Eyelash Mites (Demodex Mites)
- Maria Cholakova
- Apr 9
- 10 min read
Eyelash mites, or Demodex mites, are tiny eight-legged creatures living in the hair follicles of your skin. It might sound alarming, but almost everyone has these mites. They usually live peacefully on our skin without causing problems. Demodex mites feed on dead skin cells and oils and are a natural cleaning crew on our eyelids. Yet, when too many mites populate the eyelash area, they can lead to eyelid inflammation. This guide explains everything you need to know about Demodex eyelash mites.
What Are Demodex Mites?
Demodex mites are microscopic parasitic mites, a type of arachnid, related to ticks and spiders. They live in or near hair follicles in mammals. Two species of Demodex live on humans: Demodex folliculorum and Demodex brevis.
Demodex folliculorum is longer (about 0.3–0.4 mm) and tends to cluster in hair follicles at the base of eyelashes, where it eats dead skin cells. Demodex brevis is a bit shorter (0.2–0.3 mm) and lives deeper in the oil (sebaceous) glands attached to hair follicles, where it feeds on the oily sebum we produce. Because they often inhabit the eyelash area, these mites are nicknamed “eyelash mites” or “face mites.”
Under a microscope, a Demodex mite looks almost worm-like due to its long, segmented body. The front segment has eight short legs and mouthparts to grip onto the hair follicle and feed. The rest of its body forms a tail shape. They are tiny (around 0.15–0.4 mm long), so you cannot see them with the naked eye.
These mites often stay hidden inside hair follicles by day and come out at night to mate on the skin’s surface, then go back into the follicles to lay eggs.
It’s a bit unsettling to imagine, but having a few eyelash mites is normal. Almost everyone has them. They usually cause no harm when in balance. It’s only when they multiply excessively that they can lead to skin or eye issues.
How Do People Get Eyelash Mites?
Eyelash mites are universally present. Studies show that as people age, the chances of having Demodex increase.
By middle age and beyond, most people host mites. One study found about 84% of people over 60 and 100% of those over 70 have Demodex on their skin, according to EyeWiki.
Newborn babies do not have face or eyelash mites, but the mites are usually acquired early in life through close contact. For example, they can transfer from mother to child through cuddling or breastfeeding. Once on our skin, the mites remain lifelong companions in our skin's micro-environment.
A few misconceptions:
You can’t get Demodex from your pets or animals
You won’t pick them up from the environment
Face and eyelash mites are species-specific. Meaning the ones that live on humans stay on humans. It usually takes direct skin-to-skin contact for the mites to transfer.
Sharing personal items that touch the face could pass along mites or other microbes. That's why, avoid sharing eye cosmetics and remove makeup before bed as part of good hygiene.
Risk Factors for Getting Eyelash Mites
So if almost everyone has Demodex, why don’t we all have eye irritation? The difference comes down to how many mites are present and a person’s risk factors. Normally, our immune system and regular washing keep the mite population in check.
Risk factors for an overgrowth of Demodex mites include:
Older age
Oily skin
High sebum production
Poor eyelid hygiene
Weak immune system
Skin conditions
Close contact with an infested person
As mentioned, eyelash mites become more common with age. Many older adults have a higher mite population only because the mites have had years to accumulate. Also, older individuals may produce a less immune response to keep mite numbers down.
Demodex feeds on oils and dead skin. During puberty and early adulthood when oil (sebum) production is high, mites have abundant food and thrive. Conversely, people with oily skin or dandruff might provide more habitat for mites.
If the eyelids remain dirty for a long time, debris and oils can build up around the eyelashes. This “grimy” environment can allow more eyelash mites to live and reproduce unchecked. The eyelids, lashes, and eyebrows may be somewhat overlooked in routine face washing, so keeping them clean is important.
People with suppressed immune systems due to HIV/AIDS, medications, chemotherapy, or long-term steroids, have trouble controlling Demodex populations, leading to overgrowth. In other words, a healthy immune system tends to keep mite numbers low. So if immunity is low, mites can multiply faster.
There is a well-known link between eyelash mites and rosacea. Rosacea patients often have higher numbers of face mites on their skin. Some studies suggest up to 18 times more than people without rosacea.
RELATED: Eye Conditions from Old Age
Symptoms of an Eyelash Mite Infestation
In most cases, a few eyelash mites won’t cause any symptoms at all. You likely won’t even know they are there. But when there is an infestation, they can irritate the eyelids and eyes.
Typical symptoms of Demodex overpopulation on the eyelashes are:
Itchy eyelids
Red, inflamed eyelid edges
Burning or stinging eyes
Dry eyes or gritty feeling
Crusty or sticky eyelashes
Eyelid pain or tenderness
Blurry vision
Lash and eye changes
These symptoms are NOT specific only to Demodex. When eyelash mites ARE the culprit, a telling sign is the presence of that “cuff” of dry discharge at the base of the lashes.
