Karen Angela L. Tiuseco, MD, Ruben Lim Bon Siong, MD, Johann Michael Reyes, MD, and Eleonor B. Iguban, MD
Published: December 2012
About:
“Blepharitis is a common, often chronic, and recurrent ocular disease characterized by inflammation of the eyelid margin.
The most common parasitic infection causing blepharitis is due to Demodex folliculorum.
The Demodex folliculorum mite of class Arachnida and order Acarina is a microscopic, transparent, obligate, parasitic organism that thrives in the pilosebaceous units of human beings.
They grow most favorably in the sebaceous glands and hair follicles of the face, eyelids, forehead, cheeks, and nose.
Demodex infestation produces allergic and inflammatory reactions to the skin, such as redness, hair loss, and scarring, and gives rise to a variety of skin conditions collectively termed as demodicosis or demodicidosis.
Although Demodex mites are frequently found in patients with chronic blepharitis, they are also believed to be common inhabitants of the normal eyelash follicle and sebaceous glands.
In a study by Arici in 2005, the prevalence of Demodex mites in individuals with blepharitis was found to be as high as in the normal population. Pathogenicity is thought to occur when these mites are present in excessive numbers or when they begin to penetrate into the dermis, especially in immunocompromised hosts.”
Purpose:
“To determine the effectiveness of lid scrub with petroleum jelly versus lid scrub with tea tree oil and tea tree facial wash in patients with symptomatic blepharitis associated with above-normal Demodex counts”
Methods:
“Patients with symptomatic anterior blepharitis (AB), meibomian gland dysfunction (MGD), or mixed blepharitis (MB) were recruited into the study.
Pertinent data, including ocular symptoms and findings, were recorded. Digital photographs of the lid margins were taken. Lash sampling was done using the modified Coston method for lash epilation. Patients with below-normal Demodex counts (DC <5) were excluded while those with DC ≥5 were randomly assigned to one of either treatment regimen:
(1) lid scrub with tea tree oil and tea tree facial wash (The Body Wash®, control group), or (2) lid scrub with petroleum jelly (Apollo Pure Petroleum Jelly®, study drug).
Lid scrub with the tea tree oil (TTO) or petroleum jelly was administered at the clinic during the initial visit and at 2-week intervals thereafter for 6 weeks.
Patients were instructed to apply tea tree (TT) facial wash or petroleum jelly at home on specified intervals daily. DC post treatment was recorded, and digital photographs of the eyelids were taken at the end of treatment.”
Results:
“Thirteen patients were included in the study; 5 in the TTO and 8 petroleum jelly.
In the TTO group, 3 patients had decrease in DC and 2 an increase, but all patients reported decrease in the severity and frequency of ocular symptoms.
In the petroleum jelly group, 5 patients had decrease in DC after 6 weeks, while the remaining 3 had opposite results.
All reported a general improvement in their symptoms. No adverse reactions were observed in either treatment groups.”
Conclusion:
“Lid scrub with petroleum jelly caused a significant reduction (p<0.05) in Demodex counts compared to lid scrub with tea tree oil and tea tree facial wash.
Petroleum jelly may have some effect in the eradication of Demodex mites in cases of Demodex-induced blepharitis.
Although lid scrub with petroleum jelly and tea tree oil and tea tree facial wash both produced a decrease in Demodex counts and a decrease in the frequency and severity of ocular symptoms after 6 weeks of treatment, the presence of some conflicting results suggests that further studies with more patients should be initiated.”
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