What Are Face Mites (Demodex Folliculorum)?

Face mites are tiny parasites that live in hair follicles

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Face mites, also known as Demodex folliculorum, are microscopic tick-like organisms. They live in the hair follicles in your skin, especially on your face and around the eyelids and lashes, and feed on dead skin cells and oils. Research suggests that they are found in all adults.

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. Treatment is necessary. 

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.

What Is Demodicosis?

Demodicosis is an infestation of face mites. It causes tiny white bumps, similar to whiteheads in acne, plus redness and itching. Demodicosis develops when face mites multiply rapidly and your normal immune response cannot control them. 


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. 

Face mites are rare in children under 5, possibly because the skin doesn't have enough oil for them to feed on.

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

Signs of Face Mites

Verywell / Laura Porter

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:

  • Dryness
  • Itchy, scaly skin
  • Redness and irritation 
  • Red or white pustules
  • Acne-like eruptions
  • Sores from scratching
  • Lines (burrow marks) on the face 
  • Eczema
  • Loss of eyelashes
  • Eye inflammation
  • Decreased 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, though newer science has pointed to the latter.

Demodicosis may make acne, eczema, rosacea, and dermatitis symptoms more severe.

Recap

Face mites are microscopic organisms living in your facial hair follicles. They feed on dead skin and oil. They typically cause no symptoms unless the overgrow (demodicosis). This causes tiny white bumps and dry, itchy, scaly, irritated skin with acne-like sores. Untreated overgrowth can lead to or worsen other skin conditions.

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 both Demodex folliculorum and Demodex brevis overgrowth.

Diagnosis

You do not need to see a healthcare provider for face mites unless you have demodicosis symptoms.

Your provider may be able to predict you have 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.

Demodicosis illustration


ttsz / Getty Images

Recap

Mites are contagious through close contact, like a kiss. You're more at risk if your immune system is compromised or suppressed, you're over 40, and/or male.

Demodicosis can be diagnosed by examining skin scrapings or a biopsy sample in a lab.

Treatment

You don't need to be treated for face mites unless there's an overgrowth.

Finding the right treatment for demodicosis can be challenging at first since the skin on the face is so sensitive. 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

There are also prescription medications that can help treat demodicosis. 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.

Recap

Treatment for face mite overgrowth can include washing your face, hair, and eyelashes, and exfoliating regularly. Some OTC options, including tea tree oil, may be helpful. Prescription drugs such as metronidazole and ivermectin may be necessary in some cases.

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 daily
  • Never sharing makeup or face products with anyone else
  • Washing 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 nauseating 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. 

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10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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