When Charmian Edgerton saw a photograph of herself taken by a friend on a night out, she thought she was going mad.
‘My eyes had a sort of stitching effect around them, like tiny dots that were forming a line in the upper lashes and in the lower lashes,’ says Charmian.
She had not noticed the ‘stitching’ when she looked at herself in the mirror – but for the previous few months she had been dogged by swollen, itchy and irritated eyes that would often weep.
‘It was irritating and embarrassing,’ says Charmian, 83, a retired artist and jewellery designer from Fife, Scotland.
‘I kept going to my GP, who said there was nothing wrong. I tried different make-up, different make-up remover, all sorts of cleansers. Nothing worked.’
But after seeing the photograph, she Googled her symptoms, including the tiny dots around her eyes – and to her horror, discovered her eyes were most likely being irritated by an overgrowth of microscopic mites.
After Charmian Edgerton experienced irritation, swelling and weeping from her eyes, she soon found out she was suffering from an infestation of microscopic mites
A private dermatologist confirmed the diagnosis and informed her that the ‘stitching’ visible on the photograph was a build-up of the eggs and waste products from demodex mites.
It might sound like something from a horror film, but in fact most adults have detectable numbers of these tiny eight-legged creatures, which each measure less than a millimetre in length, says Dr Zainab Laftah, a consultant dermatologist at HCA The Shard.
‘They are most often found on the face, particularly around the forehead, cheeks, nose and eyelashes,’ she says.
The eyelids are a particularly common place for a demodex infestation, ‘because the eyelids provide a natural habitat for them, particularly the eyelash follicles and nearby oil-producing glands,’ adds Dr Laftah, who is also a spokeswoman for the British Skin Foundation.
They live within oil glands and hair follicles ‘and their presence usually causes no symptoms,’ she says.
‘But if their numbers increase it can trigger inflammation along the eyelid margins, contributing to blepharitis – which causes eye irritation, weeping, and symptoms such as itching, burning, crusting or scaling around the lashes and dry or irritated eyes,’ says Dr Laftah.
Demodex mite overgrowth was once regarded as a problem largely affecting older people, but new research suggests they are now causing problems for younger women who use false eyelashes.
And the symptoms aren’t restricted to the eyelashes.
‘In some cases, inflammation can also involve the conjunctiva, the membrane covering the white of the eye,’ says Dr Laftah.
What’s more, the mites can worsen or trigger skin conditions such as rosacea – leading to redness, scaling, itching or irritation.
‘The skin may become red and inflamed, with small pimple-like bumps or pustules, rough or scaly patches – and, in some cases, a dry sandpaper-like texture,’ says Dr Laftah.
‘Symptoms can also include burning or increased skin sensitivity, although the appearance varies from person to person and can resemble other inflammatory skin conditions.’
A private dermatologist confirmed the diagnosis and revealed that the irritation to Charmian’s eyes was a build-up of the eggs and waste products from demodex mites
The inflammation and itching that demodex mites cause is due to a combination of them irritating and damaging the follicles as they feed and ‘digestive enzymes and debris they leave behind, which can trigger an inflammatory immune response,’ says Dr Sabika Karim, a GP and founder of Skin Medical, an aesthetics clinic in London.
‘The mites can also carry bacteria, while those that live deeper in the skin can block the meibomian glands, which produce the oily layer that helps protect our tears,’ she adds.
Mite infestations become more common with age because ‘age-related changes in our skin, oil production, microbiome and immune defences may create a more favourable environment for the mites to multiply,’ says Dr Karim. ‘We also simply have more years in which to acquire and accumulate them.’
But new research suggests applying false eyelashes can increase the risk of a mite overgrowth, too.
Dr Zainab Laftah is a consultant dermatologist at HCA The Shard
Data presented at the Congress of the European Society of Cataract and Refractive Surgeons in September revealed that out of 25 women aged 16 to 28 who regularly used false lashes, 24 had demodex mites and 18 had signs of irritation around the eye as a result.
The researchers, from the National Pirogov Memorial Medical University in Ukraine, said the results highlighted ‘the importance of proper eyelid hygiene, awareness of symptoms and timely assessment when symptoms arise’ – and urged clinicians to consider mites when seeing patients ‘with chronic eyelid irritation, particularly those who regularly use eyelash extensions’.
False eyelashes may contribute to mite numbers, adds Dr Laftah, as they ‘can make thorough cleansing along the lash line more difficult, allowing oils, dead skin and debris to accumulate around the follicles where the mites live.
‘False lashes and their adhesives can also independently irritate the eyelids, producing symptoms that may resemble or compound those caused by the mites.’
A telltale sign of a demodex mite infestation is a build-up of debris around the base of the eyelashes, known as collarettes, which is made up of skin cells and waste material from the mites and their eggs.
By the time of her diagnosis months after the fateful picture was taken in 2023, Charmian became aware of what looked like ‘tiny grains of rice’ around her eyes.
‘There were like white crumb-like things below my eyes that would fall down my cheeks,’ she says. In fact it was a combination of collarettes and mites.
The eyelids are a particularly common place for a demodex mite infestation because the eyelids provide a natural habitat for them
A parasitic mite seen on the eyelash of a human eye through the lens of a microscope
By then Charmian had seen three different dermatologists over the course of almost a year, who kept telling her she had a straightforward eye infection or even eczema and prescribed antibiotics – which did nothing to help.
It wasn’t until seeing the photograph, and finding her eyes were still itchy and red despite the antibiotics, that Charmian searched for an explanation online – and the words demodex mites came up.
‘I joined a Facebook group and found hundreds of other people with the exact same symptoms,’ she says.
‘Like me they had red eyes, itchy eyes, one eye or both eyes weeping – and in some cases the telltale “stitching” around the eyes, which I discovered is actually the eggs or dead matter from the mites.’
Armed with this information she saw her fourth dermatologist, who finally diagnosed her with demodicosis (an overactive population of demodex mites) which had caused both her problem eyes and mild rosacea on her cheeks.
She was prescribed Rozex gel, an antimicrobial, anti-inflammatory treatment and Soolantra cream, which contains ivermectin (an antiparasitic drug which targets the mites causing her rosacea) as well as antibiotic eye drops.
‘I used the gel around my eyes with great care, with a cotton bud just at each corner,’ says Charmian. ‘It’s unorthodox but all I could do.’
Dr Laftah explains: ‘Treatment is generally aimed at reducing excessive mite numbers and calming the resulting inflammation.
‘Topical treatments such as ivermectin or metronidazole are sometimes prescribed.
‘Ivermectin is antimicrobial, so it reduces the number of demodex. Metronidazole is an antibiotic [an antiparasitic medication] that helps reduce inflammation.
‘Gentle skincare can also help and includes washing with a mild, non-soap cleanser and avoiding rich, oil-based skincare products that may aggravate the condition.’
Charmian, however, found the treatment from her doctor didn’t help.
She says she’s managed to control the demodex mites using a combination of tea tree oil dabbed around the eyes, blepharitis wipes from the chemist, and avoiding using oil-based products on her eyes.
Dr Karim says the evidence for using tea tree oil is weak but emphasises that ‘good eyelid hygiene is important’.
‘If you wear eyelash extensions or false lashes, I would be particularly careful about keeping the eyelids and lash line clean and removing eye make-up thoroughly,’ she says.
Charmian still has itchy eyes and the ‘stitching’ effect around her eyes but says it is less irritated.
‘I have had to throw away and change all my make-up products as some are oily which the mites love, as well as having to sometimes explain to people why I have white crumbs around my eyes.
‘It’s a good job I don’t wear false eyelashes as I would no doubt suffer even more.’
