Eyelash mites (yikes!) are a lot more common than most people realize

USA Today

6 days ago

The idea of tiny bugs living in your eyelashes might sound like something out of a horror movie, but their reality is far less alarming. Microscopic mites are incredibly common and, for the most part, as harmless as they are helpful. 'Most everyone has some eyelash mites,' says Dr. Damaris Raymondi, an optometrist at Sur Eye Care in Queens, New York. More than that, she adds, 'they're a normal part of our body's microbiome.'
At the same time, these little critters can trigger irritation, inflammation and even contribute to more serious eye conditions if their population gets out of control. Here's what eyelash mites really are, why they sometimes become a problem and how to prevent that from happening.
What are eyelash mites?
Eyelash mites, formally called Demodex, are microscopic arachnids that inhabit the hair follicles and tiny glands of the face, especially around our eyes. 'They are tiny, eight-legged critters that live in our hair follicles, including our eyelashes,' says Raymondi. More specifically, they spend most of their lives burrowed deep at the base of our lashes.
While that might sound eerie, they're not invaders in the way we typically think of pests or parasites. Rather, they are part of our skin's natural ecosystem – and even serve some useful purposes. 'These mites are responsible for eating the dead skin cells and oils that our body sheds daily,' explains Raymondi. Most of us never even know they're there.
Humans host two species of these mites: Demodex folliculorum and Demodex brevis, explains Dr. Roberto Ricardo-Gonzalez, a dermatologist and microbiologist at the University of California, San Francisco (UCSF) Medical Center. 'Like most arthropods, both species have a rigid outer covering (exoskeleton) protecting their bodies,' he notes.
Of the two species, he adds, D. folliculorum is primarily found in eyelash follicles, while D. brevis tends to occupy skin glands that produce sebum, an oily substance our bodies need to hydrate skin. No matter where they are, both species of mites are only about 0.3 millimeters long – roughly the size of a single grain of very fine sand – making them invisible to the naked eye.
What causes eyelash mites to become an issue?
The mere presence of eyelash mites isn't usually a problem. But issues arise when their numbers surge, which can lead to a condition called demodicosis. 'Our bodies can typically control the number of mites to a low level,' says Ricardo-Gonzalez. 'But when their population increases substantially, it can lead to irritation, redness, inflammation and occasional itching.'
You may also experience 'crusting and flaking at the base of your eyelashes,' adds Raymondi. 'An overgrowth may even cause your eyelashes to appear shorter or to fall out.' In some cases, demodicosis can also contribute to more serious eye conditions such as blepharitis – an inflammatory condition of the eyelids.
Several factors can trigger an overpopulation of mites. Since they feed on dead skin cells and sebum, an abundance of either can increase their numbers, explains Ricardo-Gonzalez. Poor eyelid hygiene is another culprit, especially if makeup or other facial products aren't properly or thoroughly removed after use. Eyelash extensions have also been shown to potentially cause buildup to occur. Ditto for poorly cleaned contact lenses.
"Mite overgrowth is also associated with skin conditions like rosacea and seborrheic dermatitis," adds Dr. Cory Lappin, an optometrist and founder of the Dry Eye Center in Cincinnati, Ohio. "And patients with a weakened immune system may be at a greater risk of mite overpopulation due to such a system being less effective at keeping them in check."
Age is another factor to be aware of. 'Many elderly folks have an overpopulation of these mites,' notes Raymondi. This is mainly due to mites naturally accumulating more over time.
How to get rid of eyelash mites
Fortunately, there are several effective ways of treating and managing issues like itching, crusting or redness that are caused by mite overgrowth. For example, gently cleaning your eyelids with diluted tea tree oil or specially formulated lid scrubs can help. 'Tea tree oil contains compounds toxic to Demodex mites, but it should never be applied directly to the eye,' cautions Raymondi. Warm compresses can also loosen debris and calm inflammation.
Raymondi also cites an FDA-approved lotilaner ophthalmic solution called Xdemvy. 'This is a prescription eye drop that you can get from your eye doctor,' she explains. 'This and other anti-parasitic medications such as ivermectin can effectively kill eyelash mites,' echoes Ricardo-Gonzalez. 'But these medications should only be used as directed by your doctor.' In more severe or persistent cases, an ophthalmologist may also recommend in-office treatments like professional eyelid exfoliation.
Preventing overpopulation from returning is also important. 'Good hygiene is essential to keep skin debris and oil at a normal level,' Ricardo-Gonzalez advises. Removing all eye makeup each day is also key.
But as you do so, remember that complete eradication isn't the goal. 'These mites are part of our ecosystem,' Raymondi stresses. 'The goal is to manage their numbers and restore balance.'