Demodecosis is a skin lesion caused by a conditionally pathogenic parasite – a tick of the Demodex genus.
Demodex lives in the hair follicles, in the sebaceous glands of the skin, glands of the century. Ticks are microscopic in size and not visible to the naked eye. The speed of movement of the demodex mite over the skin surface is 8–16 mm / hour. It feeds on the secretion of the sebaceous glands.
Reproduction of ticks stops outside the host. At t ° + 30 °, + 40 ° they show maximum activity, and therefore demodecosis exacerbates more often in spring – summer, during the period of maximum air temperature, after taking a hot bath, staying in a hot room for a long time, etc.
For a long time mites live in vegetable oil, petroleum jelly, cosmetic cream. Tar, kreazol , carbolic acid, chloroform, ether kill them instantly, 96 ° alcohol – in 3-4 minutes, 10 ° alcohol solution of salicylic acid – in 1 minute.
Callers demodekoz Demodex mites are found in 60% of adults, but the disease does not occur at all. In men and women, demodicosis occurs equally often. It is considered normal number of ticks 0–1pcs., Pathogenic – 3–6 ticks.
As a result of long-term coexistence, a stable equilibrium (carriage) develops between the ticks and the host, in which the effect of the parasite is balanced by the mechanisms of immunity of a healthy host host. Under the influence of various factors, the balance is disturbed, and clinical signs of demodicosis appear.
The external factors provoking the occurrence of demodicosis include: exposure to high temperatures,
adverse household and professional conditions,
Internal factors contributing to the onset of demodicosis include changes in the patient’s immune system as a result of diseases of the nervous, vascular and hormonal (for example, diabetes) systems, the gastrointestinal tract and liver, disturbances in metabolic processes, and reduced immunity.
Demodecosis of the face is manifested by reddening of the skin, expansion of the superficial vessels, small bubbles, desquamation.
Patients may complain of eye fatigue, itching of the eyelids and eyebrows, aggravated by heat, tingling, burning, feeling of a foreign body or sand in the eyes, “crawling”, heaviness of the eyelids and viscous sticky, “caustic” discharge in the morning, accumulation of foamy discharge in the corners of the eyes during the day.
Eyelid demodicosis is accompanied by dysfunction of the glands of the eyelids, skin, desquamation (scales and crusts of grayish color between eyelashes). The skin of the margins of the eyelids is slightly reddened, the mouths of the glands on the eyelids are enlarged, with pressure and massage, a thick discharge is emitted. Small pustules on the free edge of the eyelids and multiple papillary formations on the skin between the eyelashes are noticeable.
In this form of demodicosis, there can be scanty, often foamy, mucous discharge from the eyes. As a result of the dysfunction of the glands of the eyelid, the layer of the tear film decreases, its evaporation increases, leading to the development of “dry eye” syndrome.
The analysis for demodicosis is carried out directly by an optometrist or a dermatologist.
Diagnosis of eye demodicosis (ciliary test) is extremely simple, does not require special training, is carried out in the presence of the patient in the doctor’s office, carried out by identifying ticks on remote eyelashes. Freshly removed eyelashes (4 pieces each from the upper and lower eyelids) are placed on a glass slide for examination, pour 10–20% solution of caustic alkali, gasoline, kerosene or glycerin, cover with another glass and examine under a microscope.
Scraping for demodicosis from the skin is performed by a dermatologist: a scraping is taken from the affected area with a scalpel or the contents of acne are squeezed out. The resulting material is then placed on a glass slide and examined in the same way as with a ciliary test.
The method of “sticking” – a special adhesive tape is applied to the affected skin from evening to night. In the morning, the tape is peeled off, also placed between two glass slides, after which the microsporia of the biomaterial is performed.
When demodex mites are detected under a microscope, adults are counted. If their number is 1 square. see more than 5, then the diagnosis of demodicosis is confirmed and requires qualified treatment.
Long-term treatment of demodicosis , up to 6–8 weeks, is prescribed by an ophthalmologist (for the ophthalmic form of demodicosis ) or by a dermatologist (for the skin form).
