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All about Demodex

Frequently asked questions about the demodex mites

1. What are Demodex mites?
2. Where do Demodex live?

3. What are Demodex mites look like?

4. When where they discovered?

5. A Chapter from the book “Unbelievable cures & medicines from China” about Professor Zhao Zhongzhou

6. An article from a Taiwan newspaper entitled “Recognition of the Acnes”

7. Demodicosis and associative diseases

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1. What are Demodex mites?

Demodex Mites, also known as face mites, are not so well known by the public. They are parasites which live on the face and in the hair follicles of humans. They can badly damage the facial skin of humans, usually starting at middle age when the immune system is weakened and their population has increased.
There are two existing types: the longer kind, Demodex folliculorum, which live in the hair follicles and the short ones, Demodex brevis, which live in the sebaceous glands.   

The mites are invisible to the naked eye, usually measuring between 100 – 300 microns in length. In the later section, we explain how you can find them under the microscope and provide more information about demodex mites.

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2. Where do Demodex live?

The mites can live on all body parts wherever there are hair roots and sebaceous glands however, they are most prevalent in the facial area, especially the nose, forehead, chin, and cheeks. These areas have the most favorable living and breeding conditions and provide an optimum temperature for them to thrive.
The Demodex folliculorum mite can also live in the eye lash roots and can be the reason for blepharitis, itching and infections. The hair follicles from the scalp are also often infected with itching as a result.

The mouth of these mites is like a very sharp needle that can directly sting into the cells to absorb nutrition. They like a wet and warm environment and become the most active in the dark.  There are five stages in the life cycle. After mating on the surface of the skin, they go back into it and lay eggs, taking bacteria with them and excreting wastes and secretions, laying eggs and dying within its layers. After death, their corpses become liquid and decompose inside the skin.

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3. What do the Demodex mites look like?

Demdex Brevis mite

Demodex Folliculorum mite

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4. When were they discovered?

Demodex folliculorum was first described by Berger in 1841 and demodex Brevis was found in the human skin in 1963.

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5. A Chapter from the book “Unbelievable cures & medicines from China ” talks about Professor Zhao Zhongzhou

Acne disfigures, temporarily or permanently, some 130 million Chinese and countless other millions worldwide. Unlike most Western doctors, Zhao Zhongzhou believes the sole cause of the complaint to be a parasite called demodex. Eradicating its infestation of facial habitats, he stresses, is the essential step to give people blemish-free complexions.

Over the centuries, physicians have offered scores of theories to explain spotty faces, ranging from eating too much chocolate to citrus fruits, from apples to adolescence. But the stubborn red swellings remain on many faces.

Zhao Zhongzhou is believed to be one of the first doctors in the world who is capable of eliminating spots wherever they might be, after identifying the sole culprit: a parasite called demodex. Zhao, 67, has 40 years experience as a surgeon, initially in the People’s Liberation Army, then in a hospital as an enterprise, he invented Zhongzhou Ointment and is now the chairman of the board of directors of Kunming Zhongzhou Pharmaceutical Corporation Limited, based in Kunming , capital of southwest China ’s Yunnan Province .

With an invention patent granted by China ’s State Patent Office, the ointment wiped acne off the faces of 93.46 % of 107 patients who took part in a clinical test in 1985-86.

Now, more than 100 acne rosacea clinics have opened in China. They exclusively use Zhongzhou Ointment for treating the ailment. A number of dermatologists working in the clinics say that many of their patients ha  suffered for 20 or 30 years from acarodermatitis, and had tried every medicinal ointment touted as being a cure, but to no avail. Their unpleasant symptoms subsided only after they used Zhongzhou Ointment.

A survey of 2,723 acne cases, conducted at the Hospital Affiliated with the Military Medicine Academy in Beijing, No.2 Hospital Affiliated with the Shenyang Medical College and six other clinics around the country, between March 1986 and October 1992, revealed an improvement rate of 99,7 % and a cure rate of 93,39 %.

At a clinic in Zhangzhou, in southeast China ’s Fujian Province , the cure rate was as high as 96,22 %. Xiong Heping of the Xi’an Bakery and Confectionery in Shaanxi Province says that he used to have a red face covered with acne. “I was very worried, I visited a number of hospitals in Xi’an and used dozens of bottles of a medicine said to be effective for acne rosacea, but I stayed spotty”  Xiong says.

