Remember the spine-chilling creatures from Stranger Things, The Mist, or A Quiet Place? What if we told you that something just as unsettling might be living right on your eyelids — not your eyelashes, but the skin around them? Sounds gross, right? But it’s true. Demodex mites — microscopic, eight-legged intruders that make your eyelids their home. So what exactly are they, and should you be worried? Experts break it down for CE.
“Demodex mites, often called ‘eye bugs,’ are microscopic parasites that inhabit the sebaceous glands and hair follicles of the eyelids,” explains Dr Bhanu Prakash, senior consultant, cataract, cornea, and refractive surgeon at Yashoda Hospitals, Hitec City. “Though they’re a natural part of the skin’s ecosystem, problems begin when their population grows out of control, leading to a condition known as Demodex blepharitis,” says Dr Bhanu.
According to Dr Deepti Mehta, senior ophthalmologist at CARE Hospitals, Hitec City, “These mites feed on dead skin cells and oils around the lashes, which can result in symptoms like redness, itching, watering, a gritty sensation, and crust formation at the lash base. Left untreated, the condition can lead to blocked oil glands, misdirected lashes, eyelash loss, severe dry eyes, and even ulcers on the eye surface.”
Dr Bhanu further warns, “In severe cases, untreated infestations can cause permanent scarring or even vision loss, especially in people with underlying skin conditions like rosacea.”
So, where do they come from? Surprisingly, Demodex mites are typically acquired early in life — often passed from mother to child — and their numbers increase with age. “Studies show Demodex mites are found in about 13% of children aged 3–15, 69% of adults aged 31–50, and nearly 100% of people over 70,” says Dr Bhanu Prakash. “A weakened immune system, diabetes, rosacea, and advanced age all raise the risk of infestation. These mites are also nocturnal — they come out at night to feed, mate, and lay eggs, worsening inflammation and contributing to chronic eyelid disease.”
Dr Deepti Mehta adds that people with certain conditions — like diabetes, rosacea, dandruff, psoriasis, dry eye, arthritis, or weakened immunity — as well as those who wear contact lenses or eyelash extensions, are particularly vulnerable. “These mites can carry bacteria that further irritate the eyes,” she notes. Diagnosis typically involves examining the eyelids under a special microscope; in some cases, a lash is plucked and examined under magnification to confirm the presence of mites.
Prevention: Keep it clean
Good eyelid hygiene is key to keeping Demodex mites at bay. Dr Bhanu Prakash recommends frequent washing of pillowcases, avoiding shared makeup, and cleaning eyelids with gentle cleansers. Those who wear contact lenses or eyelash extensions should be especially vigilant with hygiene.
Treatment options
Treatment depends on the severity of the infestation. For mild cases, hypochlorous acid sprays or daily lid scrubs using tea tree oil-based solutions can be effective. More persistent cases might require in-office treatments like BlephEx, which exfoliates the eyelids with a microsponge, or deep-cleansing procedures using medical-grade tea tree oil.
A promising new option is Xdemvy (lotilaner), an FDA-approved eye drop used twice daily for six weeks, which specifically targets and kills Demodex mites. Additionally, topical ivermectin cream has shown success in some cases.