EP #6: Eyelash Hygiene and Treatments for Demodex Blepharitis

Ever wondered about the secret life of your eyelashes? Discover why these tiny hairs are your eyes' first line of defense and how they can sometimes harbor a microscopic mite that could cause inflammation and discomfort. This week, we have Dr. Laura Falco, an expert on a common but often overlooked condition called Demodex Blepharitis. Dr. Falco guides us through a deep understanding of the condition, its causes, and its effects on your eye health.

Listen on as Dr. Falco reveals the role of eyelashes in protecting your eyes from dirt and bacteria and how neglecting to clean this area could lead to various symptoms including irritation, redness, and itchiness. She further elaborates on the diagnosis and treatment options available, emphasizing the importance of regular eyelash cleaning and the role of tea tree oil in combating the Demodex mite. Dr. Falco also introduces us to a new FDA-approved eye drop specially designed for this type of blepharitis. You'll walk away from this episode armed with expert insights to help maintain your eye health and enhance your vision.

Transcript

Speaker 1: 0:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, dr Laura Falco.

Jeremy: 0:15

Hello everyone and welcome to another episode of the Jazzy Eyes podcast. I'm your co-host, Jeremy Wolfe, and I'm joined by your host, Dr Laura Falco. Dr Falco, always a pleasure to see you.

Dr. Falco: 0:29

Nice to see you.

Jeremy: 0:30

Yeah, of course, and thanks to our listeners, of course, for tuning in. So why don't we get into the topic today? I'm going to have you talk a little bit about and I'm hoping to pronounce this correctly Demodex blepharitis.

Dr. Falco: 0:45

Yes.

Jeremy: 0:46

All right. So please, I'm not familiar, I may or may not have this myself, because I know when I met you, you gave me some. What were they? Topical, what do you call it?

Dr. Falco: 0:59

So we're in, so lid wipes probably Little lid wipes for something that might be Demodex blepharitis.

Jeremy: 1:04

So please enlighten us, tell us a little bit about what that is.

Dr. Falco: 1:08

So the first thing I want to just talk about is blepharitis and basically the suffix itis, which is basically an inflammation of anything, so like appendicitis, any cellulitis. Any time you have an itis, it means you have an inflammation of the tissue. When you have blepharitis it's quite a general term it's an inflammation of the eyelid margin on the top and the bottom, specifically, think where your eyelashes connect into the eyelid. I tend to see a little bit more inflammation in men than women, and part of the reason I think that is is because women wear makeup. So when we remove our makeup and we wash our face at the end of the night, we pay special attention to make sure our mascara is off, our eyeliner is off. So we're using cleaning products that are specific for the eyelids on the eyelid margin.

Dr. Falco: 2:04

Every day Men no offense sometimes wash their face and kind of ignore the eyelids. So they'll wash around their face, their cheeks, their forehead, their eyebrows, but maybe not the lids per se. And the job of your eyelashes is, as you're blinking during the day, to catch everything that's in the air. Dust, pollen, bacteria likes to live right on that lid margin and all day, as you're blinking, your eyelashes are supposed to catch everything in the air from preventive, from going in your eyes, but as you blink throughout the day. If you have an accumulation of whatever is in the air and bacteria and dead skin cells on your eyelid margin as you blink throughout the day, that material will fall into the eye throughout the day. Things that you might experience are irritation, grittiness, red eye, even itching, depending upon what it is that's falling into the eye at the end of the day. So over time that can develop an inflammation of the margin and then we have blepharitis.

Dr. Falco: 3:09

Now what we've found is demodex, which is basically I'm sure we've had it for a while, but we're really just using electron microscopy to look now at exactly what's living in the eyelashes and, as you know, like all over your skin. If you looked with a microscope you would see organisms and you have natural flora. So I don't want people to freak out, but there is something called a demodex mite which under like gross magnification it almost looks like a little worm, but not a word. But it's very, very. It's a mic. It's a very little organism and it can live. It loves to live and feed on all the gunk that lives right on our eyelash margin.

