Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 11/24/20 2:00 PM
Yikes! This is a question that gives me the heebie-jeebies. The idea of mites living on our eyelashes and in the sebaceous glands around our lashes is horrifying. Sure, I’m an ophthalmologist so I probably shouldn’t sound so faint-hearted. But I’m also a human, and it’s just us talking here. In that spirit, I’ll be straightforward. I wish the idea of little prehistoric creatures living on our eyelashes and eating our skin oils didn't give me the heebie-jeebies.
And yet, sometimes they do. More often than you’d like to know. It’s not that everyone has mites living on their eyelashes, it’s just that many, many people do. They go by the name Demodex. Depending on your age, it’s usually anywhere from 33 to 50 percent chance that you’re one of those people. If I could give one piece of advice to you it would be this — don’t google Demodex and look at scanning electron microscopy images of these things. You’ll just ruin your whole day.
Okay, I know more than half of you just clicked a new tab in search for what Demodex looks like. Now that you’re back, it’s time to get to know more about it.
What are eyelash mites?
For starters, Demodex is a parasite that is commonly found on human skin. The problem is that they’re microscopic so you’d only know you have them if you suffer from the known symptoms. It’s not like dirt that you could just wipe off your face. They grow and stay, and you have to live with the fact that they live on you rent-free.
But you may also be surprised to know that some research studies suggest there is a mutual relationship between us and mites. In fact, because they feed on bacteria, we may even be lucky to have them (I know, it’s weird. No one wants to host parasites.) But this does not discount the fact that they can be causes of rosacea and blepharitis.
Different Types of Demodex
Yes, it's true. There are around 65 species of Demodex known but only two of them live on humans (that's a slight sigh of relief). Demodex folliculorum and Demodex brevis are both referred to as eyelash mites because of their similarities but the former is commonly found on eyelashes and eyelids where they feed on dead skin cells.
Demodex brevis, on the other hand, is mostly found on the sebaceous glands because they feed off the oil on the hair follicles. They are usually separated from each other, whereas Demodex folliculorum live together in groups.
A study published in the Journal of American Academy of Dermatology found out that both species appear as we age although Demodex brevis is lesser. They are both highly concentrated on the face but Demodex brevis is more pronounced on the body. Despite all the academic differences, I’m aware that whatever type of Demodex exists, they are still frightening and horrible.
What do eyelash mites look like?
A better way to come face-to-face with eyelash mites is by taking an eyelash and examining it using a powerful microscope that would enlarge the lash by 16 to 18 times. Upon careful inspection, you’d get to notice these eight-legged creatures (an arachnid, in particular, just so I can give your more creeps) are camping out in the hair follicle.
They're commonly lying face down so they can feast on the oil buildup or dead skin cells not just on your eyelashes but also on your cheeks, chin, forehead, eyebrows and nose. Again, they can't be seen by the naked eye so you may have archly curved delicate lashes but they're teeming with mites anyway.
Female Demodex are generally bigger than the male mites and just as they enjoy sucking the oil or dead skin cells, they also spend a lot of time multiplying and laying their eggs from spot to another. Yikes!
Demodex folliculorum is usually longer at around 0.3 to 0.4 mm compared to Demodex brevis, which grows up to 0.2 mm only. The former is noticeably tapered at the posterior end (or short-bottomed) while the latter has stubby legs and more spindle-like so they appear to be bigger.
Eyelash mites also hate lights much like a social sweat bee that flies around to hunt for food at night. So, it's most likely that they're all crawling and having a party on your lashes (or other parts of the body) when you're asleep.
How long do eyelash mites live?
Demodex of any type usually live from two to three weeks on the host (yes, that’s us!). If you think you can let it pass because they will die anyway, well, don’t be misled. A female mite lays as many as 20 eggs inside the hair follicle. That’s way, way faster than the population growth rate of any country.
In other words, as soon as the adult Demodex dies, the 20 baby mites have already made it past their larvae phase and are now spindly-legged petrifying creatures. They multiply so fast that the complications develop rapidly and become very visible.
