Demodicosis: Facial Redness and Spots — Signs, Testing and Treatment

Demodicosis is skin inflammation linked to an overgrowth of the microscopic Demodex mite. It shows up as facial redness, small bumps and pustules, itching and rough skin. It is often mistaken for acne or allergy and treated wrongly for months. Once correctly diagnosed, it responds well to treatment.

What is the Demodex mite?

Demodex is a mite, invisible to the eye, that lives in hair follicles and oil glands. Most adults have it, and usually it causes no trouble. Disease starts when the mite multiplies too much and the skin reacts with inflammation. Contributing factors:

• oily skin and active oil glands;
• lowered immunity, stress, fatigue;
• long-term use of steroid creams;
• heavy, greasy cosmetics and make-up left on overnight;
• rosacea and digestive disorders.

Signs of demodicosis

• redness on the cheeks, nose, forehead and chin;
• small red bumps and pustules;
• itching and burning, especially in the evening;
• rough, "sandpaper" skin and flaking;
• enlarged pores and oiliness;
• when the eyelids are affected — itchy, red lid margins, crusts on the lashes, lash loss. An ophthalmologist should also see this.

Demodicosis, acne and rosacea

These conditions look alike and often occur together:

• acne — more comedones (blackheads), in teenagers and young adults;
• rosacea — persistent redness and visible vessels in the centre of the face; Demodex makes it worse;
• demodicosis — itching, rough skin, no response to acne treatment.

So the diagnosis is made by a dermatologist: an examination, dermoscopy and a skin scraping, in which the mites are counted under the microscope.

How is demodicosis treated?

• Topical anti-mite treatment — prescribed by the doctor, usually for 1–3 months;
• in severe cases, oral medicines prescribed by the doctor;
• additional treatment to calm inflammation and redness;
• when rosacea is present too, its treatment, including device procedures for vessels and redness.

Important: steroid creams calm demodicosis for a while but then make it worse. Do not use them on your own.

Home care

• Wash your face twice a day with a gentle cleanser and always remove make-up at night.
• Pause heavy, greasy creams and foundations for a while.
• Change your pillowcase 2–3 times a week and use your own towel.
• Hot drinks, spicy food, saunas and sun worsen redness — cut back on them.
• Keep up treatment for as long as the doctor said, even once the skin has cleared.

Do not over-dry facial skin in winter: our winter skin care article covers gentle care.

Demodicosis treatment in Fergana and Kokand

At Radeski Skin Clinic a dermatologist examines the facial skin with a dermatoscope, orders a scraping when needed, tells demodicosis apart from acne and rosacea and builds a treatment plan.

• Rosacea — in brief and Acne — in brief;
• Rosacea treatment in Fergana and in Kokand;
• Dermatologist in Fergana and in Kokand.

If facial redness and spots do not clear with ordinary acne treatment, get checked for demodicosis — once the cause is found, the skin clears quickly.