title: In vitro and in vivo killing of ocular Demodex by tea tree oil.
abstract: OBJECTIVE
  To compare the in vitro killing effect of different agents on Demodex and to report the in vivo killing effect of tea tree oil (TTO) on ocular Demodex.
  
  
  METHODS
  Survival time of Demodex was measured under the microscope. Sampling and counting of Demodex was performed by a modified method.
  
  
  RESULTS
  Demodex folliculorum survived for more than 150 minutes in 10% povidone-iodine, 75% alcohol, 50% baby shampoo, and 4% pilocarpine. However, the survival time was significantly shortened to within 15 minutes in 100% alcohol, 100% TTO, 100% caraway oil, or 100% dill weed oil. TTO's in vitro killing effect was dose dependent. Lid scrub with 50% TTO, but not with 50% baby shampoo, can further stimulate Demodex to move out to the skin. The Demodex count did not reach zero in any of the seven patients receiving daily lid scrub with baby shampoo for 40-350 days. In contrast, the Demodex count dropped to zero in seven of nine patients receiving TTO scrub in 4 weeks without recurrence.
  
  
  CONCLUSIONS
  Demodex is resistant to a wide range of antiseptic solutions. Weekly lid scrub with 50% TTO and daily lid scrub with tea tree shampoo is effective in eradicating ocular Demodex.
authors.affiliation: Ocular Surface Center, 7000 SW 97 Avenue, Suite 213, Miami, FL 33173, USA.
authors.forename: Y-Y
authors.initials: YY
authors.lastname: Gao
authors.forename: M A
authors.initials: MA
authors.lastname: Di Pascuale
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: A
authors.initials: A
authors.lastname: Baradaran-Rafii
authors.forename: A
authors.initials: A
authors.lastname: Elizondo
authors.forename: C-L
authors.initials: CL
authors.lastname: Kuo
authors.forename: V K
authors.initials: VK
authors.lastname: Raju
authors.forename: S C G
authors.initials: SC
authors.lastname: Tseng
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D015822:Eye Infections, Parasitic / Q000188:drug therapy* / Q000469:parasitology / Q000473:pathology; D005140:Eyelashes / Q000469:parasitology / Q000473:pathology; D005141:Eyelid Diseases / Q000188:drug therapy* / Q000469:parasitology / Q000473:pathology; D006801:Humans; D066298:In Vitro Techniques; D008924:Mite Infestations / Q000188:drug therapy* / Q000469:parasitology / Q000473:pathology; D008925:Mites / Q000187:drug effects; D008517:Phytotherapy; D020947:Tea Tree Oil / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000891:Anti-Infective Agents, Local; D020947:Tea Tree Oil