Demodex- NOT just a myth....

[Rebecca Petris]

For those who want more information please see the study:

http://bjo.bmjjournals.com/cgi/conte...act/89/11/1468 - abstract

http://bjo.bmjjournals.com/cgi/content/full/89/11/1468 - full text

Excerpts:

Lid scrub with TTO

In the office, after we administered a drop of 0.5% oxybuprocaine (proparacaine), a cotton tip wetted in 50% TTO was used to scrub the lash roots from one end to the other as one stroke. A total of six strokes were applied to each lid. A dry cotton tip was then used to remove excess TTO from the lid margin. Because TTO scrub not only loosened CD but also stimulated Demodex to move out to the skin (see Results), a dry cotton tip was used to remove CD 5 minutes later. After another 5 minutes, the second lid scrub with TTO was applied in the same manner. Following 10 minutes of rest, the third TTO lid scrub was applied. If there was any irritation, the eye was rinsed with non-preserved saline. This office scrub was repeated weekly until the Demodex count reached 0 for two consecutive visits.

Home lid scrub and other instructions

At home, the patient was asked to mix 0.5 ml of TT shampoo with tap water in both middle fingers. With eyes closed, the lids were massaged with a medium pressure for 3–5 minutes. The skin was then rinsed with clean water and dried with a towel. Such home lid scrub was practised twice daily for 1 month and then once daily thereafter. In addition, the patient was also instructed to discard used facial make-up, and wash the hair, the face, nostrils, the external ear and the neck with TT shampoo daily. The bedding and pillow cases were washed with hot water and dried in a heated dryer immediately after the first office scrub, and once a week thereafter. If the spouse also complained of similar eye irritation, the same home lid scrub was also practised.

I WOULD LIKE TO SAY THAT IF YOU'RE CONSIDERING THIS, I WOULD URGE YOU TO DO IT ONLY UNDER A DOCTOR'S SUPERVISION.

[maria]

'The oil he gave me was 50% tea tree oil and 50% mac nut oil'

I mix the tea tree oil with johnsons baby oil.

[GeorgeT]

Hi Maria,
The creme I use for acne can be found in WALLMART in US and is called ACNEFREE. Use can buy it from the internet at: http://www.acnefree.com/node/17?source=goog&kw=[acne+free]
What type of acne you have? Mine is not bad, a few pimples here and there, and is not rosacea.

Thanks,

George

[maria]

Hi George,
I did not have acne, just a swollen face, with flushing. People react to demodex in many different ways. Now my face is normal. I used a cream from demodex solutions, and that has worked very well for me, in terms of ridding my face of demodex.

[Maria1972]

How do you knwo you have these mites?

[maria]

Studies vary, but it is generally believed that most people carry some demodex mites without showing any symptoms at all, and that the body's immune system keeps the mite population down to a level where they do not become pathogenic. When a persons immune system is not functioning at full capacity, the mites proliferate to levels where they become a problem and need to be reduced back to 'normal' levels. You can tell if you have them by becoming aware of facial itching during the day and at night. The mites particularly like the area around the nares of the nose, also the eyes and chin. Since I started treating for mites my face rarely ever itches.

[np1981]

In my case the Dr sampled a few lashes and showed me something like this:

http://www.demodexsolutions.com/alla...vis_6_main.jpg

[Maria1972]

They look as bad as I thought! Thanks for sharing the picture. Are you treating yours with tea tree scrubs as well?
My immune sustme is not working properly for a few years now. I get all sort of infections, UTIs, yeast, very easily. Just a simple cold turns into otitis and lasts more than 2 weeks!
So it may be worth looking into this demodexl.... I would not be surprised.

[YGB]

I am now 6 months post-LASIK and still struggling with the effects of dry eyes to do many of the things I used to be able to do. However, I do find that if I look month to month, I am seeing improvement but it is slower than I'd like. Therefore, I decided to visit Dr. Scheffer Tseng in Miami, FL last week http://www.ocularsurface.com/.

