Demodex is a glandular mite that parasitizes the sebaceous glands and cartilage glands of the eyelids, as well as in human and mammalian hair follicles.
The tick lives in the mouths of hair follicles, especially in the mouths of the hair follicles of eyelashes and eyebrows, in the ducts of the sebaceous glands of the skin of the face. However, it can also exist outside of this environment. In an adult demodex, the body is transparent in color and has an oblong shape. The length of the tick is 0.1–0.4 mm. The body consists of two segments and is covered with scales that help the tick cling to the hair follicle; on the first part of the body there are legs and a “mouth” with which it eats skin cells, skin fat. The digestive system of this organism is so unique that it lacks excretory openings.
The duration of the tick’s life is several weeks. During this period, he should have time to lay larvae in the hair follicles and sebaceous ducts. The larva develops within 2-3 days and after a week becomes an adult tick.
Demodex is considered a conditionally pathogenic microorganism, since it lives in a small amount on healthy facial skin, especially if the skin is oily (it is found in about 96-98% of people). Activation of the activity of ticks and an increase in their number occurs under the influence of certain factors (weakened immunity, chronic diseases of the gastrointestinal tract, diseases of the endocrine system, stress), which causes the development of demodecosis.
A pathological increase in the number of microorganisms leads to the appearance of clinical symptoms of demodecosis: acne and rashes appear on the skin of the face, similar to the manifestations of rosacea and pink acne. Most often they are localized on the nose, forehead, chin, cheeks, sometimes on the eyelids. Subjectively, the patient may feel itchy skin. If demodex affects the skin of the eyelids, severe itching appears, redness of the eyes occurs, and the loss of eyelashes may begin.
Patients often complain of severe itching of the eyelids, sometimes becoming unbearable, especially in the evening, heaviness in the eyes, redness and inflammation of the edges of the eyelids (blepharitis), scanty mucous discharge from the eyes, sometimes acquiring a foamy character. The subject of anxiety (and especially in women) may be the loss of eyelashes, the appearance of multiple white scales on them. In the future, inflammation of the edge of the eyelids is joined by inflammation of the conjunctiva, which causes the presence of complaints such as redness of the eye, lacrimation, a constant feeling of a foreign body in the eye.
Diagnostics. Microscopy is used to diagnose demodecosis. If demodex has affected the eyes, then eyelashes from the lower and upper eyelids are taken for examination. Under a microscope, a tick is found on them in large quantities, as well as its eggs, discarded chitin shells. For the study, it is necessary to use the eyelashes that have just been taken from the patient. The doctor can perform the analysis directly in the presence of the patient and immediately report its results.
If the skin of the face has suffered from demodex, then a scraping is taken from its affected areas. It is also studied under a microscope. Skin scrapings are taken in the nasolabial folds, forehead, chin and cheeks. Demodex, which is considered a conditionally pathogenic tick, can be present in scrapings and in a healthy person. But in a patient with demodecosis, its number increases significantly. Before scraping, it is recommended not to wash during the day before the procedure.
Treatment. Demodecosis, unfortunately, is difficult to treat. This is a long process that requires patience and perseverance from the patient. Treatment can take from 1.5 months to half a year. Since demodecosis is often caused by disorders in the gastrointestinal tract, the patient is referred to a gastroenterologist. Diseases such as cholecystitis and pancreatitis, as well as intestinal dysbiosis, are found in most patients with demodecosis. In addition, you may need to consult a neurologist, gynecologist, endocrinologist. Getting rid of concomitant pathologies will solve the problem of demodecosis.
Treatment of demodecosis is aimed at increasing the protective properties of the body, as well as at destroying demodex, the causative agent of the disease. In addition, antihistamines are prescribed, since the tick causes allergic reactions. To combat demodex, both tablets and local remedies are used — creams, sprays, ointments. It must be admitted that the tick is reliably protected from the effects of drugs by its multi-layered outer coverings, which complicates treatment.
For each patient, the treatment of demodecosis is prescribed individually, taking into account the peculiarities of the course of the disease. To get rid of the tick, drugs containing metronidazole are used. But in recent years, cases of demodecosis have become more frequent, for the treatment of which metronidazole is not sufficiently effective. Most likely, this is due to the fact that over many years of using the drug demodex has developed resistance to it. Therefore, other substances are used, such as, for example, ornidazole.
If demodecosis has affected the eyes, then it is necessary to treat the eyelids with alcoholic solutions of herbs (calendula, eucalyptus). After that, apply ointments on them (demalan, prenacid). Demalan is considered an effective means of destroying the demodex tick. This ointment contains metronidazole and biologically active substances from the cornea of animals that stimulate tissue regeneration. Demalan is applied not only to the eyelids, but also to the affected areas of the face. Prenacid relieves the toxic allergic reaction of the skin. If purulent blepharoconjunctivitis / blepharitis has developed, antibacterial drugs are prescribed — ointments and drops of colbiocin or eubetal-an antibiotic. In addition, it is useful to self—massage the eyelids with wet fingers for 1-2 minutes. Physiotherapy procedures such as magnetotherapy, local ozone therapy are also used to treat demodecosis. After the main course of treatment, you can rub burdock oil into the edges of the eyelids for 1.5–3 months to stimulate the growth of eyelashes.
To avoid repeated self-infection, certain rules must be observed when treating demodecosis. It is necessary to change the pillowcase every day (you can cover the pillow with a cloth napkin, which is washed daily). It is recommended to wipe your face after washing with disposable paper napkins, not with a towel. You can’t give other people your own cosmetics or use someone else’s. Creams are better used in tubes, not in jars, so as not to introduce the pathogen into the cosmetic product. It is necessary to wash or clean personal items that come into contact with the skin of the face — hats, gloves, scarves. The arches of the glasses should be washed daily with warm water and soap, and shaving accessories should be treated with an alcohol solution, since they can also be infected with ticks. During treatment, alcohol and spicy food should be excluded from the diet, do not visit baths and saunas, do not spend a long time in the sun.