Are eyelash mites a hygiene issue?
Frankly, it would be nice to know if it were just an issue of hygiene so we could all feel okay about it. “Well, lucky for me, I’m not gross. I wash my face.” Face soaps and scrubs are great. I recommend them. But unfortunately, they’re not the issue here. As I mentioned earlier, you can have the clear, flawless skin of a cherub, but these terrible eyelid mites will still be there. Thank heavens they are only a third of a millimeter tall and like to bury their heads. Gosh, this topic is gross, and I’m mad that I have to write about it.
But it’s important to offer information about it. Not because Demodex is an imminent threat to your eyes or your health, but because it is often misunderstood. There are cases of Demodex blepharitis (blephara- means eyelids and -itis means inflammation). But it is rare for it to cause problems outside of those with a very weakened immune system. In those cases, you treat it with tea tree oil, oddly enough. It kills the mites and (again, sorry for this) their eggs.
Going back to the topic, having Demodex is more than a case of having poor hygiene. If you have existing skin conditions such as inflammatory acne and dermatitis or if you have a genetic susceptibility to having these mites, then there's a strong possibility that a Demodex outbreak can occur.
Then again, poor hygiene may still contribute to its development. For example, those in their 20s or 30s have stronger sebum production while those hitting puberty can produce 500 percent more sebum that results to acne-prone skin. Failing to manage it with the right diet and topical products to strip the oil from your face and other parts of the body may be a cause for Demodex to settle in.
Furthermore, if you sleep with your makeup on (or if you happen to fall asleep because of too much stress that it’s become impossible to do your nightly facial routine), then it’s another invitation for Demodex to take up residence.
Are eyelash mites contagious?
Yes, they are. Close contact with someone who has Demodex can induce the presence of eyelash mites on the skin and lashes. But you may be wondering, who gets their eyelashes in close contact with that of others?
Well, it can happen indirectly. Those who still share their makeup and cosmetics not only expose themselves to the risk of getting eyelash mites but also make them vulnerable to pink eye and herpes. Makeup testers found in the cosmetics section of retailers are also sources of bacteria and mites when directly applied to the face.
Eyelash extensions that have not been properly cleaned can also draw Demodex easily. Furthermore, anyone who has a habit of rubbing his or her eyes also runs the same risk, especially when they have touched someone's skin with mites. If you also sleep on someone else's bed and pillow and that person has Demodex, then it's likely you'll develop the same condition.
What are the symptoms or signs that you have eyelash mites?
Before discussing the symptoms of having eyelash mites, it’s important to not some patients who have Demodex may not exhibit any symptoms. A study published in the Archives of Medical Science by Polish researchers found out that while having eyelash mites may provide ocular discomfort, a majority of people still show no clinical symptoms.
This makes it difficult to detect for such patients because only a qualified doctor can test for the presence of mites. So if a patient is unaware, he or she would not have a reason to visit a doctor until a time that rosacea or blepharitis develops.
A common symptom is that eyelashes are brittle, thin and loose, causing them to fall off easily (a condition known as madarosis). Healthy eyelashes, on the other hand, are sleek and sturdy but with female eyelash mites laying their eggs inside the hair follicles, the lashes are eventually damaged. With Demodex attached to the root, this adds pressure to the hair follicle as well.
Another symptom involves itching at the roots of the eyelashes, especially upon waking up. As I mentioned, the mites are more used to crawling at night but not in the morning when they go back to the roots. This conforms to a study in New Zealand where patients suffered severe inflammation and itchiness.
The base around the eyelashes may also be inflamed coupled with eyelid redness and stickiness. In this case, you may already have blepharitis. Although Demodex is often thought to be the cause of such, there are also other sources of the condition such as Meibomian gland dysfunction (the ones that produce oil), rosacea, and infection from herpes. The University of Medical Sciences in Poland also reports that rosacea patients have 18 times more Demodex than those who don’t.