After using a few bottles of Zhongzhou Ointment in the fall of 1991, however, only two small red spots were left beside his nose. He felt sure that they would disappear if he continued to use the ointment. “Zhongzhou Ointment is miraculous” he proclaims. The ointment consists of about eight Chinese and Western medicines such as sulphur, zinc oxide and Java brucea. It acts as a kind of germicide to kill the demodex on the skin of the face. “More often than not, most of the demodex will be killed within a month” Zhao says.

Aside from killing demodex, reducing inflammation and soothing itching which leads to pain – which is the main complaint about acarodermatitis apart from its unsightliness – the ointment also moistens the skin.
After several weeks’ use, patients can usually look in the mirror and see an unblemished facial appearance the likes of which they may have missed for years, or even decades.

And since the ointment is hormone – free and contains no poisonous substances such as lead, benzene or mercury, its long – term use will have no detrimental or side effects and its ingredients are non – addictive. Zhao says that acarodermatitis is a persistent aliment that many people suffer from throughout their lives.
“The fact that few doctors acknowledge that demodex is the only cause of the ailment compounds difficulty in curing it” he says.

Over the past few years, Zhao says, researchers from many countries including the United States, New Zealand, Australia and China have been investigating the incidence of demodicidosis among the population, What they found was a conformity, each country reported an infection rate of approximately 60 %, while the rate of incidence, mostly through contagion, was around 10 %.

As for rosacea alone, one of the two ailments caused by acarodermatitis, the occurrence rate was 2,44 percent. “That means 130 million Chinese people are suffering from acarodermatitis – 30 million of them have red noses”  Zhao says. “That is why I believe my work is so important”

The Parasite

Demodex is usually 100 – 300 microns long. In simple terms it is smaller than the tiniest insect but bigger than a germ. There are two types, the long and the short. Parasitizing the facial sebaceous glands at an appropriate temperature, demodexes reproduce by a generation every 15 days. The adult demodex die soon after the reproduction and the bodies rot and liquidate inside the sebaceous glands. Since demodex spend all their lives inside the sebaceous glands, they physically and chemically affect the skin, reducing its immune competence, and causing allergic reactions in some parts of skin tissues, where red spots (acne) breaks out. This is sometimes known as adolescent acne for obvious reasons.

“If not treated properly with correct medication, the inflammation will reoccur, In more serious cases, the epidermis, or the appearance of skin, will be permanently injured, scars resembling the texture of orange skin will be left, hair  follicle pores will be enlarged, and the skin will become thicker due to hyperplasia. Sometimes, the inflammation even leads to superfluous tumors or lumps, and red nose” Zhao explains. What hinders the permeation of medicine is the membrane enclosing the eggs of demodex.

Therefore, patients are required to apply the ointment continuously, without any intervals, until a seborrhea test shows negative, which indicates a full recovery”
Zhao says. Generally, he says, victims of superficial demodex rosacea caused by the long demodex  mites should use the ointment for 60 – 80 days, while patients of deep demodex rosacea caused by the short demodex mites should use the medicine for 90 – 120 days.

The therapies must go on to the end, even if the symptom of inflammation disappears two to three weeks after first using the ointment.
Those who are found to have demodex existing in their skin but do not yet suffer from acarodermatitis may effectively prevent themselves from contracting the disease by applying the ointment.

Zhao says he started to think about finding a way to cure the skin disorder on the battleground of the war in Korea (1950 – 53)
“I was a surgeon in the Chinese People’s Volunteers in North Korea, A friend of mine, an officer, had a red nose, he earnestly appealed to me for help, I said I will try” He recalls.

After numerous failures, Zhao developed an ointment that contained both traditional Chinese herbs and Western medicines, and in a few months, he was delighted to find it cured his comrade of the rosacea. “That was back in 1956” Zhao says.

“I was fairly young and curious. I asked myself, why not try the ointment on others and see if it also effects a cure ?" So he did, from 1956 – 76, his cure rate remained about 80 %, while the total rate of his ointment being effective to a reasonable degree approached 100 %. After demobilization in 1976, Zhao worked as a doctor and deputy director of Hospital No. 153 under the Ministry of Weaponry Industry. A worker in his 30s asked Zhao to rid him of rosacea, Zhao did it successfully.

The worker was so pleased that he told the story to everyone he met. More and more sufferers sought the same treatment. Zhao worked to improve his ointment and enhance its cure rate. By 1984, Zhao’s treatment was in such high demand that he opened a special clinic in his hospital, where he treated the sufferers of acarodermatitis on Wednesdays and Fridays.

