Clinical alert - advice on using Tea Tree Oil to treat Demodex blepharitis

Clinical alert - advice on using Tea Tree Oil to treat Demodex blepharitis

We have been asked by a member to clarify the risks associated with using Tea Tree Oil (TTO) to treat Demodex blepharitis and how to use it safely.

We have therefore released supplementary advice, in addition to our Clinical Management Guidelines. The guidelines state that ‘Demodex mites can be dose-dependently killed by daily lid scrub with 50% tea tree oil, but this should be undertaken only by experienced practitioners as such preparations are toxic to the ocular surface.’ 

Demodex infestation of the lash follicles and the eyelid glands is fairly common and may contribute to the pathogenesis of some cases of chronic lid margin and ocular surface inflammation and Meibomian gland dysfunction. Although TTO has been shown to be effective in reducing Demodex populations, its use in ocular demodecosis was given a weak recommendation based on low quality evidence for its clinical effectiveness and the potential for harm. Furthermore, because it is known that 50% TTO can be toxic to the ocular surface, the College Clinical Management Guideline on blepharitis recommends that only experienced practitioners should carry out this particular treatment. Great care is needed in the use of strong preparations of TTO, so that only lid tissue is treated, and afterwards the lid margins should be carefully wiped with dry cotton buds in order to remove residual TTO.

View this newly released advice.

View our Clinical Management Guidelines.