<i>Demodex</i> -Associated Blepharitis Treated with Nonprescription Topical Ivermectin: A Case Series

Introduction The management of Demodex mite infestations of the eyelids is a current topic of investigation. Multiple studies have reported success in treating Demodex -associated blepharitis with topical 1% ivermectin cream. These findings suggest that 0.5% ivermectin lotion, which is inexpensive and available without a prescription in the United States, may represent a novel treatment option for Demodex -associated blepharitis. Case Reports Three patients with symptomatic Demodex -associated blepharitis each received 2 in-office applications of 0.5% ivermectin lotion performed 2 weeks apart. At each visit, slit lamp biomicroscopy was performed and the eyelids were photographed. Following treatment, all patients had significant improvement in symptoms and eyelid appearance. Additionally, the patients remained almost entirely collarette-free for 1 to 2 months of observation. Conclusion This case series suggests that off-label, in-office application of 0.5% ivermectin lotion is an effective treatment for reducing the eyelash collarettes associated with Demodex mites.