New Approaches for Fighting Demodex Mites

By Keynote ContributorBy Dr. Kathryn Najafi-Tagol, MDFounder and Medical Director of the Eye Institute of Marin

By Dr. Kathryn Najafi-Tagol, MD, Founder and Medical Director of the Eye Institute of Marin

Demodex mites are one of the most challenging problems that ophthalmologists and optometrists face in the routine care of their patients.

© Kalcutta /

These mites are microscopic parasites that live on eyelids and other parts of the face. One of the two species, Demodex folliculorum, buries itself face down near the roots of eyelashes. It uses a seven-clawed organ (a “palpus”) to grab hold of cells. Then it feasts on the cells that line the follicle, sucking out their innards with a retractable needle in the middle of a round mouth.

The waste material the mites produce builds up as debris on the eyelids and causes inflammation.

In addition, the D. folliculorum typically carries Staphylococcus and Bacillus oleronius bacteria.

© Kalcutta /

The combination of mites and bacteria causes blepharitis, a condition suffered by more than 20 million Americans, where the eyes become red, irritated and painful, and crusty debris builds up on the eyes.

Meanwhile, the other species, Demodex brevis, burrows into meibomian gland to feed, often plugging up this crucial gland. The gland produces an oily substance that’s necessary to keep tears from evaporating. As a result, the D. brevis mites are associated with meibomian gland disease, also known as dry eye.

These parasites are common. One study found them in 25% of 20-year-olds, 30% of 50-year-olds and 100% in patients older than 90 years old.

My own patients are usually horrified when I tell them that there are tiny parasites, which are relatives of ticks, spiders, and scorpions, feasting on cells around their eyes.

So how can we fight these parasites? There are several approaches, which can be combined to attack the mites on multiple fronts:

Tea Tree Oil

At high concentrations, tea tree oil is a potent killer of Demodex mites. The problem is that solutions of 100% tea oil, or other high concentrations, are very irritating to the eye. So one approach is to thoroughly wipe the eyelashes and eyebrows with a diluted solution of tea tree oil, from 5% to 50%. We can also first use an anesthetic eyedrop to lessen the irritation from the tea tree oil.

In one study, a daily lid wipe with a 5% solution of tea tree oil reduced both the numbers of mites and the perceived itchiness of the eyes.3 Until recently, tea tree oil was the main method of keeping the mites in check.

Antibiotics & Steroids

An antibiotic steroid ointment can help prevent the mites from moving. It may even suffocate them. The combination of antibiotics and steroids is also a standard treatment for blepharitis. The steroid reduces inflammation, which is caused by the mites, the bacteria, and treatments like tea tree oil wipes. In addition, the antibiotic helps control the bacteria.

The problem with this approach is that steroids can worsen glaucoma, while chronic use of antibiotics can lead to the development of bacteria that are resistant to the antibiotics.

Hypochlorous Acid

Hypochlorous acid (HOCl) is a naturally occurring substance produced by white blood cells as a first defense against microbial invaders. Its antimicrobial properties were recognized more than 100 years ago, when solutions containing HOCl were used to combat infections in the wounds of soldiers injured in WWI.

Only recently, however, has it been possible to manufacture a stable, pure version of HOCl. HOCl has potent antimicrobial properties. Laboratory studies show that it effectively kills the nymph form of the Demodex mites, as well as the Bacillus oleronius and Staphylococcus aureus bacteria that live on eyelids and that are found inside the Demodex gut. In addition, HOCl also neutralizes the inflammatory toxins released by both mites and bacteria.

Moreover, unlike tea tree oil, HOCl is completely non-toxic and non-irritating.

© Nyrelle Hawkins /

Home Hygiene

Treating eyes and eyelids can bring quick relief to patients, many of whom have suffered from Demodex mites, blepharitis, or dry eye for years.

But there are also steps patients can take at home to further reduce the problem. I recommend washing sheets and pillowcases in hot water and drying with the hottest possible dryer setting to kill the mites that might otherwise jump from bedding to faces. In some cases, it might even help to get new pillows. Patients might also consider not using makeup for a week, and discarding their old makeup.

