Demodex is a genus of tiny parasitic mites that live in or near hair follicles of mammals. Two species living on humans have been identified: Demodex folliculorum and brevis, both frequently referred to as eyelash mites. Demodex folliculorum and Demodex brevis are typically found on humans. Both species are primarily found in the face, near the nose, the eyelashes and eyebrows, but also occur elsewhere on the body. Mite characteristics – The adult mites are only between 0.3mm and 0.4mm long. They have a semi-transparent elongated body that consists of two fused segments. Eight short segmented legs are attached to the first body segment.
The body is covered with scales for anchoring itself in the hair follicle, and the mite has pin-like mouth-parts for eating skin-cells, hormones and oils (sebum) which accumulate in the hair follicles. The mites can leave the hair follicles and slowly walk around on the skin, at a speed of about 8–16 cm/hour, especially at night; they try to avoid light.
Treatment for mites – There is considerable evidence linking demodex mites to some forms of the skin disease, especially rosacea. Treatment of mites is possible with certain creams but by far the most successful is by micro-fractional Co2 laser which even on low settings devastates not only the mites themselves (as they are especially photogenic with high sensitivity to all light) but all traces of eggs and larvae. The laser light particles have an exceptionally high level of effectiveness, and on a medium setting destroy mites even in eyelashes and eyebrows up to 4000 microns (4mm) distant from the delivery site. For unknown reasons eradication of facial mites appears to be long-lasting with no signs of recurrence on clinical trial patients even after 6 years.
What exactly are demodex?
Demodex is the name given to tiny mites that live in the hair follicle. In humans, demodex is found on facial skin especially the forehead, cheeks, sides of the nose, eyelashes and external ear canals. It sometimes causes a condition called demodicosis.
There are two mites principally involved in human demodex infestations, Demodex folliculorum and Demodex brevis. The folliculorum variety is found in small hair follicles, particularly the eyelashes. In both its immature and adult stages it feeds on skin cells. D. brevis is found in the oil glands that are connected to small hair follicles and feeds on the gland cells and mainly in animals.
D. folliculorum mites are 0.3-0.4mm in length and D. brevis 0.15-0.2mm. This makes them invisible to the naked eye but under the microscope their structure is clearly visible. The 8 legs of this mite move at a rate of 8-16 mm/h and this is mainly done during the night as bright light causes the mite to recede back into the follicle.
Who has demodex and demodicosis?
Human demodex mites are a normal finding in older children and adults and rarely in children under 5 years old. Demodicosis is usually diagnosed in older adults.
What are the features of this disorder?
Demodicosis results in non-specific symptoms and signs on facial skin. These most often include:
- Follicular scales
- Redness (rosacea)
- Sensitive skin, soreness
- Itch and discomfort on the face.
- Macules, papules, eczema, folliculitis and pigmentation have also been described.
- Demodex folliculorum – rough skin due to increased scale within hair follicles
- Demodectic frost of the ear – frosted, gritty follicular scaling of the ear lobe and helix
- Demodex abscess
What is the treatment for removal of demodex?
Demodex can only live in the human hair follicle and when kept in check they cause no problems. But when the immune system is impaired, e.g. pregnancy or illness, demodex multiply rapidly. They can however be quickly and permanently removed.
By far the best treatment is the skillful use of fractional lasers, with different settings on various parts of the face. Co2 lasers with the correct pulse time, area of the scanner and depth of penetration not only kills the demodex completely but as importantly destroys the eggs, usually for many years and some of Aquarius’s patients have remained clear of infestation for over 9 years with no sign of recurrence.
This result with a laser treatment not only promotes collagen fibers to soften the elasticity of the skin but destroys demodex mites even from 3-4mm from a distance of the laser beam, which is important when treating around the eyes where a large proportion of the mites exist.
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