Demodicosis in Different Age Groups and Alternative Treatment Options-A Review

Abstract

Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children.

Keywords: Demodex spp.; bacterial coinfections; demodicosis; essential oils.

Figure 1

Life cycle of the Demodex mite.

Figure 2

Ocular and blepharal manifestations of demodicosis in adults (authors’ own archive): (a) Patient with scales on the eyelashes, eyelid changes (dry, reddened skin lesion); (b) patient with conjunctivitis and slight swelling of the upper and lower eyelids; (c) patient with conjunctivitis, falling eyelashes (eyelash loss) on the lower eyelid and the beginning of abnormal growth of eyelashes on the upper eyelid; (d) patient with a chalazion in the course of demodicosis.

Figure 3

Dermatological manifestations of demodicosis in adults (authors’ own archive): (a) Patient with acute skin lesions (rosacea); (b) patient with cutaneous demodicosis and bacterial co-infection (S. aureus); (c) patient with single skin lesions; (d) patient with typical skin lesions caused by Demodex spp. on the nose, so-called “Demodex nose”.

Figure 4

Demodex folliculorum (a) and D. brevis (b) under a light microscope, magnification 100×, authors’ samples.