Short-Term Comfort Responses Associated With the Use of Eyelid Cleansing Products to Manage Demodex folliculorum

Ngo, William; Jones, Lyndon; Bitton, Etty

doi:10.1097/icl.0000000000000415

Cited by 25 publications

(29 citation statements)

References 22 publications

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“…Only one adverse effect (transient burning sensation of 3 s after each wipe application) was reported, but this did not lead to treatment discontinuation. This transient effect is somewhat consistent with a recent prospective, randomized, controlled, cross-over study showing that 4% T4O impregnated wipes (Cliradex ® ) produced minimal discomfort upon eyelid application peaking at a score of 3 (out of 10) at 45 s and lasting 180 s. 34 However, in a study by Qiu et al, 18 48% of the participants felt adverse stinging upon application of these same wipes. By comparison, contact dermatitis, allergic reaction, and ocular irritation are well-known complications of TTO solutions or ointments.…”

Section: Discussionsupporting

confidence: 83%

Improvement in ocular symptoms and signs in patients with Demodex anterior blepharitis using a novel terpinen-4-ol (2.5%) and hyaluronic acid (0.2%) cleansing wipe

Messaoud¹,

Fekih²,

Mahmoud³

et al. 2019

OPTH

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Purpose: To evaluate the clinical improvement in ocular symptoms and signs in patients suffering from Demodex anterior blepharitis after using a novel cleansing wipe impregnated with 2.5% terpinen-4-ol and 0.2% hyaluronic acid. Study design: This was an exploratory, multicenter, open, randomized, two-parallel group comparative study. Methods: Forty-eight patients with Demodex anterior blepharitis were randomly assigned to apply the sterile wipe T1172 (Blephademodex ®), either once daily (n=24, Group 1) or twice daily (n=24, Group 2) for 29 days. Overall ocular discomfort and other individual symptoms were measured using a 0-10 numeric rating scale at Day 8 and Day 29. Ocular signs, including eyelid margin hyperemia and number of cylindrical dandruff, were examined at slit lamp. Overall treatment performance by investigator, patient satisfaction and tolerance were evaluated with questionnaires. Results: Overall ocular discomfort was significantly reduced from baseline (p<0.0001) in both groups at Day 8 (−3.6±0.3 in Group 1 and −4.0±0.4 in Group 2) and Day 29 (−5.7±0.4 and −6.8±0.7, respectively), with no difference between groups (D8: p=0.718; D29: p=0.505). Each ocular symptom associated with Demodex blepharitis was improved in both groups. Eyelid margin hyperemia was significantly reduced at Day 8 (−0.7±0.7; p<0.001) and Day 29 (−1.1±0.7; p<0.0001) in Group 1. Similar results were observed in Group 2 (Day 8: p<0.001; Day 29: p<0.0001). Total disappearance of cylindrical dandruff was reported in 30.4% of patients in Group 1 and 43.5% in Group 2. Improvements in other ocular signs were observed in both groups. The product was well tolerated. All patients were satisfied or very satisfied and would continue using it. Conclusion: Daily eyelid hygiene using this cleansing wipe impregnated with 2.5% terpinen-4-ol and 0.2% hyaluronic acid during a 4-week period led to a rapid and marked reduction in ocular symptoms and signs associated with Demodex anterior blepharitis and was well tolerated.

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Section: Discussionsupporting

confidence: 83%

Improvement in ocular symptoms and signs in patients with Demodex anterior blepharitis using a novel terpinen-4-ol (2.5%) and hyaluronic acid (0.2%) cleansing wipe

Messaoud¹,

Fekih²,

Mahmoud³

et al. 2019

OPTH

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“…First line therapies of blepharitis include warm compresses to soften the debris and eyelid hygiene to manually dislodge them. 97 Targeted lid margin therapies should be adopted by ECPs, including antibacterial for Staphylococcal infestation 87 and anti-parasitic formulations for Demodex parasites, 98 , 99 in order to limit lid margin anomalies that come with chronic blepharitis. To target properly seborrheic blepharitis, a reference to dermatology is required to establish the diagnosis of seborrheic dermatitis and treat the affected skin with the appropriate pharmaceutical.…”