Many doctors worry that patients won’t comply with the treatments they recommend. But I find that once I describe to patients how parasites are burrowing into their cells and feasting on their bodies, especially if I show them pictures of the microscopic creatures, I get their attention and their complete cooperation. In addition, if the treatment is irritating like tea tree oil products, the patients are less likely to be compliant; however, if the therapy feels comfortable and makes the eyelids feel more refreshed, the patients are more likely to adhere to the regime.

And the good news is that, after years of fighting mites and treating chronic blepharitis, new approaches are making it more likely that we can finally effectively control these conditions.




Further Reading

Disclaimer: This article has not been subjected to peer review and is presented as the personal views of a qualified expert in the subject in accordance with the general terms and condition of use of the News-Medical.Net website.

Last Updated: Jan 3, 2023


  1. Linda Haghgoo Linda Haghgoo United States says:

    Wash your face as soon as possible when you wake up because they retreat into us when light hits them. I use Kirk's coconut soap

  2. Helen Turner Helen Turner United States says:

    Anyone have an idea what to do with our cloth stuffed recliners we use to take naps in the afternoon? The article suggest throwing pillows away.



    • Queen Belle Queen Belle United States says:

      They are harmful, my kids and I suffer from them badly they inside my mouth teeth have fallen out because of them my eyes my lashes and ears all over my entire body.. as my older kids have babies the newborn babies comes out with them and u notice them in pics when u zoom in and see them light up white sparkling spots.. but I feel them burrowing in my scalp everywhere constantly.. Tea tree oild does nothing the sea salt and goat milk soap does nothing I have pics of them .. so if there is anything else that really works plz help

      • Jasmine Knight Jasmine Knight United States says:

        i have the same issue and it is very annoying

      • pzl mich pzl mich United States says:

        use Davis Sulfur benz shampoo to open your pores then pour lime sulfur dip over your body.  spray thyme oil over clothes, sheets, pillows, towels etc and use kleen free preformed enzyme cleaner to wash clothes.

        • pzl mich pzl mich United States says:

          Apple Cider Vinegar works great!  It is by far the best treatment I have found for my hair and body! When I'm in the shower I have ACV in a spray bottle and I soak my hair and spray my entire body. Wait for 10 minutes, rinse.  It kills all forms of the mite including the eggs.  I did that twice a day for 5 days, once a day for 10 days, then every other day for only 5 minutes.  It is very drying so I use Moo Goo MSM cream on my face and body.  I have long hair so after I rinse I turn my head upside down and put conditioner only on the hair, not the scalp--rinse it.  I've easily spent a thousand dollars and the cure was quite simple. Also, I bought a 32oz bottle of permethrin and I put 1oz in each load of laundry so I didn't reinfect myself.  Cedarwood oil is awesome sprayed on my mattress and around my bed,  it kills the little bastards and the house smells great! Also, vacuum everyday. Also, I am taking neem capsules, MSM capsules, and NAC as a little insurance. I rarely feel a bug and I am immunosuppressed and taking steroids. Hope this helps someone! Peace!

      • Dolly Flop Dolly Flop United Kingdom says:

        I tried everything that's suggested for these parasites, and not much works 100%. However, I found that by washing my hair and combing it through with the shampoo on, and vigorously rubbing and cleaning my hair and scalp for 5 minutes non-stop, rinsing and then repeating, and keeping the washing, rubbing, and whatever else we do when cleaning our hair going for another 5 minutes, then combing through and rinsing, and then using a good hair conditioner and again really rubbing it into the hair and scalp without stopping, and then leaving the conditioner on while I deal with the body demodex I have all over me—washing with soap and water and again making sure I clean each area without stopping for a few minutes, stopping occasionally to rub the conditioner into my hair and scalp—it does seem to drown them. At least that's what seems to happen. I use something called Dimethicone on my skin that makes them come out, but you can only use it a couple of times a week. However, if you give yourself good treatment from the start and keep it up as much as you are able to, it will help you a lot. You can only leave the benzyl benzoate on for so long. Also, the hairdryer, if you can use it on the skin and hold it there for a few moments, helps dry it up, too. Homeopathy pellets with sulfur are excellent for skin mites and such. I think you'll find it's a combination of things that help you get rid of them for good. Good luck.

