Though you may consider them unwanted visitors, face mites don’t usually cause any problems. They may even help your skin by removing waste and dead cells from your face.
However, they can become problematic when they overgrow—a condition known as demodicosis. This can cause symptoms like itching and sores, as well as trigger or aggravate skin conditions like eczema or rosacea. Demodicosis requires treatment.
This article looks at symptoms and complications of face-mite overgrowth, how it’s diagnosed and treated, and how you can keep these organisms in check.
Types of Demodex Mites
Demodex folliculorum (D. folliculorum) is one of the two known types of Demodex mites in humans. They usually appears just on the face, especially around the eyelids and eyelashes.
In addition to being known as face mites, you may hear them called eyelash mites. They are one and the same.
Face mites can only survive on human skin. While they usually stay inside the hair follicle, mites come out to the surface of the skin to mate while you sleep. Females then burrow tunnels into your skin. They lay their eggs one to five millimeters below the surface.
The period from hatching to adulthood lasts about two weeks. Their life span is about one to two months.
The other type, Demodex brevis (D. brevis), usually lives on skin that’s thin and wrinkled. That includes the elbows, knees, shoulder blades, around the penis, and under the breasts.
Researchers believe other types of Demodex mites exist. They may vary depending on geographic location.
Face Mite Symptoms
Face mites usually measure between 0.2 to 0.4 millimeters, smaller than half of the thickness of a credit card. You can’t see them with the naked eye.
Normal levels of face mites don’t cause any symptoms. However, demodicosis can.
Signs of demodicosis can come on quickly, even overnight. You may notice a patch of tiny whiteheads resembling acne around your eyes or nose.
Other symptoms include:
DrynessItchy, scaly skinRedness and irritation Red or white pustulesAcne-like eruptionsSores from scratchingLines (burrow marks) on the face EczemaLoss of eyelashesEye inflammationDecreased vision
Complications
Demodicosis is usually easily treated and doesn’t cause further complications thereafter.
But when it is left untreated, it can sometimes lead to skin conditions such as:
Rosacea: An skin condition that causes inflammation, redness, and pustules on the face Blepharitis: Inflammation of the eyelids that causes redness and watering Dermatitis: Sensitive, irritated skin with symptoms like redness, itching, and pain
People with rosacea typically have higher amounts of face mites. Researchers have debated whether demodicosis causes rosacea or is a result of it.
Demodicosis may make acne, eczema, rosacea, and dermatitis symptoms more severe.
Causes
Face mites are a normal part of healthy skin. They can be passed from one person to another through close contact, like sleeping in the same bed. But they’re more likely to be passed when faces touch, such as during a kiss.
The immune system is usually able to keep the number of face mites on the skin under control. It’s when the immune system stops functioning properly that face mites have a chance to multiply and spread.
Risk Factors
Some people are at greater risk for face-mite overgrowth than others.
This includes people with conditions affecting the immune system, such as HIV or AIDS.
Medications like chemotherapy or topical steroids can also impair the immune response and put you at higher risk of overgrowth.
Other risk factors of demodicosis include:
Age: Demodicosis usually doesn’t present before age 40 and is much more common in the elderly. Sex: Biological males are more likely than biological females to experience Demodex folliculorum or Demodex brevis overgrowth.
Diagnosis
You do not need to see a healthcare provider for face mites unless you have symptoms.
Your provider may be able to diagnose face mites based on the appearance of your skin. Demodicosis often causes a white sheen to the skin, known as Demodex frost.
If you’re being evaluated for overgrowth, your healthcare provider may gently scrape skin cells from an oily patch of skin, such as around the nose or mouth—a ripe feeding ground for face mites. Alternatively, they may remove some tissue in what’s known as a standardized skin surface biopsy (SSSB).
The samples will then be examined under a microscope and the mites are counted to see if there are more than is considered normal.
How to Get Rid of Face Mites
Self-care strategies like exfoliation and over-the-counter solutions like tea tree oil are typical suggestions for how to get rid of face mites. More serious cases may require a prescription. Note, however, that you don’t actually need treatment unless there’s an overgrowth.
Demodicosis can be diagnosed by examining skin scrapings or a biopsy sample in a lab.
Even then, the sensitivity of facial skin can make eliminating the mites challenging.
Your healthcare provider can help guide you as to where to start.
Self Care
You can do some things at home to help treat and prevent demodicosis:
Wash your hair and eyelashes daily with a mild shampoo. Use a cleanser on your face twice a day. Avoid oil-based/greasy personal care products. Exfoliate regularly to remove dead cells. Avoid scratching or rubbing your face as much as possible.
Over-the-Counter Options
There are many over-the-counter (OTC) options for treating demodicosis at home:
Tea tree oil: The best treatment overall, according to 2020 research Topical permethrin: Can reduce the number of mites when used for two weeks Cliradex wipes: Contain 4-Terpineol, the key component of tea tree oil; use around the eyes for six to eight weeks
Prescription Drugs
In more serious cases, a doctor can prescribe medications to get rid of face mites. Direct treatment usually isn’t necessary unless a person shows signs of overgrowth.
Your healthcare provider can help you choose a treatment with the least amount of side effects.
Metronidazole: This antibiotic may help by hampering the mites’ movement and potentially even killing them. It comes in oral tablet and topical cream forms. Possible side effects of tablets include nausea, vomiting, diarrhea, and stomach pain. Crotamiton: This is a topical cream used to treat mites and itching. Apply after washing your face. Mild skin irritation is possible. Ivermectin: This cream is used for face mites that don’t respond to other treatments. It is most commonly used in those with compromised immune systems. Possible side effects include dizziness, nausea, and vomiting.
Preventing Spread
Though all adults are considered to have face mites, it’s best to avoid spreading more to someone else if you have an overgrowth.
You can do this by:
Removing excess oil on your skin by washing your face twice dailyNever sharing makeup or face products with anyone elseWashing potentially shared items like bedding and towels regularly
Summary
Face mites are microscopic organisms that live in the hair follicles in your face and eat dead skin. They’re usually not noticeable but sometimes over-populate and make you break out in tiny white bumps that can be itchy or even painful.
Mites are contagious through close contact. A weak immune system can allow them to get out of control.
They’re diagnosed with skin scrapings or biopsies. Extra cleansing, tea tree oil, topical products, or prescription medications may be needed to get rid of an outbreak.
To prevent a recurrence or spreading them, try not to touch your face, wash frequently, and don’t share face products with anyone.
A Word From Verywell
As strange as it sounds to have microscopic parasites crawling around your face, these mites are common. If you’re an adult, you can assume you’ve got them.
When overgrowth occurs, it’s easy to treat. To help prevent overgrowth, wash your face with a gentle cleanser twice daily and avoid oily makeup and face creams.
Exfoliating may also help since it removes the dead skin cells that mites feed on.
