Tea Tree Oil Eyelid Wipes Versus Periocular Shampoo in Demodex-Associated Chronic Blepharitis: A Retrospective Study
Abstract
Background: Demodex-associated blepharitis is a chronic inflammatory eyelid disease characterized by collarettes, eyelid margin inflammation, and the presence of Demodex mites. Comparative data on different tea tree oil (TTO)-based application forms remain limited. This study compared the clinical and microscopic outcomes of TTO-based eyelid wipes and eyelid shampoo in Demodex-positive chronic blepharitis.
Methods: In this retrospective, single-center study, 155 adults with clinically and microscopically confirmed Demodex-positive chronic blepharitis were grouped by treatment form: eyelid wipes (n=74) or eyelid shampoo (n=81). Baseline and 3-month assessments included subjective symptoms, Ocular Surface Disease Index (OSDI) scores, collarette severity, eyelid margin erythema, meibum quality, meibomian gland obstruction, and microscopic Demodex status.
Results: Baseline demographic and clinical characteristics were similar between groups. At 3 months, symptoms improved in both groups, but burning was less frequent in the wipe group (p=0.048). The OSDI score was lower in the wipe group (24.4±7.5 vs 27.3±8.6; p=0.026). Collarette and meibum quality scores favored the wipe group (p=0.011 and p=0.003, respectively). Meibomian gland obstruction scores were comparable (p=0.87), whereas improvement in eyelid margin erythema (89.2% vs 76.5%; p=0.038) and meibomian gland obstruction (83.8% vs 67.9%; p=0.022) was more frequent in the wipe group. Demodex eradication rates were similar (64.9% vs 60.4%; p=0.570).
Conclusion: Both TTO-based formulations were associated with clinical improvement and comparable Demodex eradication. Eyelid wipes may provide additional benefit for ocular surface-related quality of life and selected eyelid margin and meibomian gland outcomes. Prospective randomized studies are needed to confirm these results.
Keywords
Demodex, blepharitis, tea tree oil, eyelid hygiene, meibomian gland dysfunction
Supporting Institution
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Project Number
Not applicable.
Ethical Statement
The original study protocol was approved by the Pamukkale University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee at its meeting held on 29 July 2025 (meeting No. 14; reference No. E-60116787-020-733800). A subsequent protocol amendment was also approved by the same committee at its meeting held on 2 June 2026 (meeting No. 10; reference No. E-60116787-020-879491). The study was conducted in accordance with the principles of the Declaration of Helsinki. Because of the retrospective design and use of anonymized clinical data, the requirement for informed consent was waived in accordance with the ethics committee approval and applicable local regulations.
Thanks
The authors have no individuals to acknowledge.
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