Demodex (Face Mites)

What is Demodex?

Demodex is a genus of microscopic mites that live in human hair follicles. The tiny creatures are arachnids, cousins of spiders and ticks.

Almost everyone has Demodex mites living on their skin and in their pores, particularly their:

• Cheeks.
• Eyelashes.
• Forehead.
• Outside of ear canals.
• Sides of the nose.

Usually, the mites don’t cause any harm. But too many can cause a skin condition called demodicosis (also called Demodex folliculitis).

Are there different types of Demodex mites?

Two main species of Demodex live on humans:

• Demodex folliculorum: D. folliculorum usually lives in smaller hair follicles, especially your eyelashes. They eat skin cells.
• Demodex brevis: D. brevis usually lives near the oil glands in hair follicles. They eat sebum, a greasy substance made by oil glands.

What do Demodex mites look like?

A Demodex mite is extremely tiny (0.15 millimeters [mm]­–0.4 mm). It would take several of them to cover a pinhead.

Under a microscope, the mite looks slightly transparent and is covered with scales. It has an elongated body with two segments. The first segment has eight legs and a mouth.

When you sleep, the mites come out of your skin’s pores, mate, then go back into your skin to lay eggs.

How common is demodicosis?

Although Demodex mites are very common, demodicosis is relatively rare.

Who might get demodicosis?

Demodicosis is more likely to occur in people who:

• Are receiving immunosuppressants (for example, after organ transplantation).
• Are receiving chemotherapy.
• Have an immunodeficiency disease such as HIV and AIDS.
• Have other skin conditions, such as rosacea.
• Use itch-relieving creams on their face, such as hydrocortisone cream.

What causes demodicosis?

Demodicosis occurs when the face mites multiply out of control. This usually occurs because your immune system isn’t functioning well.

What are the symptoms of Demodex folliculitis?

The symptoms of demodicosis appear very suddenly, seemingly overnight. You may experience any of the following:

• Burning sensation.
• Itchiness.
• Pustules that look like whiteheads.
• Redness.
• Rough feeling on your skin, like sandpaper.
• Scales, perhaps resembling eczema.
• Sensitive skin.
• White sheen on your skin or eyelashes.

If the condition affects your eyes, you may experience:

• Decreased vision.
• Eye irritation and itchiness.
• Loss of lashes.
• Thickened or scaly eyelids.

Are Demodex mites contagious?

Demodex mites can spread from human to human. Babies aren’t born with mites, but they get mites from the people they live with.

How is Demodex folliculitis diagnosed?

If you suspect you have an infestation of Demodex mites that’s causing symptoms, talk to your healthcare provider or a dermatologist.

They might conduct a test, such as:

• Dermoscopy, a procedure that uses a powerful light and magnifying lens. The test may reveal spiky white structures in your pores.
• Skin biopsy, which takes a sample of your skin for examination under a microscope.
• Skin scraping, which takes a small sample of cells and oils from the top of your skin.

How is demodicosis treated?

Most people have Demodex mites on their skin. You don’t need treatment unless the mites grow out of control and cause symptoms.

Treatment for a mite infestation usually involves a cream, gel, lotion or wash containing an acaricide. An acaricide is a pesticide that kills ticks and mites.

Your healthcare provider may recommend:

• Benzyl benzoate.
• Crotamiton.
• Ivermectin.
• Metronidazole.
• Permethrin.
• Salicylic acid.
• Selenium sulfide.
• Sulfur products.

How can I reduce my risk of demodicosis?

You can’t wash or scrub all Demodex mites away. But you may be able to help prevent infestation by keeping your skin clean. This removes the extra oil and dead skin cells the mites eat. For example:

• Avoid thick, greasy skin products that can clog pores with skin cells and oil.
• Gently exfoliate your skin once a week.
• Wash your face twice a day.

What can I expect if I have demodicosis?

The prognosis with demodicosis depends on the cause. If you have an immunodeficiency condition, demodicosis can occur repeatedly.

How do I get rid of face mites at home?

Removing face mites on your own usually isn’t successful. If you have demodicosis, talk to your healthcare provider. They can help you treat the issue safely and effectively. In the meantime, continue washing your face twice a day with a mild cleanser.

A note from Cleveland Clinic

Demodex mites live inside almost every human’s hair follicles. The mites usually don’t cause any problems, but if they multiply too much, they can cause demodicosis. If you have itchy, bumpy or red skin on your face, talk to your healthcare provider or dermatologist.