see in the picture below.

blepharitis with flakes and demodex
You can see obvious flakes and collars around the base of the eyelashes. This is what Demodex feeds on.

Symptoms of demodex can also be redness, tearing, lid swelling, foreign body sensation and lashes “sticking” together especially when you wake up in the morning.

demodex blepharitis
Demodex blepharitis

Luckily this wont kill you and is pretty easy to treat. Warm compresses and eyelid scrubs at night with baby shampoo help to reduce the amount of buildup on the lashes and reduce the number of demodex on the surface. For severe cases mechanical removal at the office may be warranted.

We have found that scrubbing the eyelids with Virgin Coconut Oil reduces the parasite load and increases eyelid health.

demodex mite from an eyelid of a patient with chronic blepharitis

If nothing over the counter is working by all means see your eye doctor!

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