How to know if you have a Demodex mite? - briefly
Microscopic examination of eyelash follicles or skin scrapings reveals the characteristic elongated, translucent «Demodex» mites; a dermatologist can perform this test to confirm infestation. Persistent facial redness, itching, or a gritty sensation around the eyes often indicates their presence.
How to know if you have a Demodex mite? - in detail
Demodex mites are microscopic arachnids that inhabit human hair follicles and sebaceous glands, most commonly on the face, eyelids, and scalp. Their presence is usually asymptomatic, but over‑population can cause irritation, inflammation, and visible skin changes.
Typical indicators of an infestation include:
- Persistent itching or burning sensation around the eyes or facial skin.
- Redness, scaling, or papular eruptions on the cheeks, nose, or forehead.
- Presence of “cylindrical dandruff” – fine, grayish flakes at the base of eyelashes.
- Eyelash loss or misdirection, sometimes accompanied by a gritty feeling.
- Unexplained rosacea‑like flare‑ups, especially on the central face.
Definitive confirmation relies on microscopic examination of samples obtained from the affected area. The most common procedures are:
- Eyelash epilation – a few lashes are gently plucked, placed on a glass slide with a drop of mineral oil, and examined under a light microscope at 100–400× magnification. Adult Demodex folliculorum appear as elongated, cigar‑shaped organisms with four pairs of legs near the anterior end.
- Skin surface biopsy – a cyanoacrylate glue strip is applied to the skin, removed after a few minutes, and the adhered follicular content is evaluated microscopically.
- Standardized skin scraping – a sterile scalpel blade scrapes the lesion, the material is transferred to a slide, and a wet mount is prepared for observation.
- In‑vivo confocal microscopy – non‑invasive imaging provides real‑time visualization of mites within follicles, useful for patients who decline invasive sampling.
A count of more than five mites per centimeter of eyelash or per high‑power field in skin samples typically indicates pathological over‑growth. Laboratory reports should specify the species (Demodex folliculorum or Demodex brevis) and the density observed.
Management strategies focus on reducing mite numbers and alleviating inflammation:
- Tea‑tree oil‑based lid scrubs – 0.2 % to 0.4 % preparations applied twice daily decrease mite load.
- Topical ivermectin – 1 % cream applied to affected skin for a prescribed duration.
- Oral ivermectin – single dose of 200 µg/kg, repeated after one week for severe cases.
- Hygiene measures – regular cleansing of eyelid margins, avoidance of oily cosmetics, and replacement of pillowcases and towels weekly.
Consultation with a dermatologist or ophthalmologist is recommended when symptoms persist despite basic hygiene, when ocular involvement causes visual disturbance, or when systemic therapy is considered.