Itching is the most common symptom of eyelash mites infestation. Especially itching at the base of the eyelashes or eyebrows. Many people report intense discomfort in the morning since mites are more active at night and their waste accumulates by morning.
In addition, the eyelid margins may appear reddened and swollen overnight due to irritation of the skin and hair follicles. The eyes themselves can be a bit red, but often it’s the rims of the lids that are most inflamed. You might also feel a burning sensation or general irritation in the eyes as if they are gritty or sore.
Let's not forget, that an overgrowth of eyelash mites can disrupt the normal tear film. The eyes may feel dry, or conversely, very watery as the eyes react to the irritation. Many people describe it as feeling like there’s sand or a “foreign body” in the eye that they can’t blink away.
A visible sign of a problem with eyelash mites is crusty debris or scales at the base of the lashes, more noticeable upon waking. Some people develop “cylindrical dandruff” – a sleeve-like crust encircling the lash base. These collarettes are accumulations of mite waste, eggs, and dead skin. The eyelids can be harder to open in the morning due to crusting.
After an eyelash mites overgrowth, the lids tend to feel sore or sensitive to touch. Mild and intermittent blurry vision may result from the disrupted tear film or the eye discharge. Blinking often clears the vision, but it may blur again if the tear film is unstable.
In chronic cases, you may notice loss of eyelashes (madarosis) or misdirected inward-growing lashes (trichiasis). Usually, because of follicles damage. Recurrent styes or chalazia (pimple-like bumps on the eyelid) can occur if the eyelash mite infestation blocks the oil glands.
Consequences of Too Many Mites (Overpopulation)
When a person has too many eyelash mites, the following problems tend to follow:
Inflamed eyelids (blepharitis)
Bacterial buildup and crusts
Allergic reactions to the mites’ waste products
Blocked oil glands a.k.a. meibomian gland dysfunction causing dry eye, styes, or chalazia)
Eyelash thinning, loosening, and/or fall-out
Chronic conjunctivitis in severe cases
Corneal irritation if misdirected lashes scratch the eye
Meibomian gland dysfunction
If nothing breaks the cycle, an overpopulation of eyelash mites triggers chronic blepharitis that doesn’t go away. So you get to have persistent symptoms as described above.
Over time, chronic blepharitis damages eyelash follicles as the mites consume cells and material when laying eggs. Lashes start to fall out more easily and scar the follicle (making it difficult for new lashes to grow).
The damaged skin barrier and extra bacteria carried by eyelash mites can set the stage for secondary bacterial infections of the eyelid or conjunctiva. It may also aggravate other eye conditions.
The good news is that these consequences are preventable and treatable. With the guidance of an eye doctor, you can reduce the mite population to normal levels and allow your eyelids to heal.
Diagnosing Eyelash Mites
If you have symptoms that don’t improve with regular hygiene, consult an eye doctor. They will examine your eyelids and eyelashes for signs of Demodex mites. An experienced professional might even say they can “see Demodex from the doorway”. Referring to the distinct collarette deposits visible on the lashes.
During the exam, the doctor will likely use a slit lamp microscope with a bright light. It allows high-magnification viewing of your eyelids, lashes, and eye surfaces. The examiner will check the lids for redness, swelling, oil gland openings, crusts, and collarettes.
The doctor may take an eyelash or two for microscopic examination. Don’t worry, losing one or two eyelashes won’t harm you. Doctors tend to choose ones already loose or surrounded by debris anyway. The lash is then placed on a slide with a drop of oil or saline and examined under a microscope. Seeing the mites under the microscope provides a definitive diagnosis.
Some doctors might use other techniques such as skin scrapings or smear tests from the eyelid. Sometimes even use a confocal microscope (a special imaging device) to detect mites in the skin without removal. These tests are usually not necessary.
RELATED: What to Expect During an Eye Exam?
Treatment Options for Demodex Mites
Treatment starts by eliminating as many mites as possible from the eyelids and controlling the inflammation they cause. If you have a mild presence without symptoms, treatment might not be needed at all. But if you have bothersome symptoms, there are several effective treatments to consider:
Eyelid Hygiene and Lash Cleaning
The foundation of treatment is regular lid hygiene – in other words, keeping your eyelids and lashes very clean to remove the eyelash mites’ habitat. This involves daily gentle scrubbing of the eyelids to remove debris and dislodge mites.
Over-the-counter eyelid cleansers (lid scrubs) are available as pre-moistened pads or foam washes. Look for ones containing ingredients like tea tree oil or hypochlorous acid which can help with mites. Gently cleaning the lashes and lash line can significantly reduce eyelash mite counts over time.
Tea Tree Oil Wipes
Tea tree oil has natural acaricidal (mite-killing) properties. It has become a supplemental remedy for Demodex. Many eye doctors recommend commercially prepared tea tree oil eyelid wipes (typically containing 5–50% tea tree oil, often in the form of the active component terpinen-4-ol).