Dandruff on the eyelashes can also occur along with a burning sensation according to the American Optometric Association (AOA). When left to develop into more severe symptoms, it may contribute to blurriness of vision, missing eyelashes, and corneal inflammation. Patients are also observed rubbing their eyes when they suffer from this condition, which may lead to further complications.
How common are eyelash mites?
Several studies suggest the prevalence of Demodex in various groups. For example, research in the Archives of Medical Science found it to be asymptomatic with many cases occurring among inpatients and older people. Another study discovered that as we age, these mites appear more frequently with 25 percent of those in their 20s, 84 percent in their 60s, and a whopping 100 percent in their 70s.
Another study that appeared in Clinical and Epidemiologic Research found out that those with cylindrical dandruff in their eyelashes have more mites. Related research by Chinese scholars attribute this to lack of hygiene by not following a regular cleaning regimen everyday. Body parts such as brows, cheeks and yes, eyelashes, that protrude are often less accessible when cleaning so mite infestation is likely to spread eventually but at a faster rate in these areas.
It is also common among males more than females, according to a study in the journal Clinics in Dermatology. It’s not totally clear one way or the other. Some research, such as what was published in the Journal of Ophthalmology, concludes otherwise. Studying the prevalence of Demodex among Chinese patients, researchers discovered that more females suffer from the condition because they wear cosmetics that cause adverse effects on the Meibomian glands.
Do eyelash mites eat mascara?
Although no academic study has been published on eyelash mites eating their fill of mascara, it's not that difficult to imagine that they can devour whatever they want using their sharp teeth because their only role in life is to eat, seduce each other, and populate - and that likely includes the oil in your mascara as their main course.
You may also be wondering where they put their waste with all the eating they do. Let's consider ourselves a bit lucky for knowing that these mites cannot poop at all because, well, they don't have any anus. All they eat is stored in cells located in their gut. Maybe that’s why biologist Richard Owen first called them Demodex when he took inspiration from the Greek words “demo” (or a lard) and “dex” (or a boring worm).
The takeaway here is that greasy makeup is a feast for eyelash mites and you're putting yourself at risk when you share it.
Do eyelash mites cause blurry vision?
In a study published in the Current Opinion in Allergy and Clinical Immunology,researchers in Miami foundn that Demodex plays a huge factor in blepharitis. Demodex infestation was observed to be very high and thus make blepharitis more severe. In an explanation by the AAO, blepharitis patients do not necessarily experience blurry vision at first but rather a burning and itchy feeling. However, because the tear film is eventually affected along with the cornea, a patient's vision can turn blurry. (There’s also another case study by AAO that discusses how a patient experienced intermittent blurry vision only at night although no mention of Demodex was made.)
In terms of ocular discomfort, Korean medical researchers investigated among Asian patients the effects of eyelash mites and discovered that there's a strong correlation between Demodex presence and vision discomfort owing to the damaging effect of the mites to the tear film, inflammation of the Meibomian glands, and lid inflammation.
Ophthalmologists are also beginning to understand more about the contribution of Demodex to blurry vision. According to researchers from the Ocular Surface Research & Education Foundation, whose work appeared in the American Journal of Ophthalmology, eyelash mites have a negative impact on the oil glands. Therefore, the tear film is subsequently affected and will cause vision to blur rapidly. When they successfully treated a patient suffering from Demodex, they noticed that the tear film stabilized and the patient reported better vision.
How can you prevent eyelash mites?
Preventing eyelash mites involves a lifelong commitment because, as I mentioned above, aging has a lot to do with the increase in Demodex in the body. However, because they are microscopic, we often attribute the symptoms to more common problems such as acne until a doctor reveals it’s really the fault of mites crawling on your eyelashes.
Although it’s common, it doesn’t mean that we have to tolerate the growth of Demodex on our skin. Here are some of the best ways to avoid getting eyelash mites.
Stay away from oil-based facial products
There’s no one-size-fits-all beauty or cosmetics product. What works for some won’t necessarily work for others. This is especially true of oil-based products. A study in the Indian Journal of Dermatology recommends avoiding oil-based cleansers and makeup as this can be a breeding ground for mites. The researchers also suggest cleansing the face twice a day using a non-soap cleanser, and exfoliating regularly to shed off dead skin cells.
