Re-Evaluating The Role of Demodex Mite in Skin Bio-Balance and

Abstract

Demodex mites are obligate human ectoparasites that live in or near pilosebaceous units. D. folliculorum ingests skin cells and sebum, whereas D. brevis burrows deeper into the sebaceous glands and ducts, feeding on gland cells. They may even provide a mutualistic host advantage by feeding on bacteria or other organisms in the follicular canal to keep the dermal bio-balance in check. Demodicosis is the umbrella term for all skin disorders related to Demodex mites. It is still unclear whether Demodex is the underlying cause or the result of pre-existing conditions such as rosacea and other dermatological diseases. Given that, Demodex is not the only cutaneous microbiota involved in these conditions. This review aims to re-evaluate the pathogenicity of the Demodex mite, with a focus on systematic internal causes that may drive pathogenicity, such as immunological imbalance, microbiome alterations, or concomitant infections. Clinical suspicion of the underlying causes of Demodex pathogenicity in various dermatoses can thus aid in early diagnosis and appropriate, timely, and cost-effective treatment.