The visit lasted almost 3 hours with lots of testing. I was very impressed with the amount of testing done since most of the time, the MD's just looks at my eye with a slit lamp and says they are dry. Dr. Tseng's assistant did various tests and the findings were similar to my oph. MD's (i.e. meibomian gland dysfunction (MGD) and tear deficiency). They also plucked about 5 eyelashes from each eye and found that I had a potential over-population of Demodex. Dr. Tseng said that it is possible that Demodex can overpopulate when the "wires are cut" in LASIK and that therefore demodex concomitant with LASIK can cause MGD and other dry eye issues. Dr. Tseng told me to follow a Tea Tree oil and Tea Tree shampoo regiment for 1 month to eradicate the Demodex. He then said to see him in 2 months and if there was not enough improvement, he would express my meibomian glands since they were "constipated".

While I have included some instructions for using the Tea Tree Shampoo, I cannot recommend that the readers of this post do the tea tree oil treatment without consulting a knowledgable MD since this process requires using the concentrated oil along the lid margins with a q-tip and if it gets in your eye, it burns for awhile.

Since I realize that not everybody is going to make the trip down to see Dr. Tseng, I figured I would let you all know what the treatment is that he recommended for eradicating the demodex using the shampoo.

Here are the instructions for domestic (home) lid scrub's as prescribed by the Dr. Tseng's office:

1. Squeeze .5 ml of Tea Tree Shampoo at both middle fingers, mix with water to generate the shampoo foaming (I also wet the eyes first to assist in foaming).

2. Close the eyes and massage the Tea Tree shampoo on both eyelids and lashes with a medium pressure for 3 to 5 minutes.

3. Rinse with a lot of clean water

4. Dry the lids with towel

5. Apply the procedure twice daily for one month and then apply it daily.

I would recommend that you maybe try using Tea Tree Shampoo in the shower on your hair, face, eyes, nose, chin, eye lashes (with eyes closed), ears, neck, etc.. Doing the shampoo scrub on the eyes for 3-5 minutes one other time a day in the first month with the tea tree shampoo is also good. Just be sure to rinse well with water before opening your eyes. The shampoo is not as potent as the oil though so the sting wouldn't be as bad. Also, one of the signs of an over-population of demodex is crooked eyelashes. The demodex redproduce at night so doing a shampoo application in the shower before bed may be best.

I've included a web link to "Dr. D's Tea Tree Shampoo" ... http://www.drdshcp.com/personalcare.html.
This is exactly the same shampoo that Dr. Tseng gives to his patients in the clinic. Note that I had a different bottle of Tea Tree shampoo at home and the ingredients were totally different (barey any tea tree oil). Therefore, going with Dr. D's might be the way to go.

I have been doing the application for about 1 week so it's too early to say whether it will help a lot. However, seeing these mites on my eyelashes under a microscope makes me want to get rid of them regardless. It certainly can't hurt to try to get rid of them (unless you get too much soap in your eyes ). Note that most people have Demodex. Whether people have an overpopulation of Demodex would likely require a trip to an MD who is knowledgable in this area and would be willing to take the time to check and has a microscope on hand.

[Jade9923]

Can a regular opthamologist see these mites on your eyelashes while they are doing their routine exam of your eyes with their slit lamp etc?? Do they need special equipment? Is it necessary for them to remove a few eyelashes or can they just see them on your eyelashes as they look at them thru their equipment?

[YGB]

The mites typically cannot be seen through a slit lamp. The reason is that per Dr. Tseng, the demodex/mites only come out toward the eyelash surface at night to reproduce. That's why it's good to do a shampoo scrub before bed. In the daytime, mites are further in the eye toward the base of the eyelash and that's why they had to pull the eyelashes (it doesn't hurt much). They then have to check the eyelashes through a microscope.