Be greedy with your makeup and cosmetics
Make it a rule to never, and I repeat, never share your makeup or brushes with anyone. If you don't want someone else's Demodex living in your skin, avoid using someone else's mascara or eyeliner.
Remove your makeup every night
I know I'll sound like a broken record with this but you should never skip on removing your makeup before hitting the hay. Never sleep in it to avoid breakouts, dull skin, and eyelash mites.
Clean your makeup brushes and applicators regularly
Mite buildup can be much faster in brushes, cases, liquid tubes and beauty blenders. Make it a habit to clean your brushes at least once a week using lukewarm water and soap. You should also wipe excess liquid on the tip of tubes. Don't scrimp on replacing them once you notice that they have a certain odor, are gradually becomes discolored, are shedding bristles, or are already three months old.
Change your sheets, pillowcases and towels regularly
Most of us are guilty of this, especially for those who retire at night after a day of being swamped by paperwork at the office. How many of us stick to a rigid schedule washing bedsheets and pillow cases? It is recommended to load them in the washing machine along with your towels at least once a week to get rid of the perspiration, oil, and even saliva on the fabric.
How do I get rid of eyelash mites?
Treating Demodex is less expensive than most other skin conditions. Before doing any home remedy, it is important to first seek the advice of your doctor. No two cases are alike and it helps to seek professional advice to better diagnose your situation and receive the appropriate prescription on what to do with it.
Here are some ways to get rid of eyelash mites.
Use tea tree oil
This organic product is recommended to be applied every evening for at least six weeks. It is proven to prevent the proliferation of Demodex and destroy adult mites and eggs as well. I have to warn you that the 100 percent pure tea tree oil can be very strong on your skin though, especially when applied on your lashes (and hopefully won't get in your eyes!). That's why in some studies, they suggest combining 50 percent tea tree oil with macadamia oil to be used for scrubbing the eyelids softly with a cotton swab.
An article on the Review of Optometry that compares the various Demodex treatment products uses tea active tree oil ingredients as an important component to address bacterial presence. Most negative feedback come in the form of stinging sensation, which cannot be found in baby shampoos because they don't contain any traces of tea tree oil.
If you want a more pleasant smell without the sting, you can try lavender oil on your eyelashes before hitting the sack.
Use over-the-counter topical solutions
There are ointments designed to treat Demodex but as I mentioned above, ask your doctor first if he or she approves of the brand for your condition. The last thing you want to happen is to develop further complications because of self-medication.
Take a break from wearing makeup or contact lenses
If you are diagnosed with blepharitis, your ophthalmologist may ask you to temporarily stop applying makeup (especially mascara) or wearing contact lenses during your treatment. This will also allow the doctor to determine if there are substances that contribute to the proliferation of eyelash mites.
Apply warm water and baby shampoo or lid scrub solution
Using a clean cloth or cotton, dip it in a mixture of warm water and the solution or shampoo. Gently rub it on the eyelashes or eyelids. Finish it off by rinsing with warm water.
Sadly, it is true that you can get mites on your eyelashes. It is less true that it happens if they’re not cleaned regularly. Once you’ve gotten over the original horror of the idea (which I’ve been waiting on for 15 years), it’s really not so bad. It was thought that they were commensal (they benefit from us, but don’t cause us problems) for a long time. It’s generally considered that they are parasitic now because of those cases when they cause eyelid inflammation. They are weak, scrawny, pathetic parasites though. Considering how common they are, it is rare that they do anything to hurt us.
For most of you reading this, just know that I believe there are some facts of biology that are better left mostly forgotten. I encourage you to forget this one unless you can figure out a great way to bring it up at a party. That said, if you have chronically red and inflamed eyelids, then it is worth seeing an ophthalmologist to follow up on this. They can prescribe specific medications like tea tree oil to cure Demodex if that’s what’s causing the problem. Just don’t let them show you any photos of it.
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Author: Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Orlando Clinic in Florida. A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.