Demodicosis in humans as a current problem in dermatology and ophthalmology


blepharitis Demodex
zapalenie powiek

How to Cite

Królik S, Muth A, Polańska A, Żaba R, Adamski Z, Jenerowicz D. Demodicosis in humans as a current problem in dermatology and ophthalmology. JoFA [Internet]. 2020Dec.31 [cited 2021Oct.17];3(2):108-21. Available from:


Introduction. Human Demodex mites (Demodex folliculorum and Demodex brevis) are ectoparasites living inside the sebaceous glands and hair follicles. In most people, their presence is of no consequence. However, several conditions or various external factors might contribute to pathological Demodex infestation resulting in demodicosis. Many different cutaneous diseases can resemble demodicosis leading to misdiagnosis.
Aim. This paper aims to present information about demodicosis and provides a clear clinical portrait of demodicosis in order to distinguish it from other mimicking inflammatory dermatoses.
Material and Methods. The literature search was conducted in the English and Polish language via the PubMed database and Main Medical Library. The articles regarding Demodex infestation were selected.
Results. There is some evidence about the role of Demodex in the development of rosacea, blepharitis and clinical correlation between them.
Conclusions. More attention should be drawn to Demodex as it plays a significant role in the development of various clinical entities in both dermatology and ophthalmology.


Plewig G, Kligman AM. Acne and Rosacea, 3rd edn. Berlin Heidelberg: Springer, 2000.

Rather PA, Hassan I. Human demodex mite: the versatile mite of dermatological importance. Indian J Dermatol. 2014 Jan;59(1):60–6. doi: 10.4103/0019-5154.123498. PMID: 24470662; PMCID: PMC3884930.

Jarmuda S. Ocena udziału roztoczy Demodex folliculorum i laseczek Bacillus oleronius w patogenezie trądziku różowatego. Rozprawa doktorska. Poznań: Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu; 2013

Forton FM. Papulopustular rosacea, skin immunity and Demodex: pityriasis folliculorum as a missing link. J Eur Acad Dermatol Venereol. 2012 Jan;26(1):19–28. doi: 10.1111/j.1468-3083.2011.04310.x. Epub 2011 Oct 24. PMID: 22017468.

Akilov OE, Mumcuoglu KY. Association between human demodicosis and HLA class I. Clin Exp Dermatol. 2003 Jan;28(1):70–3. doi: 10.1046/j.1365-2230.2003.01173.x. PMID: 12558635.

Chen W, Plewig G. Human demodicosis: revisit and a proposed classification. Br J Dermatol. 2014 Jun;170(6):1219–25. doi: 10.1111/bjd.12850. PMID: 24471456.

Udziela M, Olek-Hrab K, Kleina-Schmidt P. Postępowanie w demodekozie ocznej. Polskie Towarzystwo Okulistyczne. 2014.

Fernandez-Flores A, Alija A. Scalp folliculitis with Demodex: innocent observer or pathogen? Braz J Infect Dis. 2009 Apr;13(2):81–2. doi: 10.1590/s1413-86702009000200001. PMID: 20140347.

Helou W, Avitan-Hersh E, Bergman R. Demodex Folliculitis of the Scalp: Clinicopathological Study of an Uncommon Entity. Am J Dermatopathol. 2016 Sep;38(9):658–63. doi: 10.1097/DAD.0000000000000512. PMID: 26959693.

Bohdanowicz D, Raszeja-Kotelba B. Demodex w etiopatogenezie niektórych chorób skóry. Post Dermatol Alergol. 2001;18:51–53.

Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol. 1993 Jun;128(6):650–9. doi: 10.1111/j.1365-2133.1993.tb00261.x. PMID: 8338749.

Man Peles I, Zahavi A, Chemodanova E, Vardizer Y. Novel In-Office Technique for Visual Confirmation of Demodex Infestation in Blepharitic Patients. Cornea. 2020 Jul;39(7):858–861. DOI: 10.1097/ico.0000000000002254.

Raszeja-Kotelba B, Jenerowicz D, Izdebska JN, Bowszyc-Dmochowska M, Tomczak M, Dembińska M. Niektóre aspekty zakażenia skóry nużeńcem ludzkim. Wiadomości Parazytologiczne. 2004;50:41–54.

Tsutsumi Y. Deposition of IgD, alpha-1-antitrypsin and alpha-1-antichymotrypsin on Demodex folliculorum and D. brevis infesting the pilosebaceous unit. Pathol Int. 2004 Jan;54(1):32–4. doi: 10.1111/j.1440-1827.2004.01581.x. PMID: 14674992.

Deleuran M, Ellingsen AR, Paludan K, Schou C, Thestrup-Pedersen K. Purified Der p1 and p2 patch tests in patients with atopic dermatitis: evidence for both allergenicity and proteolytic irritancy. Acta Derm Venereol. 1998 Jul;78(4):241–3. doi: 10.1080/000155598441783. PMID: 9689288.

Robak E, Kulczycka L. Trądzik różowaty – współczesne poglądy na patomechanizm i terapię. Postepy Hig Med Dosw (online). 2010;64:439–450.

Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007 Sep;157(3):474–81. doi: 10.1111/j.1365-2133.2007.08028.x. Epub 2007 Jun 26. PMID: 17596156.

O'Reilly N, Bergin D, Reeves EP, McElvaney NG, Kavanagh K. Demodex-associated bacterial proteins induce neutrophil activation. Br J Dermatol. 2012 Apr;166(4):753–60. doi: 10.1111/j.1365-2133.2011.10746.x. Epub 2012 Mar 2. PMID: 22098186.

Lacey N, Kavanagh K, Tseng SC. Under the lash: Demodex mites in human diseases. Biochem (Lond). 2009 Aug 1;31(4):2–6. PMID: 20664811; PMCID: PMC2906820.

Jarmuda S, O'Reilly N, Żaba R, Jakubowicz O, Szkaradkiewicz A, Kavanagh K. Potential role of Demodex mites and bacteria in the induction of rosacea. J Med Microbiol. 2012 Nov;61(Pt 11):1504–1510. doi: 10.1099/jmm.0.048090-0. Epub 2012 Aug 29. PMID: 22933353.

Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007 Sep;157(3):474–81. doi: 10.1111/j.1365-2133.2007.08028.x. Epub 2007 Jun 26. PMID: 17596156.

Zhu M, Cheng C, Yi H, Lin L, Wu K. Quantitative Analysis of the Bacteria in Blepharitis With Demodex Infestation. Front Microbiol. 2018 Jul 31;9:1719. doi: 10.3389/fmicb.2018.01719. PMID: 30108572; PMCID: PMC6079233.

Aumond S, Bitton E. Palpebral and facial skin infestation by Demodex folliculorum. Contact Lens and Anterior Eye. 2020 April;43(2)2020:115–122. doi: 10.1016/j.clae.2019.09.001.

Sarac G, Cankaya C, Ozcan KN, Cenk H, Kapicioglu YK. Increased frequency of Demodex blepharitis in rosacea and facial demodicosis patients. J Cosmet Dermatol. 2020;19:1260–1265. https ://

Li J, O'Reilly N, Sheha H, Katz R, Raju VK, Kavanagh K, Tseng SC. Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with Facial rosacea. Ophthalmology. 2010 May;117(5):870–877.e1. doi: 10.1016/j.ophtha.2009.09.057. Epub 2010 Jan 15. PMID: 20079929; PMCID: PMC2946826.