Evaluation of the effect of systemic isotretinoin treatment on demodex infestation in acne vulgaris patients

Demirtas S. N., SERARSLAN G., Kaya O. M.

TURKDERM-TURKISH ARCHIVES OF DERMATOLOGY AND VENEROLOGY, cilt.59, sa.4, ss.116-119, 2025 (ESCI, Scopus, TRDizin)

Özet

Background and Design: Demodex mites are common ectoparasites of human hair follicles, and Demodex folliculorum (D. folliculorum) and Demodex brevis live on human skin. The role of Demodex in acne vulgaris remains controversial, and there is limited information regarding the effects of systemic isotretinoin on these mites. This study aimed to determine the presence and type of Demodex in acne vulgaris patients and to investigate the impact of oral isotretinoin treatment on Demodex infestation. Materials and Methods: This prospective study included a total of 53 patients with moderate-to-severe acne vulgaris who were scheduled to start oral isotretinoin therapy. Standardized superficial skin biopsies were obtained from lesional areas before treatment and at the third and sixth months of therapy to assess the presence of Demodex. Results: Demodex was detected in 31 (58.49%) of the 53 patients (39 female, 14 male). D. folliculorum + Demodex brevis (n=16), D. folliculorum (n=14), and Demodex brevis (n=1) were determined. Demodex was negative in all patients at 3 and 6 months of treatment. There was no statistically significant difference between Demodex positivity and Demodex type, disease duration, acne type, or acne localization (p>0.05). Conclusion: Demodex brevis was frequently observed along with D. folliculorum. Oral isotretinoin treatment was effective against Demodex. Systemic isotretinoin may be considered a treatment option for patients with demodicosis.