Permethrin Cream for the Treatment of Demodex Blepharitis.

Abstract

PURPOSE:

To evaluate the safety and efficacy of permethrin 5% cream for the treatment of Demodex blepharitis.

METHODS:

Patients with confirmed Demodex blepharitis were prospectively recruited and treated with permethrin 5% cream for 6 months. Blepharitis symptoms, ocular examination findings, ocular surface disease index, and ex vivo eyelash Demodex counts were regularly assessed.

RESULTS:

Twenty-three patients were recruited, of which 2 were lost to follow up and 21 entered the analysis. Mean patient age was 57.2 ± 16.8 years (range: 24-82 years), and 13 (62%) were women. Mean Demodex counts improved after treatment from 1.36 ± 1.233 to 0.48 ± 0.6 parasites per eyelash (P = 0.03), and the overall blepharitis symptoms score improved from 42.9 ± 22 to 32.7 ± 21 (P = 0.01). Improvement in disease symptoms (scored on a scale between 0 and 4) was noted including feeling of dry eye (2.85 ± 1.3-1.85 ± 1.7, P = 0.006), discharge (1.86 ± 1.7-1.00 ± 1.1, P = 0.040), and dandruff-like debris (1.69 ± 1.7-0.9 ± 1.6, P = 0.033), as well as clinical findings including a decrease in scaling (on a scale of 1-5; 1.43 ± 0.9-0.86 ± 0.7, P = 0.006) and corneal staining with fluorescein (on a scale of 1-4; 1.29 ± 0.4-1.05 ± 0.2, P = 0.040). No change in the ocular surface disease index score was noted (37.5 ± 24.1-41.63 ± 42.5, P = 0.913), and no adverse events were reported.

CONCLUSIONS:

Treatment of Demodex blepharitis with permethrin 5% cream resulted in a decrease in parasite burden and improvement in blepharitis signs and symptoms, with no reported adverse events. Permethrin might be a safe and effective alternative for the treatment of blepharitis associated with Demodex infection.

• Authors: Idan Hecht, Asia Melzer-Golik, Naava Sadi Szyper, Igor Kaiserman
• Journal: Cornea (Cornea) Vol. 38 Issue 12 Pg. 1513-1518 (Dec 2019) ISSN: 1536-4798 [Electronic] United States
• PMID: 31169611 (Publication Type: Journal Article)

Chemical References

• Insecticides
• Permethrin

Topics

• Adult
• Aged
• Aged, 80 and over
• Animals
• Blepharitis (diagnosis, drug therapy, parasitology)
• Eye Infections, Parasitic (diagnosis, drug therapy, parasitology)
• Female
• Humans
• Insecticides (administration & dosage)
• Male
• Middle Aged
• Mite Infestations (diagnosis, drug therapy, parasitology)
• Mites (drug effects)
• Permethrin (administration & dosage)
• Prospective Studies
• Skin Cream
• Young Adult