What to use to treat eyelash mites? - briefly
Topical tea‑tree oil (5 % solution) or a prescription permethrin‑based ointment effectively eradicate eyelash mites. Both treatments also alleviate associated inflammation.
What to use to treat eyelash mites? - in detail
Eyelash mites, primarily Demodex species, thrive in the follicular and sebaceous glands along the lash line. Effective control requires a combination of hygiene measures and pharmacologic agents that target the organisms and reduce inflammation.
Topical agents with proven efficacy include:
- Tea‑tree oil preparations (1–5 % concentration). The terpinen‑4‑ol component exhibits acaricidal activity; dilute with a carrier oil to prevent ocular irritation. - Cliradex® (0.5 % tea‑tree oil gel). Formulated for peri‑ocular use, it reduces mite density after twice‑daily application for two weeks. - Ivermectin cream (1 %). Applied to the lid margin once daily; systemic absorption is minimal, and the drug disrupts mite neural transmission. - Metronidazole gel (0.75 %). Offers anti‑inflammatory benefits and modest acaricidal effects; apply once daily. - Benzoyl peroxide (2.5–5 %). Keratolytic action removes excess debris, indirectly limiting mite habitat; limit exposure to 5 minutes to avoid irritation.
Adjunctive measures enhance outcomes:
- Lash cleansing with a sterile, diluted baby shampoo or a commercial lid‑scrub solution twice daily. Gentle rubbing removes crusted debris and reduces bacterial load. - Warm compresses (5–10 minutes) soften secretions, facilitating mechanical removal of mites during cleansing. - Avoidance of oily cosmetics, heavy mascara, and eye‑contact lenses until the infestation resolves.
In refractory cases, oral ivermectin (200 µg/kg) administered as a single dose can be considered, followed by a repeat dose after one week. Monitor hepatic function and contraindications before systemic therapy.
Treatment duration typically spans four to six weeks, with reassessment of mite count via microscopy at two‑week intervals. Successful eradication is indicated by the absence of live mites and resolution of blepharitis symptoms.