Introduction
Demodex is a genus of small mites that reside in the hair follicles and sebaceous glands of humans. These usually live on the face, cheeks, forehead, eyelashes, and sides of the nose. These mites cause the skin to be itchy, and irritation is known as demodicosis. These do not cause any harm to the human skin. But these mites multiply too quickly and then may cause a skin condition known as Demodex folliculitis. Almost every individual has these mites. The condition is contagious that it can spread from one human to another. Around 23 to 95 % of healthy individuals have these mites. These cannot be seen by the naked eye. An individual needs a microscope to see them. Demodex is also known as face mites. The Demodex mites do not remove even by scrubbing. The condition requires treatment, which includes topical and systemic medications. The article discusses demodex, its types, causes, histologic features, symptoms, diagnosis, and treatment.
What Is Demodex?
The Demodex mites invade the face and cause white bumps with redness and itching. These white bumps are the same as whiteheads. The condition happens when the Demodex mites multiply quickly, and the immune system of the human cannot control them, leading to the formation of white bumps.
What Are the Types of Demodex Mites?
There are two main types of Demodex mites are as follows:
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Demodex Folliculorum: The Demodex folliculorum mite lives in the hair follicles on the face, cheeks, forehead, nose, and eyelashes. These mites can also be present on the neck and ears. These are 0.3 to 0.4 mm in length. They can survive on the oil and skin cells.
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Demodex Brevis: These mites are shorter and measure around 0.15 to 0.2 mm in length. They live in the sebaceous gland and affect the face and eyes. They can travel to the chest and neck area. These types of mites can go deeper into the oil glands and feed on them.
What Do Demodex Mites Look Like?
The Demodex mites are extremely small, and they are covered by a pinhead. Demodex folliculorum is a worm-like shape and has eight short legs. These legs are used for gripping. These mites are semi-transparent when seen under a microscope. Demodex brevis are shorter in length than Demodex folliculorum and also have eight short legs. The life span of these mites is one to two months. These are not visible by the naked eye and can be seen under a microscope.
What Are the Causes of Demodex?
Several factors can lead to the development of Demodex. The factors responsible for the condition are as follows:
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Natural Microbial Skin Flora: Demodex occurs naturally in the skin of every individual. A small number of mites invade the human skin, usually on the face, without causing any harm to the skin.
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Weakened Immune System: Demodex mites multiply quickly in a weakened immune system people because certain autoimmune diseases can suppress the immune system and create the environment for the mites to proliferate.
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Skin Conditions: Several skin conditions, such as blepharitis, can increase the proliferation of Demodex mites.
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Environmental Factors: Factors such as heat, humidity, and poor hygiene can create an environment for Demodex mites to invade the skin.
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More Sebum Production: Demodex mites feed on the oily substance that is produced by sebaceous glands. This will provide the environment to increase the growth of these mites.
What Are the Signs and Symptoms of Demodex?
The signs and symptoms of Demodex are as follows:
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Redness: Demodex mites can cause irritation, redness, and inflammation on the skin, such as the face, nose, cheeks, and eyelids.
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Discomfort: Invasion of Demodex mites deep into the skin may cause itching and discomfort.
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Pustules Like Whiteheads: Demodex mites can lead to the development of pustules or papules that resemble whiteheads. This is more common in the areas such as the cheeks and forehead.
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Other Symptoms: The other symptoms include a burning sensation, dryness, a rough feeling on the skin, and skin sensitivity. If the eyes are affected, then there may be eye irritation and itchiness.
How Is Demodex Diagnosed?
The healthcare provider may diagnose Demodex by clinical evaluation and microscopic examination. The diagnostic methods are as follows:
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Visual Examination: The healthcare provider may look for the symptoms of Demodex mites infestation. The symptoms include redness, inflammation, and pustules-like eruptions that resembles whitehead.
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Skin Scrapings: The healthcare provider may take skin scrapings from the affected skin and send it to the laboratory for examination under a microscope to check for Demodex mites.
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Skin Biopsy: The healthcare provider may take a skin sample from the affected area and examine it under a microscope to look for Demodex mites.
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Dermoscopy: It is a procedure in which the doctor uses a magnifying glass and powerful light. The results include white spiky structures in the skin pores.
How Is Demodex Treated?
The treatment options for Demodex are as follows:
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Topical Medications: The healthcare provider may prescribe topical medications that include creams, lotions, or gel. The ingredients include Metronidazole, which helps the patient to relieve the symptoms.
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Oral Medications: The doctor may prescribe oral medications in case of severe Demodex. Antibiotics, including Ivermectin and Doxycycline, help in inhibiting mites' production.
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Eyelid Hygiene: The mites invade the hair follicles on eyelashes where proper eye hygiene is needed. The doctor may advise the patient to wash the eyelids with warm water.
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Other Treatment: The doctor may prescribe tea tree oil to apply over the affected area. Tea tree oil has antimicrobial properties. It helps in reducing skin irritation.
What Are the Complications of Demodex?
The complications of Demodex are as follows:
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Skin irritation and inflammation.
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Demodex mites can cause rosacea exacerbation. The condition that increases the pustule formation and redness.
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Blepharitis (eyelid inflammation).
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Secondary infections.
Conclusion
Demodex are small mites that live in the hair follicles of the face, eyelids, nose, cheeks, and neck. These mites normally live in every individual, and they quickly multiply and cause redness, inflammation, and pustules like whiteheads on the affected area. The healthcare provider may advise the patient to maintain personal hygiene and eyelid hygiene; these help prevent the growth of the Demodex mite population.
