Demodex mites are tiny mites that live in the hair follicles and oil glands of humans. Although they are present on most adults, an overgrowth can cause symptoms like itching, redness, and scaling. Fortunately, there are several effective ways to kill Demodex mites and treat an infestation.
What are Demodex mites?
Demodex mites are 8-legged mites that are related to spiders. There are over 100 species of Demodex mites, but only two normally live on humans:
- Demodex folliculorum – Lives in the hair follicles
- Demodex brevis – Lives in the sebaceous glands
These mites feed on skin cells and oils in the pores and follicles. They are usually harmless, with adults having an average of less than 5 mites per square centimeter of facial skin.
However, in some people, the mites can overpopulate and cause an infestation. This leads to symptoms like:
- Itching and redness on the face, eyelids, or scalp
- Pimple-like bumps called papulopustular rosacea
- Scaly or crusty skin patches
- Eyelash loss and stye development (blepharitis)
An overgrowth of Demodex is more common in those with a weakened immune system and poor skin barrier. Infestations are also associated with rosacea.
What kills Demodex mites?
There are several methods that can be used to kill and destroy Demodex mites on the skin. The most common and effective treatments include:
Prescription medications
- Ivermectin – This antiparasitic drug can be applied topically or taken orally to kill mites. It paralyzes and destroys the mites.
- Crotamiton – An antipruritic and scabicide cream that eradicates mites.
- Permethrin – Used topically, this pediculicide destroys mites.
- Metronidazole – This antibiotic medication also has antiprotozoal effects that kill mites.
Topical treatments
- Tea tree oil – The terpinen-4-ol in tea tree oil can kill Demodex mites and reduce symptoms.
- Oregano oil – Carvacrol, its active ingredient, has acaricidal effects against mites.
- Clove oil – Eugenol in clove oil helps destroy mites and reduce inflammation.
- Neem oil – Components like azadirachtin exhibit mite-killing abilities.
In-office treatments
- Sulfur compounds – Sulfur ointment can eradicate mites and unclog follicles.
- Cryotherapy – Freezing mites with liquid nitrogen destroys infestations.
- Laser therapy – Laser light targets and kills mites in follicles.
- Photodynamic therapy – Light-activated compounds kill mites.
Lifestyle measures
- Washing the face twice daily with an acaricidal cleanser
- Exfoliating regularly to remove dead skin cells and debris
- Shampooing hair frequently
- Avoiding oil-based makeup and lotions
- Using hypoallergenic skincare products
- Avoiding crowding around eyes with makeup
- Washing pillowcases, towels, and hats regularly
How do these treatments work to kill mites?
Most of the treatments that kill Demodex mites work in a few main ways:
- Paralysis and disruption of nervous system – Ivermectin causes paralysis of the mite’s muscles. Clove and tea tree oil likely also disrupt nerve function.
- Destruction of cell membranes – Tea tree oil, oregano oil, and neem oil break down cell membranes and structures.
- Suffocation – Oils applied topically can coat mites and suffocate them.
- Dehydration – Alcohol-based cleansers dehydrate and kill mites.
- Damage to cellular proteins and DNA – Permethrin and sulfur alter mite cell components.
Additionally, treatments like cryotherapy, photodynamic therapy, and laser therapy use controlled damage and destruction of tissues to kill mites in follicles.
How long does it take for treatments to kill mites?
Most of the treatments start killing Demodex mites within the first few applications or doses. However, it can take weeks to fully eliminate an infestation and resolve symptoms. This is the general timeframe for mite eradication:
- Ivermectin – Kills mites within 8-12 hours. Takes 4 weeks to resolve symptoms.
- Permethrin – Begins working within 30 minutes. Takes 4 weeks to eliminate mites.
- Tea tree oil – Starts killing mites within 3 days. Takes 4-6 weeks to fully treat.
- Sulfur – Kills mites after several days of use. Takes 6-8 weeks to eliminate.
- Cryotherapy – Destroys mites immediately but takes 2-3 sessions spaced weeks apart.
- Photodynamic therapy – Works in 1-2 sessions spaced 2-4 weeks apart.
With topical treatments, be sure to continue use for at least 1-2 weeks after symptoms resolve to ensure any remaining mites are eradicated.
Are Demodex mites becoming resistant to treatments?
At this time, there are no reports that Demodex mites are becoming resistant to common treatments like topical permethrin, ivermectin, and tea tree oil. Mite resistance has been documented with some livestock applications of avermectins.
However, Demodex mites on humans have not developed significant resistance. Rotating between different treatment classes may help prevent resistance. Using natural oils with multiple active ingredients can also avoid selective resistance.
How to prevent Demodex infestations
You can lower your risk of developing an overgrowth of Demodex mites through daily skin and hair care:
- Wash the face twice daily with a gentle cleanser
- Use oil-free and non-comedogenic skin products
- Exfoliate skin weekly with a scrub or acid
- Shampoo hair frequently
- Avoid oil-based creams and cosmetics around eyes and eyelids
- Cleanse eyes daily with sterile wipes
- Do not share washcloths, towels, pillows, hats, and hairbrushes
- Wash bedding weekly in hot water
Improve skin barrier function through moisturizers with ceramides and hyaluronic acid. Also, manage chronic skin conditions like rosacea and seborrheic dermatitis that increase susceptibility to mites.
Can Demodex mites spread between people?
Demodex mites are contagious and can spread in several ways:
- Direct skin-to-skin contact
- Sharing personal items like makeup, razors, and towels
- Touching surfaces like pillowcases and furniture
Newborn infants can acquire mites from their mother during childbirth. To prevent transmission, avoid sharing personal items, wash hands frequently, and disinfect surfaces in the home.
When to see a doctor
You should consult a dermatologist if you have persistent symptoms like redness, irritation, and itching of the skin and eyes. They can diagnose a Demodex infestation through skin scrapings and microscope examination.
See a doctor promptly if you experience:
- Severe spreading facial or eyelid redness
- Papules and pustules resembling severe rosacea
- Crusting or scaling skin
- Styes on the eyelids
- Eye redness and irritation
- Eyelash loss
Treatment under medical supervision is especially important if Demodex mites are causing blepharitis or ocular rosacea that can damage the eyes.
Conclusion
In summary, Demodex mites are microscopic mites that commonly live in the skin but can occasionally overpopulate and cause symptoms. Prescription medications like ivermectin and permethrin can effectively kill mites, as can natural oils like tea tree oil. With topical treatments, it may take 4-6 weeks to fully eliminate an infestation. Preventing mite transmission and maintaining good daily skin hygiene helps reduce infestation risk. See a dermatologist promptly for evaluation and treatment if you suspect a Demodex problem.
