How should I treat demodex mites? - briefly
Use topical agents such as ivermectin cream, tea‑tree oil, or metronidazole, paired with daily gentle cleansing to reduce mite load. If the infestation is severe, a physician may prescribe oral ivermectin or a short course of doxycycline.
How should I treat demodex mites? - in detail
Managing a demodex infestation involves confirming the diagnosis, reducing mite numbers, and preventing recurrence.
First, obtain a definitive diagnosis. Microscopic examination of skin scrapings, eyelash epilation, or a standardized skin surface biopsy can quantify mite density. A count above 5 mites per cm² typically indicates pathological proliferation.
Second, implement hygiene measures that limit the mites’ habitat. Wash the face twice daily with a non‑comedogenic cleanser, avoid oil‑based cosmetics, and replace pillowcases, towels, and makeup applicators weekly. For ocular involvement, use sterile saline to rinse the lids and apply warm compresses for 5–10 minutes, twice a day, to loosen debris.
Third, apply topical acaricidal agents. Effective options include:
- 1 % ivermectin cream, applied once daily for 2–4 weeks.
- 0.1 % metronidazole gel, applied twice daily for 6–8 weeks.
- 0.1 % tea‑tree oil solution, applied once daily; monitor for irritation.
For moderate to severe cases, oral therapy may be required. Suggested regimens:
- Ivermectin 200 µg/kg orally, single dose; repeat after 2 weeks if needed.
- Doxycycline 100 mg twice daily for 4–6 weeks; useful for inflammatory rosacea associated with demodex.
Adjunctive treatments can improve outcomes:
- Topical benzoyl peroxide 2.5 % to reduce bacterial overgrowth.
- Low‑dose isotretinoin (0.25 mg/kg) for refractory skin disease, under specialist supervision.
- Antihistamine eye drops for ocular itching.
Monitor progress by repeating mite counts after 4–6 weeks. A reduction to fewer than 1 mite per cm² signals successful control. If counts remain elevated, extend therapy or combine oral and topical agents. Maintain strict hygiene practices indefinitely to prevent re‑colonization.