Before he retired in 1989, Zhao prepared his ointment in the dispensary of the hospital. His retirement however, terminated that privilege. He had to think of finding a manufacturer. In 1990, Zhao signed a contract with the Xinxiang People’s Pharmaceutical Factory based in Xinxiang , Henan Province. The ointment was named “Fu Man Ke Xing” witch means “Killer of demodexes”

In September 1993, the ointment satisfied a panel of medical experts in Henan Provincial Public Health Bureau. A year later, Zhao set up Zhongzhou Pharmaceutical Corporation Limited in Kunming. Having improved the production of the ointment, he renamed it Zhongzhou Ointment. Zhao was a voluntary expert donating his ointment to those who needed it during Beijing ’s staging of the Asian Games in 1990.

In August 1991, the International Congress of New Drug Development in Seoul , South Korea , invited Zhao to present his thesis,
Instruction of Zhao Zhongzhou’s Ointment for Acne Rosacea”

The congress granted him an official product number of (91) P.D.-7 for his ointment. In 1993, the ointment won a gold medal at the Fair of New Science and Technology Results and Patent Technology and Products, sponsored by the State Science and Technology Commission. In 1994, Zhao’s ointment won another gold at the Fifth Asian and Pacific International Trade Fair.

Zhao feels it critical to stress that acarodermatitis is never a hereditary disease. “It is contagious” Zhao emphasizes. Newborn babies have no demodex mites, they get it only after constant contact with infected persons, for example by kissing, or sharing towels, with those adults carrying demodex mites. He complains that prevention is neglected due to ignorance. “Doctors should tell people how to avoid being infected”  Zhao’s target for 1997 is to turn out two million boxes of his ointment, and gain gross sales of 60 million yuan (US$ 7,2 Million). It’s a means to an end, to wipe out all acne.

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6. An article from a Taiwan newspaper entitled “Recognition of the Acnes”

Recently some newspapers in Taiwan carried an article by Lin Xinmei entitled “Recognition of the acnes”. “Fight the acne from its predisposing causes”. He called on the people to fight the causes of acne and eliminate them through the treatment and prevention of the predisposing causes.  He summed them up as originating from seven sources:

1. Excessive endocrine hormones
2. Too much oily food
3. Dirty skin
4. Physical injury
5. Environmental humidity
6. Cosmetic irritation
7. Medical by-effect.

In fact, besides the above-mentioned predisposing causes, medical textbooks and journals both at home and abroad state further causes which may be related to genetics or due to bacterial infection. Doctors have been conducting their treatment and giving instructions on the basis of so many theories. However, there is no final conclusion thus far. Doctors have prescribed medicines whose results are not so satisfactory. Prevention is almost beneath mentioning. The patient’s normal complexion has frequently been affected by acne attacks. Even worse, acne infections sometimes leave scars on the face, which causes much vexation.
Acne has attracted much attention in the general population. Whether or not it can be eliminated depends upon a new and correct interpretation of its predisposing causes.

Following the research of the medical specialists in this field for many years, and based on my clinical diagnosis for over 30 years, I am of the opinion that acne is a skin disease caused by demodex mites and that after the application of my patented new medicine “Zhongzhou ointment”, the acnes soon vanishes.
According to an investigation of the infection of demodex mites in the human body made by scholars both at home and abroad, the total infection rate makes up 60%, and from those 60%, some 10% are heavily infested with demodex mites, the same amount as those are suffering from acne.
Some aged people also suffer from acne and rosacea, which some would mistake as being hereditary but they are not. They are in fact, contagious diseases.
Medical science has proven that newly born babies are free of these diseases and they become infested by physical contact with adults suffering from these diseases by kissing, face to face hugging, towels etc.

As they grow, the babies will have more and more contact with infested people. This means a greater chance of the reproduction rate of the demodex. However, as previously stated, only 10% out of the 60% of those with infection from the mites will grow into a disease.  People with stronger immune systems don’t have a negative reaction to the mites etc.

According to the research, once the human body is infected, the demodex will become parasitic, mainly in the sebum of the hair follicles of the face where body touch is frequent, the sebaceous glands are well developed and the temperature is perfect. They absorb nourishment, excrete wastes, copulate and laying eggs. Within 15 days, they give birth to a new generation, the mites die, rot and  liquefying in the skin.

