Demodex is a species of mite that can be found on virtually everyone’s skin by the time they reach 75 years of age. Sometimes these mites are able to enter eyelash follicles which results in inflammatory buildup around the base of lashes. It begins asymptomatic, but can progress to itching, burning, dryness, allergy, fluctuating vision, lash misdirection, and lash loss.
Treatments include in-office procedures as well as an eyedrop called XDemvy. In-office treatments are more geared toward removing the buildup but more extensive treatments can kill the mites. XDemvy is the most cost-effective way to kill the mites as long as insurance or payment plans allow for the price to be reasonable. On average these drops will cost between 0 and 50 dollars and will need to be used twice a day for 6 weeks. Rarely XDemvy can cost several hundreds or even thousands of dollars, in which case in office procedures are more cost-effective.
Holistic tea-tree or okra based formulations can be used to prevent the mites from returning to the lash follicles as quickly, but are not known to kill the mites. We especially recommend these in patients where mites return to the follicle quickly following an XDemvy treatment. WeLoveEyes foam is a personal favorite. Developed by an optometrist, WeLoveEyes is a tea-tree based foam that you scrub your lids, lashes, and face with, then allow to sit for around 30 seconds before rinsing. The special formulation of tea-tree oil is much safer and comfortable than traditional tea-tree oil would be around the eyes. I would discourage anybody from trying to create holistic ophthalmic formulations on their own as well as beware of allergies when looking into these types of treatments.
BlephEx is an in office procedure that removes the buildup immediately. XDemvy drops are great at killing mites, however the buildup mites create can resemble a glue or resin which takes weeks to fall off of the lash. Traditional face and eye washing is not an effective method for removing said debris considering how adhered it is to the lashes. In patients that want or need the buildup gone quickly, this treatment polishes the eyelashes clean in a matter of 4-5 minutes.
Low level light therapy (LLLT) is another in-office procedure Insight Eyecare can utilize. In a series of 4 treatments, a specific wavelength of light is used to create an environment unsuitable for mites. It is known to kill adult mites but can fail to kill eggs, which is why a series of treatments is needed. LLLT is multi-faceted and depending on the wavelength can treat much more than mites. Acne, dry eye, Meibomian gland dysfunction, and fine lines/wrinkles are a few examples.
Intense Pulse Light (IPL) is the strongest in-office tool we have to kill demodex. It wipe out the demodex population as well as shrinking inflammatory vessels which often times allow demodex to return to the follicle sooner. Similar to LLLT, it requires a series of 4 treatments to take maximum effect.
Overall, we still have a lot to learn when it comes to demodex. Some things I tell my patients: Virtually everybody has demodex on their skin, so for that reason it shouldn’t be treated as contagious. I’m not aware that there is any strong evidence that activities such as washing sheets on hot would prevent recurrence. As a rule of thumb, it is generally accepted by eye professionals that mascara brushes should be replaced every 3 months and eyeliner every 6 months (Yes, I’m aware that this is expensive. Sorry!). Lash extensions can make the buildup much more symptomatic, and when I see somebody with lash extensions I’m usually expecting there to be demodex mites present. Knowing this, patients with eyelash extensions should be using hypochlorus acid, WeLoveEyes foam, or some other cleaner that’s safe around the eyes very regularly. In some situations I’ve had to recommended discontinued use of eyelash extensions altogether.
I hope that this content was interesting to you guys. The doctors at Insight Eyecare Glenpool and Jenks will always make sure to tell you if mites are present and will be quick with a recommendation to fix the issue. We always do paperwork and use special pharmacies to make sure treatments are as inexpensive and accessible as possible. We look forward to the possibility of meeting with you and caring for eyes!
Sincerely,
Dr. Jacob Allred and the Insight EyeCare Team