      • Leslie Brown Leslie Brown United States says:

        I'm so glad I've seen your comment about them in your mouth and as a result your teeth falling out I'm having the same problem but when I Google to see if it could be the months making my teeth bad I have found nothing nothing no website has said that they even have said that they don't get in your mouth and something's causing mine to go bad and I've always had good teeth all my life they are getting bad quick their nail in my front for top teeth and I have no insurance to go to the dentist and I need to figure out something to get these out of my mouth so when I seen your comment I was glad finally someone is saying it is the mites.. if anyone knows anything I could use to kill these in my mouth I would be much appreciative of any advice I can get willing to try anything at this point...¯⁠\⁠_⁠ಠ⁠_⁠ಠ⁠_⁠/⁠¯

  4. Ingrid Tarien Ingrid Tarien United States says:

    Good article. A few questions and comments for clarification:
    1. The mites have no anus and they eventually deteriorate or rupture after their 2 week lifespan (releasing whatever has been building up inside them). (There is reference to “the waste material that mites produce” but they don’t actually produce waste in the sense that they can’t poop, not having an anus. Maybe the reference is to what they have stored up inside them that gets released when they break down/rupture after death).
    2. I’ve read males outnumber females by 4-5x. They come out only at night (thus washing in daytime would have limited effect?). Nothing really reaches them inside the follicle and inside the pores as far as I understand. Can you elaborate on this detail please?
    3. They mate at night near the surface of the skin and the female heads back down to eventually lay about 20 eggs. An army of 20 from any one mite missed is a big threat. Would be great to keep them from mating.
    4. It seems that to be really effective, washing and treating should take place at night (away from light). I don’t know if such simple organisms have any rhythms that tell them what time is appropriate other than sensing bright light (if you cover an eye with a tightly fitting dark cup at noon, will they think it is night?)
    5. Does mineral (or other) oil clog their respiration and kill them? Little is written on Demodex from a phylogenetic perspective. I assume they respire somewhat like termites do, from openings in the sides of their body. If so, they should be capable of being suffocated by such - but reaching them/finding access to them doesn’t seem at all easy (they’re not on top of the skin; when we wash, we wash right over where they reside in the pores).
    6. Don’t know what they are made of (chitin exoskeleton?). With regard to using hot water and hot drying cycle, don’t they expire under water when detergent/soap is added (not pure water, as fleas also walk right off the water - the soap would break the surface tension of water and take them down). I don’t see how they could survive a wash cycle. Seems all air pockets would be pretty much gone in fabrics.
    7. With “jumping” from bedding to face - aren’t these extremely slow crawling .3 mm creatures who only move a very short distance in an hour. They don’t have the ability to “jump,” right? The word may be have been used figuratively.
    8. If they only live about 2 weeks, I imagine they don’t survive in the environment (and certainly can’t mate) - so the environment doesn’t seem like much of a threat unless you’re burying your face in something or using hands in a sloppy way (we don’t want them anywhere, but they’re still ubiquitous on humans). And humans only - they are not transmitted to/from pets (dogs and cats have their own species). I don’t know if they can survive harmlessly on another host long enough to live out their short life, but they would not be able to mate and make more (just like if they were on carpet)

    • Helen Cochems Helen Cochems United States says:

      Hello.  I would sure like to learn more about DIY treatments for scalp mites.  Your post provided useful clarification in many areas.  I especially like your use of the term phylogenetic perspective, which is new to me, and will help me in my search.  Thank you very much.

  5. agauerm agauerm Brazil says:

    Seriously, this is like trying to keep ice dry using a towel every couple of seconds. You will never get rid of this mite if every human being on earth has them and they are spread everywhere...

  6. Carolyn Cornie Carolyn Cornie United States says:

    It is believed that all humans have Demodex mites somewhere on their faces.  It is only when they become at the infested level that we would be aware of them.  I can speak from...horrible...experience.  At the Computer I could feel them crawling up and/or down my neck.  They were in my eyebrows enough to make them itch.  They would crawl on my face, usually at the base of my nostrils.  And, of course, the crunchy stuff on my eyelashes along with the burn and the itch.   I used a substantial routine of all Clinidex products and eventually calmed them all down.   But every few months, I can tell they are multiplying faster again.  Gross....but real.

