Increase in facial Demodex mite infestation is associated with skin barrier damage and development of sensitive skin in the Chinese population

Severe Demodex infestation causes demodicosis, but its impact on skin function remains unclear due to a lack of sensitive detection methods. To develop an accurate, user-friendly detection method and assess the effects of Demodex on skin function. A modified squeezing/scraping method (MSS) was developed, combining mud pretreatment cleaning with traditional squeezing and scraping. Skin function was then assessed using Antera3D and a lactic acid sting test. The proposed method not only led to more consistent results compared with the traditional squeezing/scraping method, but also showed a higher detection rate by increasing the positive infestation threshold from 5 to 13 mites. Based on a subsequent assessment for skin physiological parameters, we found that aging was a risk factor for Demodex mite infestation. In addition, Demodex mite infestation was associated with skin barrier damage, characterized as reduction in skin water content, elevated transepidermal water loss, stimulated sebum secretion, and increased skin roughness, which may eventually lead to sensitive skin. The MSS method improves Demodex detection. Infestation may contribute to sensitive skin and may be a therapeutic target.