Demodex & Eyelash Extensions

Have you seen an uptick in eyelash lice or Demodex with your patients in the last few years?

There seems to be an increase in the number of diagnosed case of Blepharitis (inflammation of the eyelids) among our patient population. Two main contributors to anterior Blepharitis are bacterial overgrowth and demodex (eyelash lice).

Demodex has a classical presentation known as cylindrical dandruff which resides at the base of the eyelashes. Patients may present asymptomatically (we see signs but they don’t experience any discomfort). On the other hand, those who are symptomatic may report itchy eyes, fluctuating vision, epiphora/tearing, lash loss, and overall conjunctival injection (red eyes). Both types of patients should be treated to avoid long term complications.

Have you seen an uptick in eyelash lice or Demodex with patients who have eyelash extensions specifically?

At Beverly Hills Optometry: Advanced Dry Eye Center, we seek to properly diagnose and treat ocular surface disease. One of the leading causes of dry eye disease is blepharitis. The frequency with which we diagnose Demodex seems to be on the rise among male patients who don’t have good eyelid hygiene techniques as well as women with eyelash extension. The eyelash extension act as a sort of sponge for bacterial buildup which is an ideal environment for Demodex to thrive.

If so, how many cases so far have you seen?

In the past five years, we treated 100s of cases of Blepharitis and over fifty percent of those cases were Demodex Blepharitis. 

Have you seen any research that suggests an uptick in eyelash lice with eyelash extensions?

More clinical experience with false lashes and Demodex. There are numerous studies on Demodex mites and it’s role in Blepharitis and rosacea.

Would Demodex primarily affect people with eyelash extensions? Since Demodex can live anywhere on the face and other parts of the body?

Demodex live dormant on skin, when there’s an imbalance or overgrowth then they can cause various issues and symptoms for the patient(s). Unfortunately many of these women with false lashes avoid washing their eyelashes because they are worried that they may ruin the extensions; thus, creating an ideal environment for Demodex to flourish.  

Demodex is often the main contributor to chronic Blepharitis (anterior and posterior) which can worsen MGD and evaporative dry eye. 

Another subset of the population, patients who Rosacea, are at a higher risk of developing demodex Blepharitis, according to the National Rosacea Society. 

In our practice, we also warn against using oil-based cosmetics; instead we support the use of water-based makeup. ideally, treatment with in-office device, BlephEx, in combination with at-home, diluted tea tree oil (TTO)  such as Ocusoft Demodex wipes or foam work best to eradicate the mites.

Please feel free to visit Fox News LA (where the author of the article quotes Dr Silani): 

https://www.foxla.com/news/amid-popularity-of-eyelash-extensions-some-doctors-see-uptick-in-lash-mites-due-to-poor-hygiene