  7. Jasmine Knight Jasmine Knight United States says:

    i have the same problem and i am getting so frustrated and dont know what to do

  8. Shirley Kubica Shirley Kubica United States says:

    I have this too! I have been to 4 different doctor's and none new anything about these mites! One thought I had scabies and gave me a prescription for permethrin cream to put on from the neck down. Ha! The neck down, these things start on the face! I did rub it on my face too even though the directions said not too! I can say I had relief for a day or 2 at the most. I had done my own research and found an article about these critters and the symptoms of demodex mites, and sure enough , I know this is definitely what I have. I see my dermatologist on the 3rd of August and I am desparately waiting to talk about this and find out everything I have to do to get this under control. I have been going through this for 3 months not eating and hardly sleeping. I've lost 60lbs because of the stress, and almost lost my job because some days I'm to exhausted to work! My life is so upside down and I'm starting counseling because of this! I noticed after the first 2 shots of the vaccines, I've had more and more problems with my immune system! More infections and now this! I am not saying for sure the vaccines started this for sure, but I really want to know if that could be possible?

  9. Leslie Tenney Leslie Tenney United States says:

    I have a friend (seriously) who has everything that was mentioned! Feeling these critters, the sparkles, losing serious weight! Trying to get them under control? I have been beside her through all of her fight against these bugs help! I'm really worried about her! Oh the Doctors thinks she has lost it! Something is going on and some how I need to help her this is very serious business someone please help me help her it's been going on fo over a year!

  10. T England T England United States says:

    Has anyone tried the Hypochlorous Acid?  Did it work on your scalp?  If so brand product bdid you use?

  11. N N Austria says:

    I have the same problem since 2 weeks ago.  It started as  a burning red eye lid. Doc said -eczema . Never had it,  2 weeks after that had  a horrible night itch, my skin was burning all over. Next Doc said , he can see nothing on my skin, no parasites, gave me histamine pills and sent me home. Histamine helped a bit to be able to sleep. And kaboom , 3 days after that my whole face, neck, thighs, chest area were covered with tiny marks/ burrows and 2 long very pronounced on  my forehead, plus a few pimples like a teenager. I cried like a baby. I'm not even 50 and had always beautiful skin all over, now  I look like a shrivelled prune. It's very contagious, you can get it even from a handshake or a kiss on the cheek.I don't know how I will put from now on  an open dress or a bathing suit. I was prescribed  Soolantra , a cream with 10 % ivermectin lol and Elidel to calm the irritation. It stopped the itching , applied it also on chest and neck , although it was not in  the instructions. Unfortunately , the tiny marks/ scars  on my face and body will not disappear.  I understand now, why so many women where I currently live (Austria, Germany) have bad prematurely wrinkled skin, with discolourations. It has nothing to do with the sun and cancer ladies, blame it on the bugs.  My Mom is 70 and has wrinkles only around  the eyes and marionette lines, smooth skin on rest of  the face , without botox. And it's also funny that every 2nd person here has allergy, eczema , psoriasis, peri oral dermatitis, neurodermities and so on. If you enter the pharmacy, half of the shelves are full with allergy tablets and anti-itch creams. Supposedly, the sun kills the bugs. So off we go. I think doctors are kind of powerless at this point. They just shrug and say, some people have bad reactions. A lot of people here have bad skin, because of this problem I think, not just teenagers with acne or rosacea. Everybody around scratching hair and body like they didn't shower for weeks lol.

  12. pzl mich pzl mich United States says:

    I am immunosuppressed and deal with these little bastards constantly.  You can get rid of them or get them under control, rather.  I am getting ready to try NAC and neem oil capsules twice a day to stop recurrences.

    • Mary Spinazola Mary Spinazola United States says:

      I have chronic lymphocytic leukemia and I've been to the dermatologist the infectious disease they don't say anything nothing but after putting tea tree oil on my head half a day and overnight when I combed it the next day with a regular comb a little tiny tiny tiny look like a maggot was on the comb what the heck

  13. t j t j United States says:

    These die right away if you SWEAT! I use a infrared sauna and my hubs just went out and worked in the sun for several days! The sauna needs to be turned up all the way though and I woudl recommend sitting in the sauna while the heat is increasing this way your body gets adjusted to the heat. I am not a physician but read profusely. This method worked for us immediately. Wash/dry all bedding/towels on high heat and vacuum.  Gone!!

