What Are Face Mites (Demodex Folliculorum)?

Face mites are tiny parasites that live in hair follicles

Face mites, also known as Demodex folliculorum, are tiny insect-like organisms that live in the hair follicles on your skin and feed on dead skin cells. They look like microscopic ticks and have a body with eight legs. Face mites usually measure between 0.2 to 0.4 millimeters, smaller than half of the thickness of a credit card. It’s impossible to see them with the naked eye. 

While the thought of these tiny organisms making your face their home can sound sickening, it’s actually very common. Most of us have small amounts of face mites on our skin and will never see or notice them. They may even provide a helpful cleaning process by removing waste and dead skin from your face. They usually only cause a problem when they aggravate a skin condition that you already have, such as eczema or rosacea. An overgrowth of face mites, demodicosis, requires treatment. 

What Is Demodicosis?

Demodicosis is an infestation of Demodex folliculorum or face mites. It can appear as tiny white bumps, similar to whiteheads in acne, and lead to redness and itching. Demodicosis becomes a concern when it begins to cause symptoms such as irritation of the skin. This occurs when the number of face mites multiplies rapidly and the body’s normal immune response cannot control them. 


Face Mites


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Types of Face Mites

There are two types of Demodex mites: Demodex folliculorum and Demodex brevis. These mites usually live on the skin that is thin and wrinkled, and make their homes in the elbows, knees, shoulder blades, and faces. Mites may also be found around the penis and under the breasts. Demodex folliculorum usually appear on the face, especially around the eyelids and eyelashes.

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 people are sleeping. To lay their eggs, females then burrow tunnels into the skin on the face and lay their eggs one to five millimeters deep into the skin. A mite egg hatches and reaches adulthood in about two weeks; they live on our skin for about one to two months. 

Symptoms 

Demodicosis illustration


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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 signs of demodicosis include:

  • Dryness
  • Itchy, scaly skin
  • Redness and irritation 
  • Red or white pustules
  • Acne-like eruptions
  • Sores from scratching
  • Lines (burrow marks) on face 

Causes 

Face mites are a normal part of healthy skin, but can become problematic when they multiply too quickly. Some people are more at risk for this overgrowth, while others catch face mites from close contacts. Mites are contagious and can be passed from one person to another through close contact, such as by sleeping in the same bed. They are more likely to be passed by touching faces, such as during kissing. 

Risk Factors

Doctors believe that conditions affecting the immune system, such as HIV or AIDS, put us at higher risk for demodicosis. This is because our immune systems are usually able to keep the number of face mites present on our skin under control. Once the immune system is not functioning properly, face mites have the chance to multiply and spread. Medications like chemotherapy or topical steroids can also impair the immune response and put people at higher risk of overgrowth. 

The risk factors of demodicosis include:

  • Age: Face mites usually don’t present before age 40 and are much more common in the elderly
  • Gender: Men are more likely to experience both Demodex folliculorum and Demodex brevis than women
  • Immune function: People with a compromised immune system are more at risk for demodicosis. This includes those who are diagnosed with HIV or AIDS, receiving chemotherapy, or taking steroids. 

Diagnosis 

Face mites can be detected in scraping of the skin or skin biopsy. To diagnose face mites, your doctor will gently scrape skin cells from an oily patch of skin, such as around the nose or mouth, because face mites feed off of the oil produced on the skin. Your doctor then examines those skin cells and hair follicles under a microscope to look for the eight-legged creatures. Your doctor will count the number of face mites in the sample to determine if your skin issues are being caused by an overgrowth of them. 

Your doctor may be able to predict if you have face mites based on the appearance of your skin. People experiencing demodicosis usually have a white sheen to their skin, known as Demodex frost. 

Complications 

Face mites are usually easily treated and do not cause further complications after treatment. When left untreated, however, they can sometimes lead to conditions, including:

  • 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

Treatment 

Finding the right treatment for demodicosis can be challenging at first since the skin on the face is so sensitive. If you’re unsure where to start, talk with your doctor. 

Home Remedies

There are several natural remedies that claim to treat demodicosis. They need to be used with caution because they are not proven to be safe or effective. 

Home remedies that can potentially help with an overgrowth of face mites include:

  • Tea tree oil: Helps with the itching but may cause skin irritation
  • Aloe vera: Soothes the itching and redness
  • Turmeric: Helps with the symptoms, but won’t cure the problem
  • Apple cider vinegar: Believed to help treat face mites 

Washing any clothes and bed sheets that have touched your face may also help. While it won’t treat the condition, it will help to prevent spreading face mites to those you have close contact with. 

Over-the-Counter Options

There are many over-the-counter (OTC) options for treating demodicosis at home:

  • Topical permethrin: A scabicide cream that can be applied to the face to reduce the number of mites. It is used for those ages two months and up for two weeks
  • Cliradex wipes: These wipes use 4-Terpineol, the key ingredient in tea tree oil, to treat demodex. The wipes can be used to wipe the eyes twice daily for six to eight weeks

Prescription Drugs

There are also prescription medications that can help treat demodicosis. Your doctor can help you choose a treatment with the least amount of side effects: 

  • Metronidazole: An antibiotic that stops the growth of bacteria. Your doctor may prescribe an oral tablet or topical cream. Possible side effects of the oral form include nausea, vomiting, diarrhea, and stomach pain 
  • Crotamiton: A topical scabicide used to treat mites and itching. The cream should be applied after washing your face, and mild skin irritation is possible 
  • Ivermectin: A medication that can be used for hard-to-treat face mites that do not respond to other treatments. It is most commonly used in people with compromised immune systems, and is usually taken as a single dose. Possible side effects include dizziness, nausea, and vomiting 

Coping

Besides treatment, there are some simple actions you can take to recover and prevent an overgrowth of face mites in the future. They include:

  • Avoiding scratching or rubbing your face as much as possible
  • Removing excess oil on your skin by washing your face twice daily
  • Never sharing makeup or face products with anyone else

A Word From Verywell

As nauseating as it sounds to have microscopic parasites crawling around your face, these mites are common, and just about everyone has them. When an overgrowth occurs, it is easily treated. 

To help prevent an overgrowth of face mites, wash your face with a gentle cleanser twice daily and avoid oily makeup and face creams. Exfoliating your face may also help since it removes the dead skin cells that mites feed on. 

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Article Sources
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  2. 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

  3. 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

  4. MedlinePlus. Permethrin topical. Last updated Jan. 15, 2018.

  5. MedlinePlus. Metronidazole. Last updated Dec. 15, 2017.

  6. Cleveland Clinic. Crotamiton topical cream or lotion.

  7. MedlinePlus. Ivermectin. Last updated May 5, 2020.

Additional Reading
  • Cassidy J. Meet The Mites That Live On Your Face. NPR. https://www.npr.org/sections/health-shots/2019/05/21/725087824/meet-the-mites-that-live-on-your-face. Published May 21, 2019. Accessed November 20, 2020.