As the demodex complete the entirety of their life cycle in the sebum glands and hair follicles, they cause mechanical and chemical stimulation to the skin. More and more stimulation will produce an allergic reaction that leads to inflammation such as, popular eruption, pustules etc. which we all know as acne and even erythema.

If this situation is not followed by correct diagnosis and treatment, the mites will increasingly multiply and the inflammation will get worse, leaving scars on the face, the damaged pores accompanied with widening of the capillaries, thicker skin, hyperplasis and worse, there might be vegetation or pimples which will spoil the skin.
Starting from this new medical theory and practice, we would come to a new comprehension and explanation of the predisposing causes of acne, and open up a new path for combating it.

In order to get rid of acne, we must popularize advanced medical knowledge, cast away all the specious theories, and prevent the infection and spreading of the demodex mites. To achieve this, the adults must take care of the younger generation. They will have to take measures for the prevention and effective cure of the demodex mite infection themselves. Where there are facilities, training classes should be opened and general investigation and treatment of the disease be conducted, by doing so, the acne and rosacea can definitely be eliminated in a sweeping battle.

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7. Demodicosis and associative diseases

Translation of a article published in "Bulletin of the academy of Sciences of the Republick of Kazakhstan", 1992, No. 4, pp.84-88
(NOTE: We made some slight changes in an attempt to make this article more readable.)

Demodecosis as an independent disease has not yet well investigated. However, in the past decades the interest in this and other mites diseases has considerably grown (A.A.Antonyev et al.., 1988; R.D.Zhaxylykova, 1990) The clinical picture of the demodicosis from the moment of infestation to development of various complications has not been adequately described. Moreover, up to now, the issue of pathogenic role of the mites Demodex upon the human beings remains disputable.

Material and investigation methods

In the laboratories, the Demodex mites were detected in almost all 6547 patients examined. In the investigation, we used the methods developed by our team (R.D.Zhaxylykova, 1990)

  1. Direct micro scoping of the skin and mucous membrane surfaces in vivo by application of the adapted devices magnifying at least 50 times.

  2. Rubbing in the pores of the skin with rapidly penetrating anti parasitics that cause destruction of the Demodex in the place of their habitat, and thereby release the allergenic components on which the local allergic reaction is being developed in the form of an edema of the connective tissue capsule, this leads to appearance of a visible papule - demodicosis focus. Moreover, we applied the universally known methods of scraping (B.P.Baksht,1966) and epilation (M.M.Mukhina, V.E.Yevseeva, 1980).

The 790 patients infected with Demodex were examined by the provocative method of detection of the Demodex colonies (R.D.Zhaxylykova, M.K.Kenenbayeva, 1990) Amongst the papules detected in all the patients examined, 873 colonies of the mites were subjected to enucleation and to subsequent micro scoping. In 93% of them were Demodex mites detected, in 0,4% - Sarcoptes scabiei, in 6,6% - colonies of by us, unidentified mites. Moreover, 10 persons with healthy skin were examined by, for us, accessible methods and in which the mites and their colonies not have been found.

A long-term dynamic observation was conducted over 342 patients infected by Demodex, infestation of these patients occurred through natural conditions more then 15 years ago till they became the sick persons with the laboratorial confirmed demodicosis. Besides that, demodicosis was also produced experimentally on a volunteer who had a healthy skin and on two cats which preliminary were thoroughly prepared for the experiment in witch the cats, during a period of tree months where bathed every day with soap and brush. Infestation of the volunteer was executed through the pre-boiled wisp of bast, on which the Demodex mites were taken from the "butterfly" region from the face a patient having laboratorially confirmed demodicosis on the face. By use of anti parasitics, there were 151 patients successfully cured who had various clinical manifestations and complications (so called clinical masks) /R.D.Zhaxylykova, 1990/ of the demodicosis (see Table).
Results of the investigations and discussion

