From the Guidelines
Recurring hordeolum (styes) are not typically caused by Demodex mites, but rather by bacterial infections, usually Staphylococcus. If you're experiencing frequent styes, you should clean your eyelids daily with baby shampoo or commercial eyelid cleanser to remove oils and debris. Apply warm compresses for 10-15 minutes, 3-4 times daily to help drain the stye. For persistent cases, your doctor may prescribe antibiotic ointments like erythromycin or bacitracin to apply to the eyelid margin, or oral antibiotics such as doxycycline 100mg twice daily for 7-10 days for more severe infections 1.
However, if you suspect Demodex mites (which typically cause blepharitis rather than styes), tea tree oil products specifically formulated for eyelids, such as 5% tea tree oil wipes or 50% tea tree oil applied with a cotton swab to the lash base, can be effective when used daily for 4-6 weeks 1. These mites live in hair follicles and oil glands and can contribute to eyelid inflammation. Some key points to consider:
- Demodex folliculorum has been found in 30% to 68% of patients with chronic blepharitis, but this mite has also been found in a significant percentage of patients without blepharitis 1.
- Patients with recalcitrant blepharitis have responded to therapy directed at decreasing or eradicating the Demodex mites 1.
- Eyelashes with cylindrical dandruff or sleeves at the eyelash base are reported to be a sign of ocular Demodex infestation 1.
- Studies have shown that the severity of ocular surface discomfort has a strong positive correlation with the number of Demodex per cilia 1.
If symptoms persist despite home treatment, consult an eye doctor as recurrent styes may indicate underlying conditions like blepharitis, meibomian gland dysfunction, or rarely, skin cancer that requires professional evaluation. Topical lotilaner was recently FDA approved for the treatment of Demodex blepharitis and can be considered as an alternative treatment option 1.
From the Research
Demodex Mites and Recurring Hordeolum (Styes)
- Demodex mites are a type of saprophytic mite that can infest the ocular adnexa and cause various ocular surface diseases, including blepharitis and keratoconjunctivitis 2, 3.
- While Demodex mites have been linked to several ocular and skin conditions, there is no direct evidence to suggest that they cause recurring hordeolum (styes) 2, 3, 4, 5, 6.
- However, Demodex mites can cause meibomian gland dysfunction (MGD), which may contribute to the development of hordeolum (styes) 3.
- Treatment of Demodex infestation typically involves eyelid hygiene, oil-based ointments, and topical treatments such as tea tree oil and ivermectin 2, 4, 6.
- Some studies have also explored the use of Thai herbal essential oils as a potential alternative therapy against Demodex mites 6.
Associated Conditions
- Demodex mites have been linked to various skin conditions, including rosacea, facial demodicosis, and blepharitis 2, 3, 4, 5.
- These conditions can cause symptoms such as itching, dryness, and general ocular discomfort, which may be similar to those experienced by individuals with recurring hordeolum (styes) 3, 5.