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.

Episode Transcript

Speaker 1 (00:03):
Welcome to the Jazzy Eyes podcast.
Taking care of your vision withexpert precision.
Here's your host, dr LauraFalco.

Jeremy (00:15):
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 tosee you.

Dr. Falco (00:29):
Nice to see you.

Jeremy (00:30):
Yeah, of course, and thanks to our listeners, of
course, for tuning in.
So why don't we get into thetopic today?
I'm going to have you talk alittle bit about and I'm hoping
to pronounce this correctlyDemodex blepharitis.

Dr. Falco (00:45):
Yes.

Jeremy (00:46):
All right.
So please, I'm not familiar, Imay 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 (00:59):
So we're in, so lid wipes probably Little lid wipes
for something that might beDemodex blepharitis.

Jeremy (01:04):
So please enlighten us, tell us a little bit about what
that is.

Dr. Falco (01:08):
So the first thing I want to just talk about is
blepharitis and basically thesuffix itis, which is basically
an inflammation of anything, solike appendicitis, any
cellulitis.
Any time you have an itis, itmeans you have an inflammation
of the tissue.
When you have blepharitis it'squite a general term it's an

(01:29):
inflammation of the eyelidmargin on the top and the bottom
, specifically, think where youreyelashes connect into the
eyelid.
I tend to see a little bit moreinflammation in men than women,
and part of the reason I thinkthat is is because women wear
makeup.
So when we remove our makeupand we wash our face at the end

(01:51):
of the night, we pay specialattention to make sure our
mascara is off, our eyeliner isoff.
So we're using cleaningproducts that are specific for
the eyelids on the eyelid margin.
Every day Men no offensesometimes wash their face and
kind of ignore the eyelids.

(02:11):
So they'll wash around theirface, their cheeks, their
forehead, their eyebrows, butmaybe not the lids per se.
And the job of your eyelashesis, as you're blinking during
the day, to catch everythingthat's in the air.
Dust, pollen, bacteria likes tolive right on that lid margin
and all day, as you're blinking,your eyelashes are supposed to

(02:34):
catch everything in the air frompreventive, from going in your
eyes, but as you blinkthroughout the day.
If you have an accumulation ofwhatever is in the air and
bacteria and dead skin cells onyour eyelid margin as you blink
throughout the day, thatmaterial will fall into the eye
throughout the day.
Things that you mightexperience are irritation,

(02:57):
grittiness, red eye, evenitching, depending upon what it
is that's falling into the eyeat the end of the day.
So over time that can developan inflammation of the margin
and then we have blepharitis.
Now what we've found is demodex,which is basically I'm sure
we've had it for a while, butwe're really just using electron

(03:18):
microscopy to look now atexactly what's living in the
eyelashes and, as you know, likeall over your skin.
If you looked with a microscopeyou would see organisms and you
have natural flora.
So I don't want people to freakout, but there is something
called a demodex mite whichunder like gross magnification

(03:38):
it almost looks like a littleworm, but not a word.
But it's very, very.
It's a mic.
It's a very little organism andit can live.
It loves to live and feed onall the gunk that lives right on
our eyelash margin.
Sometimes people think this isdandruff, if they have, if they
look in a magma and see theyhave flaking along the lid

(03:59):
margin, the demodex is reallydiagnosed by your doctor because
you do need to look with amicroscope because it leaves a
slightly different kind ofresidue on the eyelash margin.
Now for everyone you knowpanics and freaks out I have my.
It's pretty common.
I think it's been there forquite a while.
We're just looking at a tissuenow and gross magnification and

(04:22):
the good news is it's supertreatable.
So you'll see a lot of productssay demodex now and the thing
that really gets them is teatree oil, which I don't want
anyone to get out and get teatree oil and use it right on
their eyelash margin becausethey would find tea tree oil.
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

(04:47):
gunk, it kills the mites, itcleans everything in it and it
works For patients that havereally, really severe cases.
I have an in-house treatmentthat we do, where I numb the
eyes and I really scrub with aspecial tea tree scrub that you
can't use at home.
I have to do it, or a doctorhas to do it, and it gets rid of

(05:09):
it all.
And there is a new medicationout by a company called Tarsus.
The medication it doesn't rolloff the tongue, it's called
X-dem-V.
Anyway, that is the firstmedication of its kind.
That is an eye drop that youwould really put on your eyes
but like really concentrate inthe eyelid margin, and it's one

(05:29):
drop twice a day for about sixweeks.
That is the first FDA approvedeye drop for this particular
type of blepharitis.
So there are all different waysyou can have an inflammation in
the eyelid margin calledblepharitis, but we were just
specifically today, going overthis one, which is the Demidex

(05:50):
mite, which is super responsiveto the tea tree based oils, and
then this one new medication forthose cases that are pretty
severe.
So, again, this is why you goin once a year for an eye exam.
We check to make sure theeyelashes look clean.
I would also caution women whoare getting extensions in their
eyelashes, which is superpopular to really make sure that

(06:12):
they get those inspected,because those are just breeding
ground for more gunk to live on.
So it's really important thatyou clean those properly as well
.

Jeremy (06:21):
Interesting.
So if I understand this wholesegment correctly on the
blepharitis right, the way I'mseeing it in my mind is kind of
like the eyelids or thewindshield washers on a car and
they constantly are cleaning allthe gunk off and they're
pulling it down to the, I guess,the base of the windshield

(06:41):
where it kind of builds up there.
And that would be like the baseof the eyelids that are getting
kind of gunk built up from allthe blinking throughout the day,
right, and the eyelashes pickup the dirt and whatnot, and
then it deposits on the.
Is that a good analogy?

Dr. Falco (06:52):
So, yeah, the eyelashes.
The point of the eyelashes andthe reason just like you have
cilia in your nasal passages asyou're breathing is to catch all
the dust, pollen, everything inthe air that you don't want to
get into your eye per se.
The eyelashes job is to catchthat, to be like a pre-filter
and a HEPA filter, if you will,to catch some of the stuff

(07:13):
before it lands in your eyes,and it's important to clean it
and clean those.
So I think that's where a lotof people fall short is that
when they wash their face theydon't really pay special
attention to the eyelashes andover time you can have all the
stuff that's in the air andthose of us who have pets if you
snuggle your dogs and your catsand then obviously gunk lives

(07:36):
on their hair and now it canlive in your eyelashes like it's
just, you know, every night,every morning, to get into the
routine to clean the eyelashmargin.

Jeremy (07:45):
All right, very good, and that was definitely helpful
for me anyway, right, becauseyou gave me those little pads to
wipe my eyes, and I'll be thefirst to admit, I haven't been
doing it daily.

Dr. Falco (07:55):
So any friendly reminder to continue, that is
definitely helpful so you'rethere with that, I love the
pre-moist and towelettes too,because if you travel one less
liquid that you have to worryabout getting through TSA
because you can literally justtake a pack of.
They're good eye makeupremovers.
They're good end of day likethey refresh the whole eye area,

(08:15):
clean off all the gunk andthey're easy to travel with.
So I love those.

Jeremy (08:19):
All right, very good, dr Falco, always a pleasure.

Dr. Falco (08:22):
Thank you.

Jeremy (08:23):
Looking forward to our next segment.
Everyone thanks for tuning inand we will catch you next time.
Everyone take care.