The main therapy is the use of tick-borne drugs: 1–2% yellow mercury ointment and zinc- thiol paste. In addition, the funds from demodicosis should have a disinfecting and anti-inflammatory effect, as well as help reduce sebum production.
Important! The use of yellow mercury ointment for demodicosis due to high toxicity does not exceed 4 weeks, it is contraindicated in pregnancy.
For the treatment of facial demodicosis , the following are used:
- Sulfuric ointment;
- benzyl benzoate;
- 1% permethrin ointment;
- 1% lindane;
- 10% Crotamiton ( Jurax ).
Against demodicosis of the eye will be effective agents used in the treatment of glaucoma:
- physostigmine, 0.02%;
- phosphacol , 0.01%;
- Armin , 0.5%;
Their active ingredients paralyze the mite muscles. Lubrication of the margins of the eyelids with 4% pilocarpine gel or treatment of them with a thin bunny moistened with a 1.5–3% solution of carbachol also reduces the motor activity of the tick, leading to its complete paralysis.
Good results in the treatment of demodicosis were obtained using a cream or gel of 2% metronidazole ( Klion , Metrogil , Metroseptol ).
To the note: ointments with hormones (for example, hydrocortisone ophthalmic) reduce local immunity and lead to an increase in the number of ticks, therefore they are not included in the treatment regimen of demodicosis .
Auxiliary treatment of demodicosis:
preparations of artificial tears in the “dry” eye syndrome (eye drops);
treatment of eyelid margins with dimexide solution , water extract of tansy, alcohol tincture of wormwood;
eyelid massage in violation of the function of the eyelid glands;
physiotherapy: D’Arsonval , magnet, electrophoresis for eyelids with dimedrol, zinc sulfate, 2% calcium chloride, 3% potassium iodide.
In the course of treatment, it is necessary to properly care for the affected skin. For the local cleansing of the skin from sebum and waste products of the tick, soft caring procedures are suitable: scrub or peeling. However, their use should be coordinated with the attending physician, as some cosmetics withdemodicosis can not only reduce the effectiveness of treatment, but also cause an exacerbation of the disease.
It is important to conduct treatment of concomitant diseases of the gastrointestinal tract and liver, correction of immunological and metabolic disorders, treatment of foci of chronic infection, treatment of seborrhea, optical correction of visual impairment.
An integral part of the treatment regimen of demodicosis is diet therapy: salty, pepper, spicy, sweet foods should be excluded from the patient’s diet. Alcohol is also prohibited.
Folk remedies for demodicosis
Regarding the use of traditional medicine for the treatment of demodicosis should be sure to consult with your doctor.
With eyelid demodicosis, lotions from oak bark or aloe juice are the most effective. A decoction of bitter wormwood can be taken inside, and infusion of celandine to lubricate the affected area in the skin form of the disease.
A prerequisite for obtaining a positive result in the treatment of demodicosis with folk remedies is the duration and regularity: in unallocated cases of the disease, the tick population is significantly reduced.
Recommendations for more effective treatment
During the treatment of demodicosis, it is desirable to observe the following rules:
- to wipe the face with ordinary towels, replace with disposable cloths;
- personal items (hat, scarf, mittens or gloves, clothes) should be washed at least once every 2 days;
- bed linen changed daily;
- process glasses, a razor and their cases, tweezers and tweezers, and other cosmetic accessories with alcohol or any skin antiseptic regularly;
- replace feather or down pillows with padding polyester;
- temporarily abandon the use of caring and decorative cosmetics;
- check pets for demodicosis.
After the main course of treatment, rubbing oil at the edges of the eyelids for 1.5–3 months is recommended to stimulate eyelash growth.
The period of remission of demodicosis lasts from 3 months to a year, depending on skin type, age, and the presence of concomitant diseases of internal organs. 10% of patients treated had relapses, more often due to incomplete treatment or non-compliance by the patient with all medical recommendations.