Controversial Issues of Hyperinfestation with Demodex Mites in Rosacea and Acne

Demodex mites, particularly D. folliculorum and D. brevis, are prevalent ectoparasites on human skin, with nearly universal carriage in older adults. While typically asymptomatic, an overgrowth of these mites can lead to skin issues such as acne and rosacea due to factors like decreased immune activity and epidermal barrier dysfunction. These conditions result in damage to skin structures, blockage of sebaceous glands, and inflammation. The role of Demodex mites in skin diseases remains debated, but they are implicated in disrupting the skin's microbial balance and contributing to sebaceous gland diseases. The review discusses the mites' etiology, epidemiology, and pathogenic role, and suggests methods for addressing mite hyperinfestation.