You usually close your eyes and wipe the lash area and eyebrows with these pads. This can be done daily or a few times a week as directed. Tea tree oil helps kill existing mites and their eggs. Use tea tree oil products safely: NEVER apply 100% pure tea tree oil directly on the lids, as it’s too strong and can irritate or burn the skin.
Some resources suggest applying castor oil to the eyelids at night as a home remedy. However, there is NOT enough scientific proof that castor oil is in any way effective in treating Demodex mites.
Prescription Topical Medications
Doctors can prescribe creams or ointments to eradicate eyelash mites in stubborn cases. These are applied carefully to the eyelid, usually at bedtime. Common prescription topical treatments include:
Ivermectin – an antiparasitic medicine that paralyzes and kills mites
Permethrin – an insecticidal agent often used in lice treatments; in ointment form, it can be applied to lashes to kill mites
Metronidazole or Sulfur – antiparasitic and anti-inflammatory ingredients, can reduce Demodex when compounded into eyelid creams
Prescription topical treatments should be used with care. Usually, a thin film at the lash base, avoiding getting it in the eye. They can reduce eyelash mites over a few weeks of use. Your eye doctor will determine the appropriate medication and instruct you on the proper application.
Prescription Eye Drops
In 2023, the first FDA-approved prescription eye drop for Demodex blepharitis was introduced. It’s called lotilaner ophthalmic solution 0.25% (brand name XDEMVY™). This medication was specifically developed to target Demodex mites in the eyelids. In clinical trials, lotilaner drops used twice a day significantly reduced mite infestations and improved eyelid inflammation, according to Ophthalmology Times.
The standard drops application is one drop in each eye, twice daily, for about 6 weeks. Because this treatment is new, not every provider may have adopted it yet, but it's a promising option for moderate-to-severe cases.
Procedures
Some eye clinics offer treatments like intense pulsed light (IPL) therapy or mechanical lid scrubbing devices for blepharitis. IPL is used primarily for meibomian gland dysfunction but has shown some benefit in Demodex by improving gland health (more study is needed).
Another option is a doctor-performed eyelid debridement, or cleaning with specialized tools to remove collarettes and apply mite-killing agents. These interventions apply to difficult cases.
No matter which eyelash mite treatments you choose, consistency is key. Demodex mites have a life cycle of around 2–3 weeks, so treatment often needs to continue for at least a full life cycle (4–6 weeks). That's to ensure that not only the live mites are killed, but also any eggs and newly hatched mites.
It’s common to do a course of treatment for several weeks and then re-check the eyelids. You might need to repeat or combine methods to fully get rid of eyelash mites.
Eyelash Mites Prevention Tips and Eyelid Hygiene
Hygiene and early intervention prevent a few mites from turning into an infestation.
Wash your face and eyelids daily
Remove eye makeup every night
Keep your bedding clean
Don’t rub or touch your eyes
Manage skin conditions
Go for regular eye exams
Keeping your skin clean can remove excess oils and dead skin that mites feed on. Use a gentle cleanser each morning and night. Be careful not to get soap or cleanser in your eyes. The idea is not to sterilize your skin but to avoid letting debris accumulate.
Take off mascara, eyeliner, or eye shadow, before bed. Makeup residue can clog follicles and provide food and shelter for eyelash mites. Avoid old or shared eye makeup. Replace mascara and liners every few months.
Mites can end up on your pillows and sheets. Regularly wash your pillowcases, sheets, washcloths, and towels in hot water and dry on high heat. If you’ve had a significant infestation, wash pillowcases every 2-3 days during treatment.
Fingers can transfer oils, dirt, and potentially Demodex mites, to the lashes. If your eyes are itchy, use a clean tissue or wash your hands first and then gently dab.
Manage skin conditions like rosacea or seborrheic dermatitis. Keeping those under control may also keep eyelash mites counts down.
Maintain check-ups with your eye doctor, especially if you’ve had blepharitis in the past. They can spot early signs of Demodex buildup even before you notice the symptoms, and advise preventative care.
In Summary...
Just having Demodex mites is NOT a disease – it’s a normal occurrence. Issues arise only when certain conditions allow the mite population to explode. When too many eyelash mites gather around the eyelids, they start to trigger inflammation and other problems.
External Resources:
Mayo Clinic – Blepharitis: Symptoms, Causes, and Treatments
EyeWiki (American Academy of Ophthalmology) – Demodex Infestation
American Academy of Ophthalmology – Are Tiny Mites Causing Your Blepharitis?
Michelle K Rhee, Elizabeth Yeu, Melissa Barnett, Christopher J Rapuano, Deepinder K Dhaliwal, Kelly K Nichols, Paul Karpecki, Francis S Mah, Arthur Chan, James Mun, Ian Benjamin Gaddie - Demodex Blepharitis: A Comprehensive Review of the Disease, Current Management, and Emerging Therapies. PMCID: PMC10351901, PMID: 37272680, 2023
✅ Medically reviewed
Checked by Atanas Bogoev, MD.
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