Swabs Containing Tea Tree Oil and Chamomile Oil Versus Baby Shampoo in Patients With Seborrheic Blepharitis: A Double-Blind Randomized Clinical Trial

Abstract

The comparison of the efficacy of swabs containing tea tree oil and chamomile oil and baby shampoo (BS) in the treatment of seborrheic blepharitis was aimed. Methods: This randomized, double-blind, parallel-group, active control, multicenter clinical trial included patients with seborrheic blepharitis using block randomization (BS, n¼23; swabs, n¼26). Patients were treated with BS or swabs for 8 weeks followed by 4 weeks of treatment withdrawal. Change in Blepharitis Symptom measure (BLISS), Demodex count, Ocular Surface Disease Index (OSDI) score, Schirmer test, tear breakup time (TBUT), noninvasive TBUT (NI-TBUT), corneal staining, and meibography at different visits (baseline, fourth, , and 12th week) were the main outcome measures. Results: Patients in both groups showed similar baseline parameters (P.0.05). Patients using swabs showed significantly lower BLISS scores compared with patients using BS at the 4th, 8th, and 12th week visits (3.666.1 vs. 6.364.5 P¼0.011; 1.162.8 vs. 6.666.7, P,0.001; 0.962.8 vs. 5.766.6, P¼0.002, respectively). Patients using swabs showed improvement in OSDI scores after 8 weeks of treatment compared with the baseline visit (P,0.001). Despite a similar Demodex reduction effect in both treatment arms even after 4 weeks of treatment (P,0.001), both treatment modalities did not show any effect on the other parameters. Conclusion: Although both swabs and BS showed efficacy for the treatment of seborrheic blepharitis in terms of the Demodex reduction and symptomatic improvement, swabs may provide better symptomatic improvement. Four weeks of treatment discontinuation may not cause any recurrence in the symptoms or Demodex infestation.

Recent Evidence of Tea Tree Oil Effectiveness in Blepharitis Treatment

“…Mergen et al [ 28 ] compared tea tree oil and chamomile oil swabs to baby shampoo (BS) in patients with seborrheic blepharitis in a double-blind randomized clinical experiment. For 8 weeks, 23 patients were given BS, and 26 were given swabs, followed by 4 weeks of therapy discontinuation.…”

“…In Vivo. The effectiveness of TTO treatment was then also tested in vivo by several authors [22][23][24][25][26][27][28][29][30][31] and reviewed in Table 2.…”

Antiparasitic Activity of Tea Tree Oil (TTO) and Its Components against Medically Important Ectoparasites: A Systematic Review

“…Except the four studies published in Mandarin [87,88,90,94], all studies were published in English. Most (n = 41) of the included studies were clinical studies involving 2456 participants, with RCT (n = 17) [56,62,63,72,74,77,85,86,88,92,93,107,108,110,111,120,121] or non-RCT (n = 24) type study designs [52,58,59,61,69,73,75,76,78,79,82,87,[89][90][91]94,98,99,101,102,106,109,113,117]. While 25 of them were solely laboratory-based studies with in vitro (n = 24) [31,[53][54][55]…”

“…Acaricidal effect of TTO and its components against mites. Fifty-five studies targeted mites, which include Demodex mites (n = 44) [52,56,58,59,[61][62][63][64][69][70][71][72][73][74][75][76][77][78][79]81,82,85,[87][88][89][90][91][92][93][94][97][98][99][100][101][102][107][108][109]112,114,117,120,121], scabies mites (n = 5) [57,86,113,118,119], and house dust mites (n = 6) (Tables 1-5)…”

“…Among 44 studies involving Demodex mites, six were in vitro studies [64,70,71,100,112,114], two studies followed a mixed in vitro/clinical approach [81,97], and 36 were clinical studies (14 RCTs [56,62,63,72,74,77,85,88,92,93,107,108,120,121] and 22 non-RCTs [52,58,59,61,69,73,75,76,78,79,82,87,[89][90][91]94,98,99,101,102,109,117]) (Tables 1 and 2).…”