Dr. Falco: 3:53

Sometimes people think this is dandruff, if they have, if they look in a magma and see they have flaking along the lid margin, the demodex is really diagnosed by your doctor because you do need to look with a microscope because it leaves a slightly different kind of residue on the eyelash margin. Now for everyone you know panics and freaks out I have my. It's pretty common. I think it's been there for quite a while. We're just looking at a tissue now and gross magnification and the good news is it's super treatable. So you'll see a lot of products say demodex now and the thing that really gets them is tea tree oil, which I don't want anyone to get out and get tea tree oil and use it right on their eyelash margin because they would find tea tree oil.

Dr. Falco: 4:38

So that's an essential oil but, if you see, it is now part of a lot of eye cleaners wipes, because it really it cleans the gunk, it kills the mites, it cleans everything in it and it works For patients that have really, really severe cases. I have an in-house treatment that we do, where I numb the eyes and I really scrub with a special tea tree scrub that you can't use at home. I have to do it, or a doctor has to do it, and it gets rid of it all. And there is a new medication out by a company called Tarsus. The medication it doesn't roll off the tongue, it's called X-dem-V.

Dr. Falco: 5:20

Anyway, that is the first medication of its kind. That is an eye drop that you would really put on your eyes but like really concentrate in the eyelid margin, and it's one drop twice a day for about six weeks. That is the first FDA approved eye drop for this particular type of blepharitis. So there are all different ways you can have an inflammation in the eyelid margin called blepharitis, but we were just specifically today, going over this one, which is the Demidex mite, which is super responsive to the tea tree based oils, and then this one new medication for those cases that are pretty severe. So, again, this is why you go in once a year for an eye exam. We check to make sure the eyelashes look clean. I would also caution women who are getting extensions in their eyelashes, which is super popular to really make sure that they get those inspected, because those are just breeding ground for more gunk to live on. So it's really important that you clean those properly as well.

Jeremy: 6:21

Interesting. So if I understand this whole segment correctly on the blepharitis right, the way I'm seeing it in my mind is kind of like the eyelids or the windshield washers on a car and they constantly are cleaning all the gunk off and they're pulling it down to the, I guess, the base of the windshield where it kind of builds up there. And that would be like the base of the eyelids that are getting kind of gunk built up from all the blinking throughout the day, right, and the eyelashes pick up the dirt and whatnot, and then it deposits on the.

Jeremy: 6:50

Is that a good analogy?

Dr. Falco: 6:52

So, yeah, the eyelashes. The point of the eyelashes and the reason just like you have cilia in your nasal passages as you're breathing is to catch all the dust, pollen, everything in the air that you don't want to get into your eye per se. The eyelashes job is to catch that, to be like a pre-filter and a HEPA filter, if you will, to catch some of the stuff before it lands in your eyes, and it's important to clean it and clean those. So I think that's where a lot of people fall short is that when they wash their face they don't really pay special attention to the eyelashes and over time you can have all the stuff that's in the air and those of us who have pets if you snuggle your dogs and your cats and then obviously gunk lives on their hair and now it can live in your eyelashes like it's just, you know, every night, every morning, to get into the routine to clean the eyelash margin.

Jeremy: 7:45

All right, very good, and that was definitely helpful for me anyway, right, because you gave me those little pads to wipe my eyes, and I'll be the first to admit, I haven't been doing it daily.

Dr. Falco: 7:55

So any friendly reminder to continue, that is definitely helpful so you're there with that, I love the pre-moist and towelettes too, because if you travel one less liquid that you have to worry about getting through TSA because you can literally just take a pack of. They're good eye makeup removers. They're good end of day like they refresh the whole eye area, clean off all the gunk and they're easy to travel with. So I love those.

Jeremy: 8:19

All right, very good, dr Falco, always a pleasure.

Dr. Falco: 8:22

Thank you.

Jeremy: 8:23

Looking forward to our next segment. Everyone thanks for tuning in and we will catch you next time. Everyone take care.