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. 2025 Jun;24(6):e70249.
doi: 10.1111/jocd.70249.

Therapeutic Modulation of Demodex Density via Isotretinoin: Insights From a Prospective Dermatological Investigation

Ahmed Muayad Jirjees Chakmakchi  1 , Emine Tugba Alatas  1 , Aslan Yurekli  1 , Ceyda Tetik Aydoğdu  1 , Suzan Demir Pektas  1
Affiliations

Therapeutic Modulation of Demodex Density via Isotretinoin: Insights From a Prospective Dermatological Investigation

Ahmed Muayad Jirjees Chakmakchi et al. J Cosmet Dermatol. 2025 Jun.

Abstract

Aim: Demodex spp. are ectoparasites that reside in pilosebaceous units, particularly on the face where sebum secretion is prominent. The sebum-reducing effects of isotretinoin play a crucial role in the management of acne vulgaris and rosacea. This study aims to assess the effect of isotretinoin on Demodex density in patients with acne vulgaris and rosacea accompanied by demodicosis. The evaluation includes Demodex mite density, before, during, and after 6 months of isotretinoin treatment.

Materials methods: The study included patients diagnosed with acne vulgaris and rosacea accompanied by demodicosis who were prescribed isotretinoin treatment. Demographic data were collected, and Demodex spp. mites were detected using superficial skin biopsy before treatment initiation. Follow-up samples were obtained at 2 and 6 months. Statistical analysis was performed using SPSS version 23, with a significance level set at p < 0.05.

Results: A total of 36 patients, 25 with acne and 11 with rosacea, were included in our study. Demodex density was assessed before treatment, at 2 months, and at 6 months. Our findings showed a significant decrease in Demodex density with isotretinoin treatment, especially in relation to the decrease in sebum secretion (p < 0.001).

Conclusion: This study makes a notable contribution to the existing literature by being the first to assess the impact of isotretinoin treatment on Demodex density. Our results indicate that isotretinoin effectively reduces Demodex density, likely due to a reduction in sebum production. To further explore isotretinoin's effects, future research should involve larger sample sizes and extended follow-up periods. These findings enhance our understanding of isotretinoin's role in managing Demodex-related dermatological conditions.

Keywords: demodex; acne vulgaris; demodicosis; isotretinoin; rosace.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Demodex density in the treatment of second month.
FIGURE 2
FIGURE 2
Demodex density in the treatment of sixth month.
FIGURE 3
FIGURE 3
Demodex density in the treatment of 0th, second and sixth months (Friedman test mean rankings).
FIGURE 4
FIGURE 4
Pairwise comparisons on Demodex density in both groups (acne and rosacea patients).
FIGURE 5
FIGURE 5
Pairwise comparisons on Demodex density in acne patients.
FIGURE 6
FIGURE 6
Pairwise comparisons on Demodex density in rosacea patients.
See this image and copyright information in PMC

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