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Comparison of the efficacy of tea tree (Melaleuca alternifolia) oil with other current pharmacological management in human demodicosis: A Systematic Review

Published online by Cambridge University Press:  10 August 2020

Nelson Siu Kei Lam Open the ORCID record for Nelson Siu Kei Lam [Opens in a new window] ,
Xin Xin Long ,
Xuegang Li ,
Li Yang ,
Robert C Griffin  and
James CG Doery
Nelson Siu Kei Lam*
Affiliation:
Department of Medicine, Monash University, Clayton, Victoria, Australia Department of Pathology, Monash Medical Centre, Clayton, Victoria, Australia Department of General Medicine, Monash Medical Centre, Clayton, Victoria, Australia Department of Pharmacy, Monash Medical Centre, Clayton, Victoria, Australia Faculty of Health and Sciences, The University of Adelaide, Adelaide, South Australia, Australia
Xin Xin Long
Affiliation:
Faculty of Health and Sciences, The University of Adelaide, Adelaide, South Australia, Australia
Xuegang Li
Affiliation:
Department of Rheumatology, The Fifth affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong province, China
Li Yang
Affiliation:
Department of Dermatology, The Fifth affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong province, China
Robert C Griffin
Affiliation:
Consultant Emeritus of The Canberra Hospital, Woden Valley, Canberra, Australian Capital Territory, Australia
James CG Doery*
Affiliation:
Department of Medicine, Monash University, Clayton, Victoria, Australia Department of Pathology, Monash Medical Centre, Clayton, Victoria, Australia
*
Author for correspondence: Nelson Lam, E-mail: nelson.lam@monashhealth.org; James Doery, E-mail: james.doery@monash.edu
Author for correspondence: Nelson Lam, E-mail: nelson.lam@monashhealth.org; James Doery, E-mail: james.doery@monash.edu
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Abstract

Various treatments are found to be moderately effective in managing Demodex-related diseases except tea tree oil (TTO) and terpinen-4-ol (T4O), which showed superior miticidal and anti-inflammatory effects in numerous clinical studies. Their possible effects include lowering mite counts, relieving Demodex-related symptoms, and modulating the immune system. This review summarizes the current clinical topical and oral treatments in human demodicosis, their possible mechanisms of action, side-effects and resistance in treating this condition. TTO (especially T4O) is found to be the most effective followed by metronidazole, ivermectin and permethrin in managing the disease. This is because TTO has anti-parasitic, anti-bacterial, anti-fungal, anti-inflammatory and wound-healing effects. Furthermore, nanoTTO can even release its contents into fungus and Pseudomonas biofilms. Combinations of different treatments are occasionally needed for refractory cases, especially for individuals with underlying genetic predisposal or are immuno-compromised. Although the current treatments show efficacy in controlling the Demodex mite population and the related symptoms, further research needs to be focused on the efficacy and drug delivery technology in order to develop alternative treatments with better side-effects profiles, less toxicity, lower risk of resistance and are more cost-effective.

Keywords

Crotamitondemodicosisivermectinlindanemetronidazolepermethrintea tree oilterpinen-4-ol
Type
Review Article
Information
Parasitology , Volume 147 , Issue 14 , December 2020 , pp. 1587 - 1613
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

Contributed equally.

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