Concurrent ocular and facial treatments for demodicosis improve outcomes

A recent study published in the American Journal of Ophthalmology unveiled a significant link between ocular and facial demodicosis, shedding light on more effective treatment methods. The study by Wei-Lun Huang and team aimed to investigate the association between these two conditions and assess the impact of facial treatment on ocular demodicosis.

Between April and December 2020, 89 outpatients suffering from ocular demodicosis were enrolled in the study. Diagnosis relied on the epilation of four eyelashes from each upper eyelid, with a high ocular Demodex load (ODL) defined as eight or more mites per eye. Facial infestation was evaluated through direct microscopic examination, identifying facial Demodex overgrowth (FDO) as a density exceeding five mites per square centimeter. All patients were prescribed a three-month ocular treatment, and FDO patients received dermatologic care.

The results, based on patients who completed the treatment regimen, are eye-opening. Patients with low ODL had lower cylindrical sleeve counts compared to those with high ODL (8 vs. 14, P = 0.009). Notably, the prevalence of FDO was significantly lower in this group (49% vs. 77%, P = 0.012).

Moreover, the Ocular Surface Disease Index score showed marked improvement in patients without FDO, decreasing from 20.0 ± 17.1 to 14.0 ± 16.6 after three months of topical tea tree oil treatment (P = 0.027). Additionally, topical ivermectin treatment on facial skin exhibited a remarkable ocular Demodex eradication rate in FDO patients, with a striking 76% success rate compared to only 16% for those without this dermatological intervention (P < 0.001).

The findings suggest a close connection between ocular and facial demodicosis, particularly in cases of severe ocular demodicosis. While ocular treatment alone proves effective for patients solely suffering from ocular demodicosis, the introduction of topical ivermectin treatment on facial skin substantially enhances ocular Demodex eradication in patients concurrently battling facial Demodex overgrowth.

These results offer new hope and a more effective treatment path for demodicosis patients. Further research may build upon this foundation, potentially transforming the way medical professionals approach and manage these related conditions.

Source:

Huang, W.-L., Huang, C.-M., Chu, C.-Y., & Hu, F.-R. (2023). Comorbidity of Ocular and Facial Demodicosis. In American Journal of Ophthalmology. Elsevier BV. https://doi.org/10.1016/j.ajo.2023.09.010