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Controversial issues of hyperinfestation with Demodex mites in rosacea and acne

https://doi.org/10.21518/ms2025-339

Abstract

Demodex mites (D. folliculorum and D. brevis) are the most common ectoparasites found on human skin, with carriage rates reaching up to 100% in older age groups. The majority of the population are asymptomatic carriers; however, an increase in Demodex mite colonies, observed with decreased innate immune activity and epidermal barrier dysfunction, can lead to enzymatic damage of pilosebaceous follicle structures, mechanical blockage of sebaceous gland ducts, activation of pro-inflammatory cytokines, and disruption of microbial balance in the skin. These factors are key in the pathogenesis of sebaceous gland diseases. First identified nearly two centuries ago, Demodex mites remain a subject of ongoing debate regarding their role both in the normal skin microbiome and in the pathogenesis of diseases such as acne, rosacea, perioral dermatitis, seborrheic dermatitis, and others. This review presents current scientific data on the etiology, epidemiology, and pathogenetic role of Demodex mites in the development of acne and rosacea – the most common sebaceous gland diseases. Additionally, methods for etiotropic correction of mite hyperinfestation are proposed.

About the Authors

O. B. Tamrazova
Russian Medical Academy of Continuous Professional Education; Bashlyaeva City Children’s Clinical Hospital
Russian Federation

Olga B. Tamrazova - Dr. Sci. (Med.), Professor RAS, Professor of the Department of Pediatric Infectious Diseases, Russian Medical Academy of Continuous Professional Education; Head of Children Dermatology Department, Bashlyaeva City Children’s Clinical Hospital.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 28, Geroev Panfilovtsev St., Moscow, 125373



A. V. Tamrazova
Central State Medical Academy of Department for Presidential Affairs of the Russian Federation
Russian Federation

Anait V. Tamrazova - Cand. Sci. (Med.), Associate Professor at the Department of Dermatovenerology and Cosmetology.

19, Bldg. 1а, Marshal Timoshenko St., Moscow, 150000



G. E. Bagramova
Federal Clinical Research Centre for Specialized Healthcare and Medical Technology of Russia’s Federal Medical-Biological Agency
Russian Federation

Gayane E. Bagramova - Dr. Sci. (Med.), Professor of the Department of Plastic and Aesthetic Surgery with a Course in Dermatology.

91, Volokolamskoe Shosse, Moscow, 125371



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For citations:


Tamrazova OB, Tamrazova AV, Bagramova GE. Controversial issues of hyperinfestation with Demodex mites in rosacea and acne. Meditsinskiy sovet = Medical Council. 2025;(14):57-62. (In Russ.) https://doi.org/10.21518/ms2025-339

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