Dr. Tseng instructed his assistant as to which areas to pull the lashes from based on how my eyelashes looked to him. Again, crooked or white looking eyelashes are a sign of over-infestation. Also, anytime the eye has a suppressed immune system, there is a risk of mite overinfestation. In my case, LASIK was my immune suppressant. However, there are many other immune deficiency disorders such as Sjorgen's. Also, Restasis itself suppresses the immune cells in the eye so I suppose it is conceivable that Restasis can potentially add to the risk of demodex overpopulation (that's just my layman's opinion of putting what seems like 1+1 together). I am not looking to make everyone fear the possibility that they have a high population of demodex in their eyes. I am just looking to share some information in case it may help some who feel like they've already tried everything and nothing has helped much. I think Dr. Tseng made an interesting analogy when he compared demodex to dust mites. Most people can do just fine with dust and dust mites. However, there are some who can have an allergic reaction to dust. What he is looking to do is rule out the possibility that I may be one of those people who is having a reaction to too many mites in my eyes since my immune system was short-circuited for awhile causing these mites to over-populate. I'll take this type of proactive approach any day over MD's just putting me in a standard dry eye diagnosis box and telling me to just use doxycycline, restasis, and artificial tears and then, in essence, just keep my fingers crossed that time will heal.

http://bjo.bmj.com/cgi/content/full/89/11/1468

[Lucy]

YGB--thanks for posting this. This kind of info is really important, being detailed and clear.

Not sure if I have the little critters, but I'm ordering several bottles of Dr. D's tea tree shampoo from the site you gave us. Thanks.

Lucy

[Lucy]

OK, the old Visa just went up $44. 3 bars of soap and 3 shampoo. Don't know if I have "these", but I know the products are good and I'll be able to use them in any event. Wouldn't it be a WONDER if this did make me (some) better? Like I said, these are products I'll use no matter what. Will report any differences I may notice after using for awhile.

[Lucy]

Got my package from Dr. D's today. Fast service. The soap has an unusual smell to it. Now, I need to go back and read the instructions on how to use the shampoo on the peepers.

Lucy

[YGB]

I just wanted to update all of you on my second visit with Dr. Tseng yesterday (2/7). As with my first visit, I was impressed with the thoroughness provided by Dr. Tseng and his fellows. It would be nice if his clinic would be a model of how all dry eye clinics should run.

The visit yesterday took about 1.5 hours with a cost of approx. $300. I am still lipid/oil deficient although it has improved in the last 2 months. The hope was that eradicating the demodex on my lids would help the oil production. I went from having 11 out of 12 lids with demodex 2 month ago to having 1 out of 12 lids with demodex yesterday. However, since there is still at least one critter still there and since my meibomian glands are still not functioning normally, Dr. Tseng recommended another month of tea tree oil treatment once a week + tea tree shampoo treatment as stated in a prior post.

Also, my dry eye symptoms have changed over the last 2 months. 2 months ago, I had very frequent dry eyes, scratchiness when blinking, foreign body feeling, etc.. Now, I still have dry eyes but my main symptom is an aching pain that resonates through my temple region toward the back of my head (and even toward my teeth as well). Does anyone else get this pain? If so, has it been diagnosed?

Dr. Tseng believes it is a type of neuralgia. He said that treatment of this is not directly eye related. He recommended that I use ben gay (or something like it) on my shoulder and back of the neck area, that I make sure my pillow/head is properly aligned, and that I get better sleep (he recommended 100mg DHEA supplement to help). I also plan on seeing my acupuncturist several times in the next month to help this process along.

The hope is that I will continue seeing improvement in the next month or two as I have done in the past two months. Just wanted to provide an update for those who may be interested in seeing Dr. Tseng. As you can see, like everybody else, he doesn't have the magic answer. However, I am impressed with the fact that he and his group are very thorough and help the patient develop good plans of action with appropriate next steps. Best. YGB

P.S. Dr. Tseng suggested that I hold off on the bandage lens trial until my oil/tear film improves or I put in at least a plug in each eye (future possible steps). His thought was that at this point, my eyes are not at the proper point to provide a good indicator of whether the lenses will help or not. Like most MD's, Dr. Tseng does not like to change too many variables at one time. Therefore, the lenses are in the plans if needed, but likely at least 1-2 months out.