Section: Pathophysiology Of the Lashes And Their Managementmentioning

confidence: 99%

The eyelash follicle features and anomalies: A review

Aumond

Bitton

2018

Journal of Optometry

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The primary role of eyelashes is to protect and maintain the health of the lid margin. However, the mechanisms to fulfill this role are not fully understood. Unraveling these mechanisms will stand to greatly improve the efficiency of eye care professionals’ interventions in anomalies of the eyelashes. The aim of this article is to provide a review on eyelashes including highlights and new avenues for research; the biology of both the lash and its follicle; the pathophysiology and management of lash anomalies by eye care professionals; and the effect of iatrogenic factors on lashes. Using the database of Ovid MEDLINE, we reviewed studies specifically directed on human/mammalian eyelashes and key articles on current trends in scalp hair methodologies that can be applicable to lash research. The eyelash morphology, pigmentation and growth rate have been documented using techniques ranging from lash imaging to follicle immunohistochemistry. Furthermore, studies have demonstrated that the lash follicle is sensitive to many factors of the external environment, a variety of systemic/topical medications and cosmetics. Recently, aerodynamic studies using a mammalian eye model confirmed that an optimal lash length was needed so that eyelashes serve a protective role in reducing the number of particles that can reach the eye. Despite recent advances in lash research, studies are still scarce, due to the limited availability of the human lid for sampling. This review brings awareness that further research is needed with respect to eyelashes and will hopefully reduce the gap with scalp hair research.

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“…They are instructed to cleanse the lids and lashes, as well as smear the lid cleanser onto the eyelash roots of both the upper and lower eyelid margin 4,41. Complete coverage of the eyelash base by the tea tree oil lid cleanser is necessary to be effective so that mites are unable to lay eggs and hatch more Demodex mites 41. Patients should be instructed to use the wipes on their eyelashes, forehead, eyebrows, and cheeks as the mites live in all of those areas 32,39…”

Section: Managementmentioning

confidence: 99%

“…The most commonly used over-the-counter lid cleansing wipes (Table 1) for the management of Demodex include Cliradex ® (Bio-Tissue, Inc., Miami, FL, USA) and OCuSOFT ® Lid Scrub Plus (OCuSOFT, Richmond, TX, USA). Cliradex ® is a lid wipe that contains terpinen-4-ol 39–41. OCuSOFT ® Lid Scrub Plus contains a 0.5% solution of 1,2-octanediol, which when used over a 4-week period has been shown to decrease Demodex infestation 41.…”

Section: Managementmentioning

confidence: 99%

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Demodex blepharitis: clinical perspectives

Fromstein

Harthan

Patel

et al. 2018

OPTO

108

125

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Demodex folliculorum and Demodex brevis are two mites which infest the human eye and which may, in excess, lead to a wide range of anterior segment findings. Demodex mites have been implicated in anterior and posterior blepharitis, blepharoconjunctivitis, blepharokeratitis, and beyond. Due to significant overlap with other anterior segment conditions, Demodex infestation remains underdiagnosed and undertreated. Definitive diagnosis can be made with lash sampling, and the most common mode of treatment is with tea tree oil in varying concentrations. This article summarizes elements of pathogenesis, diagnosis, and management critical to clinical care of this common condition.

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Short-Term Comfort Responses Associated With the Use of Eyelid Cleansing Products to Manage Demodex folliculorum

Abstract: Of the cleansers used in this study, the ones that induced significant discomfort were CD, TT, and ODS. The results from this study may help clinicians educate patients about what to expect when approaching the topic of eyelid Demodex treatment.

Cited by 25 publications

References 22 publications

<p>Improvement in ocular symptoms and signs in patients with <em>Demodex</em> anterior blepharitis using a novel terpinen-4-ol (2.5%) and hyaluronic acid (0.2%) cleansing wipe</p>

<p>Improvement in ocular symptoms and signs in patients with <em>Demodex</em> anterior blepharitis using a novel terpinen-4-ol (2.5%) and hyaluronic acid (0.2%) cleansing wipe</p>

The eyelash follicle features and anomalies: A review

<em>Demodex </em>blepharitis: clinical perspectives

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