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The other day I diagnosed a pretty bad case of demodex blepharitis. What’s that you ask? It’s a form of eyelid inflammation caused by demodex mites. Yes. You heard me. Mites.  

I’m not saying this to scare anyone, but rather, I’d like to let you know so you can prevent it from happening to yourself.

Demodex blepharitis more commonly occurs with people aged 65 and older. The more time you spend on this earth, the more likely this normal flora mammalian mite will have met your eyelids!

A group of patients I have been diagnosing lately, was a bit of a surprise to me. They were women aged 25-50 who tended to wear eyeliner and mascara and not remove it nightly. And if they did remove it, they mostly used soap and water which did a lousy job. Who wants to get soap in their eyes anyways?

After months of bad makeup hygiene, I can see why mites would like this. An area that offers food (sebum in oil glands) that are seldomly cleansed well. Mites are pretty normal stuff, but can cause chronic, unexplainable dry eyes, red eyes, uncomfortable contact lens wear, itchy eyelids (especially in the morning), feeling as if something is in the eye (because there is), and bumps on the eyelid margins.

If you wear eyeliner or mascara, my recommendation to avoid future complications with demodex blepharitis, is to remove it every night . . . but remove it well. In my exam room, I have learned that eyeliner tends to be more problematic than mascara. It gets trapped at the base of the eyelash follicle and is very difficult to remove. 

I find that oil based makeup removers do the best job. They grab onto and remove oily debris and waterproof makeup better than water based cleansers. Oil based cleansers are also more gentle in the sense that you have to rub less; lashes don’t get damaged and eyelids are not left rubbed raw.

For my patients I always recommend a tea tree oil medicated eye makeup remover that is oil based, unless they are allergic to tea tree, eucalyptus, myrtle or clove (as they are in the same family). It has the best of both worlds. Tea tree oil is a natural enemy to demodex, and an oil based cleanser promises to be gentle yet highly effective in pulling out oily debris from the base of the eyelash follicle. 

One word of caution though. Tea tree oil can really burn your eyes, so make sure your product has been: 1) tested in an FDA approved facility; 2) has been tested specifically on the eyes; and 3) earns a score of “Non-Irritating” to the eyes. Many products that are sold on the internet do not meet these criteria.

My current recommendation for an eye makeup remover can be found here: www.oaklandvisioncenter.com/shop.

Happy Makeup Removing, 

Dr. Gill



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  • Written by Tanya Gill

    Dr. Gill is also a member of the Ocular Surface Society of Optometry. In addition to her Doctor of Optometry, Dr. Gill also has a BA in Integrative Biology and a BS in Vision Science, both from UC Berkeley. Go Bears!
    In 2015, Dr. Gill developed and founded We Love Eyes, which is a green cosmetics company that produces eyelid and eyelash cleansing products that are natural, non-toxic, and vegan.

    More Articles by Tanya Gill

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