How to treat demodicosis caused by mites? - briefly
Effective management combines topical acaricides (e.g., ivermectin, benzoyl peroxide) with systemic therapy such as oral ivermectin or milbemycin, alongside regular grooming to lower mite burden. Adjunctive anti‑inflammatory agents and strict skin hygiene help prevent relapse.
How to treat demodicosis caused by mites? - in detail
Demodicosis results from overpopulation of Demodex mites on the skin. The condition manifests as erythema, papules, pustules, or alopecia, often accompanied by itching or burning. Confirmation requires microscopic examination of skin scrapings or standardized skin surface biopsy to establish mite density above normal thresholds.
Therapeutic management divides into topical, oral, and supportive measures.
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Topical agents
- Avermectin 1% cream or lotion applied once daily for two weeks, then tapered according to response.
- Ivermectin 1% lotion applied once daily for four weeks; monitor for irritation.
- Metronidazole 0.75% gel applied twice daily; useful for inflammatory lesions.
- Benzoyl peroxide 5% wash used once daily to reduce bacterial colonization and aid mite clearance.
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Systemic therapy
- Oral ivermectin 200 µg/kg administered on days 1, 2, and 7, then weekly for three weeks; repeat cycle if necessary.
- Doxycycline 100 mg twice daily for 4–6 weeks; benefits include anti‑inflammatory and anti‑mite effects.
- Minocycline 100 mg twice daily as an alternative to doxycycline, especially in patients with contraindications.
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Adjunctive care
- Gentle cleansing with non‑soap, fragrance‑free cleansers twice daily to remove excess sebum.
- Regular laundering of bedding and towels at ≥60 °C to eliminate environmental reservoirs.
- Avoidance of oil‑based cosmetics and heavy moisturizers that may nourish mites.
Treatment duration depends on clinical response and repeat microscopy. A decline in mite count to ≤5 mites /cm² typically indicates remission. Relapse warrants reassessment of regimen, potential escalation to combination therapy, and stricter environmental control. Monitoring for adverse effects, particularly hepatic or hematologic changes with oral ivermectin, is essential throughout therapy.