Potential Health Hazards of Eyelash Extensions

In the past few years, eyelash extensions have become very popular, especially among young women. The extensions, attached by a professional at a salon, are glued individually to existing eyelashes in a process that can take three hours1 and cost up to $400.2

The glue is made with butyl cyanoacrylate and octyl cyanoacrylate, although some glues may contain formaldehyde — which can potentially cause great irritation and other eye problems.3

The popularity of eyelash extensions stems from the time saved in makeup routines: Mascara does not need to be applied (or removed to prevent “raccoon eyes”), nor is eyelash curling necessary. Extensions are sometimes worn for six weeks before being touched up and, unlike false eyelashes or “falsies,” do not fall off during some activities since they are individually anchored.4

But now doctors are saying that what many wearers think is the best feature of eyelash extensions — their duration — may be their worst. Left in place for weeks, the extensions’ glue and accumulating bacteria can invite mites to move in, especially when the lashes are not cleaned adequately.

Doctors say they are increasingly seeing these tiny parasitic mites, which are sometimes referred to as “eyelash lice,” on the lashes of extension users.5

What Are Eyelash ‘Lice’?

The mites found on eyelashes, aka eyelash “lice,” are Demodex folliculorum and Demodex brevis. They are contagious and can potentially spread from one host to another.6 They are so small — D. folliculorum is 0.3 to 0.4 mm long and D. brevis is 0.15 to 0.2 mm long — they can hardly be seen by the unaided eye.7

While both mites can inhabit the eyelashes, D. folliculorum feeds on skin cells while D. brevis feeds on sebum from oil gland cells. According to the Indian Journal of Dermatology the small size of these mites:

” … makes them invisible to the naked eye, but, under the microscope, their structure is clearly visible. It has a semi- transparent, elongated body that consists of two fused segments. Eight short, segmented legs are attached to the first body segment.

The eight legs of this mite move at a rate of 8-16 mm/h and this is mainly done during the night as bright light causes the mite to recede into its follicle.

The body is covered with scales for anchoring itself in the hair follicle and the mite has pin-like mouth parts for eating skin cells, hormones, and oils (sebum) accumulating in the hair follicles …The mites are transferred between hosts through contact of hair, eyebrows, and sebaceous glands on the nose …

… Demodex mites are present in healthy individuals and may have a pathogenic role only when present in high densities. The infestation may be clinically inapparent, but, under favorable circumstances, these mites may multiply rapidly, leading to the development of different pathogenic conditions.”8

Eyelash ‘Lice’ Can Be Tricky to Diagnose

What are the symptoms of those in whom the mites have “multiplied rapidly” as the research above describes? Itching and burning eyes and eyelids are key signs, according to Review of Optometry,9 along with a feeling that something’s in your eyes and fluctuating blurry vision.

While eye professionals may instinctively treat the conditions with artificial tears, if mites are the culprit, there will be no improvement.10 Since Demodex mites are so small, the eye conditions can be attributed to other causes, yet if not treated correctly, you can develop the infestation symptoms of redness, inflammation, blood shot eyes and blocked oil glands.

Demodex can also contribute to the more serious eye inflammation conditions of blepharitis, blepharoconjunctivitis and blepharokeratitis.11 Demodex may look like blepharitis,12 an inflammation of the eyelids from clogged oil glands, and the related conditions of blepharoconjunctivitis13 and blepharokeratitis.14

However, blepharitis and the related conditions are treated with lid hygiene, warm compresses and sometimes antibiotics or steroids, which are treatments that can actually worsen Demodex.15 Moreover, blepharitis conditions are usually not contagious,16 whereas Demodex infestations are. Clearly, a correct diagnosis is essential, and it requires an exam by a medical eye professional.

Demodex Are Spread by Lack of Hygiene

Eyelash mites are thought to develop from a combination of the glue used to adhere extensions and the accompanying bacteria when users don’t remove their makeup and clean their lashes adequately.17 Though some wearers favor eyelash extensions for the time they save in makeup routines, time is usually not the reason some don’t clean their lashes properly, says one makeup professional.

“There is an increase in women thinking if they … wash them they’ll fall out faster,” Janet Figueroa, a cosmetologist in Ontario, California, told Fox News.18 Demodex infestations can also stem from salon staff who fail to adequately clean their tools after each customer.19 It’s very important to choose your salon carefully and read the online reviews of other customers.

While the mites themselves are not visible, evidence of an infestation can be apparent if you know what to look for, Figueroa said. She has seen -“yellow/flesh-colored buildup of old cells or makeup” in customers who admit they don’t wash their lashes regularly.20 The “yellow bulb like bumps on the lashes at the base of the natural lash” that Figueroa described to Fox have a scientific explanation, according to research in Clinical Optometry.21

“As these mites have no excretory organs, undigested material is regurgitated and combines with these epithelial cells, keratin, and eggs to form the bulk of the cylindrical lash deposits pathognomonic of Demodex infestation. These deposits, in turn, contain proteases and lipases, which cause symptoms of irritation.

In fact, of all ocular symptoms investigated, the only symptom to correlate directly with Demodex was lid irritation. Specifically, this irritation is caused both directly by biting of the mites and by lipolytic enzymes used to digest sebum, their main food source.”

