The Dry Eye Zone

Rebecca's Blog

-

Study: Permethrin 5% cream for demodex blepharitis

This was a small study (21 patients). But there were no reported adverse events, which is good. It surprises me, though, that OSDI scores showed no improvement.

Permethrin Cream for the Treatment of Demodex Blepharitis. Hecht et al, Cornea. 2019 June 3.

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.