Demodex folliculorum: What You Should Know

With large D. folliculorum infestations, you may notice sudden increased roughness of the skin.

Other symptoms may include:

• itchy or scaly skin
• redness
• increased skin sensitivity
• burning sensation
• skin that feels rough like sandpaper
• eczema

Many people with mites in their skin don’t know it. A small number of mites is unlikely to cause any symptoms.

D. folliculorum naturally occurs in human skin. However, the mites can be spread by contact with someone else who has them.

Unlike other types of skin mites, D. folliculorum increases the amount of skin cells in the hair follicles. In large amounts, this can create scaly symptoms on the face.

D. folliculorum is currently being investigated as a potential cause of rosacea. There’s evidence that these mites can cause flare-ups if you have rosacea. In fact, the National Rosacea Foundation estimates that rosacea patients have up to 18 times more Demodex mites than patients without rosacea.

Though D. folliculorum isn’t an uncommon occurrence, you may be at an increased risk for getting these mites if you have:

• a weakened immune system
• dermatitis
• skin infections
• alopecia
• acne, especially inflammatory types
• HIV
• rosacea, though increasing evidence suggests the mites can actually cause this condition

Since D. folliculorum aren’t visible to the naked eye, you’ll need to see a doctor to get a definitive diagnosis. To diagnose these mites, your doctor will scrape a small sample of follicular tissues and oils from your face. A skin biopsy shown under a microscope can determine the presence of these mites on the face.

People who have large amounts of the mites on their face may be diagnosed with demodicosis. Symptoms of demodicosis include:

• scales around the hair follicles
• red skin
• sensitive skin
• itchy skin

Your doctor can prescribe a cream that can help get rid of the mites as well as their eggs.

D. folliculorum can also cause complications with preexisting skin conditions. It may worsen acne outbreaks, rosacea rashes, and dermatitis patches. Controlling the mites may help the outcome of these types of inflammatory skin conditions.

Certain home treatments can help get rid of D. folliculorum while also preventing them from spreading. Gently scrub your eyelashes with a 50 percent solution of tea tree oil. Then apply tea tree oil to kill any eggs left behind. The tea tree oil should get rid of mites and mite eggs.

In most cases, you don’t need to do anything about the mites unless they’re causing symptoms.

Medical treatments

Medical treatments are used when there is a large number of mites on your face. For D. folliculorum on the eyelashes, a medicated ointment may be used. This helps trap the mites and prevent them from laying their eggs in other hair follicles.

Creams, gels, and face washes with the following active ingredients may also help:

• benzyl benzoate
• salicylic acid
• selenium sulfide
• sulfur

Your doctor may also prescribe:

• crotamiton (Eurax)
• ivermectin (Stromectol)
• metronidazole (Flagyl)
• permethrin (Nix, Elimite)

The outlook for D. folliculorum depends on the underlying cause. People with inflammatory conditions, such as rosacea and acne, might have recurring mites that aggravate their symptoms. Frequent skin infections can also increase the likelihood that the mites will return.

Most cases also don’t cause any symptoms. Mites live for several weeks and decompose often without notice. In small amounts, D. folliculorum may actually offer benefits, as they can remove excess dead skin cells.