Demodex Is Not Lice, but Lice Can Occur on Eyelashes

Demodex may be mites, not lice, but lice can make a home on the eyelashes too, and can be similarly treated with nontoxic, natural methods. A case study in Experimental and Therapeutic Medicine describes how a patient’s inflammatory condition was initially confused with blepharitis and not diagnosed as lice:22

“Phthiriasis palpebrarum is a rare type of eyelid infestation. In the present study, a 63-year-old woman presented with a case of phthiriasis palpebrarum, which was initially misdiagnosed as anterior blepharitis.

The patient had a 2-month history of repeated episodes of itching and burning sensations and moderate pain in both eyes that were not improved by antibiotic and corticosteroid eye drops.

Slit lamp examination revealed lice and nits anchored to the eyelashes. All eyelashes were removed from the base along with lice and nits. The patient recovered fully within 2 weeks with no further management, and no evidence of lice or nits was found at the follow up.

In conclusion, the findings of the present study suggests that patients presenting with itching of the eyelids and with clinical findings resembling seborrhea accumulation on the eyelashes should be carefully examined by prolonged observation with a slit lamp.”

Lice Can Be Removed With Natural Treatments

People who read my newsletters know that I’ve talked about lice becoming a growing problem because some lice strains have developed resistance to the harsh chemicals used to treat them. That’s why I recommend natural treatments that are just as effective as their harsher counterparts.

If you or your children contract lice, which are more commonly found on the head, the following treatments have proven effective.

Diatomaceous earth (DE) — Diatomaceous earth is made from tiny fossilized water plants called diatoms. The diatoms are ground up to make a chalky powder that’s rich in minerals and toxic to insects.

DE works because it absorbs fats from the insects’ protective outer coating, drying them out and killing them. DE is nontoxic to humans, although you should be careful to avoid breathing in the dust, especially for a prolonged period. Here’s how to safely use DE for lice treatment:


  • Place an old T-shirt upside down over your or your child’s head so the collar forms a seal around the scalp. Apply DE to the hair, while being careful to keep the dust inside of the T-shirt “bag.” Tie off the open end of the T-shirt and massage the DE into the scalp.
  • Allow it to sit overnight, then shampoo it out the next day. This should be followed by a thorough combing with an extra-fine tooth comb. You may need to repeat the treatment once a week for three weeks.

Tea tree oil — Tea tree oil has long been valued for its antifungal, antibacterial and antiviral properties; however, it’s also very effective at killing head lice. To create a tea tree oil solution, follow these steps:


  • Mix 1 teaspoon of tea tree oil, 1 ounce of natural shampoo and 3 teaspoons of coconut oil. Gently apply the mixture throughout the hair, then cover it with a shower cap or towel. Leave it for 30 minutes, then rinse it out with warm water. While the hair is wet, use an extra-fine tooth comb to remove the dead lice.

Salt and vinegar mixed with coconut oil — A mixture of salt and vinegar can work to dehydrate and, eventually, kill lice on the scalp. Check out these steps for creating a spray mixture:


  • Dissolve one-fourth cup of Himalayan salt in one-fourth cup of warm apple cider vinegar. Spray the mixture onto the scalp until it is wet. Allow the scalp to dry, and then coat it with a layer of coconut oil. Leave the oil for eight hours and then comb out the dead lice. Wash the hair and scalp to remove the aroma created by the mixture.

How to Prevent and Remove Demodex From Eyelashes

Hygiene is the key to preventing Demodex, according to the experts. That’s why the mites are seen on users who neglect washing around their eyes and eyelashes. For the record, Demodex is also seen in those without eyelash extensions and in men, for the same reason: lack of appropriate hygiene, which then allows the mites to multiply.23

The best Demodex prevention is a daily routine of washing around the eyes with warm, soapy water to break up oils that fuel the mites, says Dr. Gregory J. Nixon, associate dean for clinical services at The Ohio State University College of Optometry.24

To treat a Demodex buildup, medical professionals recommend a tea tree oil mixture, a versatile and well-regarded natural product that is available over the counter. Patients can treat themselves at home, according to research published in Clinical Optometry:25

“Patients with Demodex are typically prescribed an eyelid cleanser that contains tea tree oil twice daily in order to eradicate the Demodex mites. They are instructed to cleanse the lids and lashes, as well as smear the lid cleanser onto the eyelash roots of both the upper and lower eyelid margin.

Complete coverage of the eyelash base by the tea tree oil lid cleanser is necessary to be effective so that mites are unable to lay eggs and hatch more Demodex mites. Patients should be instructed to use the wipes on their eyelashes, forehead, eyebrows, and cheeks as the mites live in all of those areas …

… Studies have demonstrated that as low as 5% concentration (when applied to the lids twice daily) and as high as 50% concentration (when applied once weekly) of tea tree oil are effective at reducing Demodex infestation when applied to the lids and base of the eyelash follicle.

A 38% concentration of terpinen-4-ol has been shown to reduce Demodex effectively over a period of 4 weeks.”

Tea tree oil should be diluted before use and caution should be used when applying it to sensitive areas around your eyes and eyelids. A holistic health care practitioner who is familiar with essential oils can guide you in its safe usage for Demodex.

The popularity of eyelash extensions will likely not go away. Like hair extensions, they are simply part of today’s beauty and glamour landscape. Luckily, wearers can reduce their risk of contracting Demodex mites with simple hygiene.

“Everybody knows to brush their teeth twice a day and don’t even think about it,” says Nixon. “We know in the eye care field that your eyes are no different. A lot of patients don’t necessarily comprehend that.”26

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