    • Helen Taylor Helen Taylor United Kingdom says:

      Eye masks that you heat up - at least to 30 Deg C, will kill the little blighters.  Dry eye now when I wake up, so can't use monthly contacts any more.  I use eye drops to ease my eyes when I wake up - why can't you get eye drops that kill them too?  I'm in the UK, we have stricter rules on what you can sell, with regards to cures for things with no research and official approval, than the USA, I think.  

      Can't use a sauna, have MS and heat makes it worse ....

  14. t j t j United States says:

    Sorry, I meant "an" infrared sauna. My post has disappeared. Hopefully, it will re-appear soon. I was in a hurry to offer help. I may have made other typos as well but hopefully you all will understand what we did to rid ourselves of these.

  15. Ginger H Ginger H United States says:

    As a child (and adult), my eyelashes would sometimes hurt so bad I would pull them out. Thankfully the internet showed me I wasn’t crazy. I always wash my face twice a day and never sleep with make-up on. Change pillowcases a few times a week. TEA TREE OIL is the solution! But not full strength. For most people, it’s a random situation, but for those with autoimmune conditions, including myself, this can be a lifelong issue. For years I thought I had trichotillomania but came to realize that trich is only undiagnosed overactive demodex mites, not a psychological condition.

  16. Michael White Michael White United States says:

    Sorry for bad comment try tetsomo soap from Walmart that should work

  17. Kris Womack Kris Womack United States says:

    This is terrifying! Feeling things crawling on me all the time makes me feel absolutely insane. Sometimes, the sensations and acne aren't so bad, for a week or two, and then for the next week or two (or longer), it's really bad. Has anyone tried waxing the hair off of their face? Not ALL of it, but the little hairs that are everywhere besides your eyebrows and your head? This is literally torture. I got a steam cleaner and berm doing everything and ironing my clothes everyday, going to try the ACV and see how that works...

  18. Holly Hill Holly Hill Puerto Rico says:

    I hope someone has seen some improvement in their condition. I have the exact same problems you are and just recently was able to diagnose what my problem even was. The demandex mites have gotten into my hair and they're needing it it's ruined I've talked to every doctor that I've seen it's due to my anti immune condition that I suffer and my low white cell blood count. I've asked every doctor I've seen trying to get something somewhere in the last doctor I talked to was an ER doctor and without even looking at me he said shave your head and do have lice and I said this is not lice and I'm a woman and I'm not going to shave my head as I held back tears. Since that date I've been afraid to even go to my doctor's to talk to them about it again. What has worked anything please teach her your oil has been ineffective I have put every single thing I can think of in my hair from vinegar to apple cider vinegar to pure rubbing alcohol 91% and they just won't go away it's ruining my life and nobody seems to understand. I hear that everybody has hair that begins to thin around my age This is not the same thing and they just don't see it. Anyway when I keep up with this group to see if anybody has come across anything that works. I was looking today at a box of stuff that I was given by a friend and they had a honey treatments in there and I might try that because I've done a little research on it but not a lot and I found this group called doing my research. Best to all Holly

    • StylishEffect YouTubeSensation StylishEffect YouTubeSensation United States says:

      The fact that this post was written today makes me feel better, just a little. All the research seems old. I am suffering horribly. I have tried all things listed.. even been to a dermatologist, eye doctor, and teledoc. The teledoc doctor was very familiar with it, but couldn’t prescribed anything unless I was diagnosed. He stated that dead skin needs to be scraped off in the area and placed under a microscope… he said there is a pill that will help once I get diagnosed. I just send new pictures to my dermatologist.. I’m thinking about sending a link to this thread.. because she said “you definitely don’t have bugs” but could tell me what it was that I was feeling. She diagnosed with ccc alopecia.. but it’s the mites that’s ruining me hair and teeth!!!

  19. Holly Hill Holly Hill Puerto Rico says:

    I don't exactly understand  what this created or extracted.  Is HOCI a naturally occurring product or is it chemically made? Does it require a prescription or can I buy it off the shelf? If so where when I look?

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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