Several investigators /A.K.Akbulatova, 1966; T.Rufli, G.Mumcuoglu, 1981/ marked in their papers at the high percentage of the Demodex infestation of the skin of the dermatologic patients and of "practically healthy" persons. We have a different point of view upon this fact. Among the infected by Demodex, in 62% of the examined persons there were clearly found expressed subjective sensations from the part of the skin. At the purposing questioning this percentage increased up to 84%. Periodical slight strokings, mainly of the face skin, scratchings that were observed in almost all examined patients allow us to speak about availability of the subjective symptoms in 100% of the patients under observation. Upon examining the subclinical and clinical manifestations of the demodicosis or its complications were found in all persons infested by Demodex. Absence of the mites in the skin of the examined persons with healthy skin testifies correctness of the clinical observations being carried out. Also this is confirmed by effective antiparasitic treatment of the patients, to which the specialists of different profiles gave different diagnosis. Absence or sharp decrease in percentage of detection of the mites in the skin of the treated patients (see Table) together with the positive dynamics of the clinical picture allow us to conclude as per their involvement in origination and development of the indicated diseases. However we consider necessary to continue investigations in this aspect with the acarological observation of the affected ("shock") organs and tissues.

As per mechanisms in development of allergic complications due to demodicosis, our points of view completely coincide with points of view and conclusions of the allergologists /V.I.Pytsky, et al.,1984/. Long-term, let it be even symbiotic (as the dermatologists and some other specialists consider) presence of Demodex in the human being skin pores in considerable amounts (from 1 sq. cm of the skin there were picked out up to 500 specimen of the Demodex /Yu.S.Balashov, 1982/) may cause sensibilization of the host`s organism. Effectiveness of the antiparasitic therapy makes it possible to conclude that over 151 years from the moment of detection in the glands of the skin of the human being in 100% of the examined persons the Demodex could transfer from the symbiotic to the parasitic mode of life. A similar phenomenon can be observed in the microcosm not infriquently /K.I.Skryabin et al., 1934/. This fact can explain the infectious nature, being found by the epidemiological investigators, of growth and dissemination of allergy and other, so called noninfectious, diseases /A.M.Vikhert, A.V.Chaklin, 1990/, some of which are listed in the Table given in this paper.

The demodicosis in 100% cases are inherited from the mother /Yu.S.Balashov,1982/. Our clinical observations have also shown 100% infestation by Demodex of the children of all ages beginning from the first days of their life. Therefore we consider that demodicosis and the associative diseases with participation of the Demodex began to affect the younger persons than it was earlier /K.S.Ternovoi et al., 1990/. Our investigations show that majority of the famous allergenes destroy the microscopic mites present in the organism of the patient with allergy. In this case a great amount of allergene components of the mites are being released, to which the host organism has been sensibilized. This fact was considered by us during treatment of the allergologic patients.

For complete deliverance of the patients organism from the mites we used the "allergenic" for them earlier factors (food, medical preparations, pollen, etc.), which gave us possibility to reach complete liquidation of allergy in 91% of the allergologic patients. Diversity of clinical manifestations and complications of the demodicosis, from one part, may be the result of high self-organization of such microscopic organism as the mites Demodex /V.I.Zakharov, 1972/. From the other part, as it is known from literature, the mites can transfer on their bodies the smaller organisms: viruses, bacteria, fungi, etc. /Yu.S.Balashov,1982/. This may be the reason of development of the associative diseases, being caused, for example, by the Demodex and by the definite virus (including AIDS), by the Demodex and by the definite bacterium, etc. There may be very many such combinations, therefore clinical manifestations of the associative disease may be very different. Availability of the pricking-sucking-cutting mouth apparatus in the Demodex /Yu.S.Balashov, 1982/ promotes the appearance of the above-listed combinations of various associations (bacteria, viruses, etc.).

Detection in one and the same patient of three varieties of the mites allows to speak about existence of the diseases caused by association of different mites with different microorganisms. The afore said may be added with information about high invasiveness of people to helmiths /N.N.Glamazanova, 1987/. Taking into consideration the above-mentioned data there may be supposed a possibility of wide spread of associative diseases, in which the Demodex may be an active etiological component. The high percentage of invasiveness of the skin and mucous membranes by the Demodex together with the available information in the literature gives us possibility to ascertain the availability of the demodicosis pandemic. It would be more correct to say about the pandemic of the associative diseases, in which the Demodex is the etiologic connecting base.

The demodicosis, that is not taken into consideration in the medical practice, considerably complicate the cause of famous infectious and noninfectious diseases. Availability of pandemic of the demodicosis and the associative diseases requires consolidation of the efforts of biologists, parasitologists, veterinary and medical specialists for liquidation of all manifestations and complications of these diseases.

In the original this paper was published in the journal "Bulletin of the Academy of Sciences of the Republic of Kazakhstan", 1992, No 4, pp.84-88.

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