1. Academic Validation
  2. Treatment of Demodex-associated inflammatory skin conditions: A systematic review

Treatment of Demodex-associated inflammatory skin conditions: A systematic review

  • Dermatol Ther. 2019 Nov;32(6):e13103. doi: 10.1111/dth.13103.
Sherin Jacob 1 Madeline A VanDaele 2 Jamie N Brown 3
Affiliations

Affiliations

  • 1 Department of Pharmacy, James J. Peters Veterans Affairs Medical Center, Bronx, New York.
  • 2 Department of Pharmacy, North Florida/South Georgia Veterans Health System, Gainesville, Florida.
  • 3 Pharmacy Service, Durham Veterans Affairs Health Care System, Durham, North Carolina.
Abstract

Bacterial folliculitis, rosacea, and other common skin conditions have been linked to infestation by Demodex mites (human demodicosis). Currently, there is little guidance for treatment of inflammatory conditions associated with demodicosis. Thus, the objective of this review is to evaluate the efficacy and safety of treatments utilized for Demodex infestation. PubMed (1946 to January 2019) and Embase (1947 to January 2019) were searched with the following term combinations: Demodex mites, Demodex folliculitis, demodicosis, Demodex folliculorum, or Demodex brevis and articles evaluating treatment of body surface colonization with Demodex mites were included. Common interventions used for Demodex infestation include metronidazole-based therapies, permethrin, benzoyl benzoate, crotamiton, lindane, and sulfur. Short courses of metronidazole taken orally have shown efficacy in reducing Demodex density. Additionally, topical administration of permethrin daily or twice daily was shown to be efficacious across multiple studies. Crotamiton and benzyl benzoate were also efficacious treatments. Several therapies were associated with mild-to-moderate skin irritation. Due to limited data, no standard of care can be identified at this time. Efficacious treatment options may include permethrin, crotamiton, benzyl benzoate, and oral metronidazole; however, long-term efficacy has not been established.

Keywords

demodicosis; folliculitis; metronidazole; mites; permethrin; rosacea.

Figures
Products