How should mites on eyebrows and eyelashes be treated? - briefly
Apply a topical acaricide—commonly tea‑tree oil, permethrin, or a prescription cream—and clean the area gently with a mild, non‑irritating cleanser; if symptoms persist, seek dermatologist‑directed therapy.
How should mites on eyebrows and eyelashes be treated? - in detail
Mite infestation of the eyebrow and eyelash region is most often caused by Demodex spp., primarily D. folliculorum and D. brevis. Clinical signs include itching, redness, scaling of the skin, cylindrical dandruff at the lash base, and occasional secondary bacterial infection. Diagnosis relies on microscopic examination of epilated hairs or skin scrapings, revealing live mites or their eggs.
Effective management combines mechanical cleaning, topical acaricidal agents, and, when necessary, systemic therapy.
Mechanical decontamination
- Warm compresses (5–10 minutes) to loosen debris.
- Lid and brow scrubs twice daily using a dilute tea‑tree oil (5 %) or a commercial lid‑cleaning solution.
- Removal of crusts with a sterile cotton swab; avoid abrasive rubbing.
Topical acaricides
- 1 % ivermectin cream applied to the affected area once daily for 2–4 weeks.
- 0.1 % metronidazole gel or cream, twice daily, for 4–6 weeks.
- 5 % tea‑tree oil diluted in a carrier (e.g., mineral oil) applied nightly; monitor for irritation.
- 10 % benzyl benzoate ointment, once daily for 7 days, repeat after 2 weeks if needed.
- Sulfur ointment (2–5 %) applied at night for 2 weeks; suitable for patients with sensitivity to other agents.
Systemic therapy
- Oral ivermectin 200 µg/kg as a single dose, repeated after 1 week for refractory cases.
- Oral doxycycline 100 mg twice daily for 4 weeks can reduce inflammation associated with mite proliferation.
Adjunctive measures
- Discontinue heavy or oily cosmetics; replace with non‑comedogenic products.
- Wash pillowcases, towels, and makeup tools weekly in hot water.
- Maintain facial hygiene; avoid excessive touching of the brow area.
Treatment duration typically spans 4–6 weeks, with reassessment at the end of the course. Persistence of symptoms warrants repeat microscopy and possible escalation to systemic medication. Regular maintenance cleaning (once weekly) helps prevent recurrence.