Every mite in the video above was collected from my own forehead and filmed under a microscope.

Demodex mites are one of the main culprits behind fish-roe-like bumps on the face.1 So why is my forehead so clear?

Everyone has them, yet some people stay clear while others break out in roe-like bumps.2 I will explain when Demodex mites stay quiet and when they cause trouble.

Demodex Mites Leave Inflammation Behind When They Die

Just as a tiger leaves its skin behind when it dies, a Demodex mite leaves inflammation behind. It used to be thought that the mites had no anus, so they caused no problem while alive and caused trouble only after dying. In 2022, however, it was found that Demodex mites do have an anus.3

Even so, live mites rarely cause trouble. In fact, live Demodex mites dampen the immune response.4 Demodex mites are shifting from parasites that harmed humans to symbionts that live together with us.3

Demodex mites cause trouble after they die. As the dead mite breaks down inside the pore, its shell and the bacteria in its body are released together, and these set off the skin's alarm system and trigger inflammation.5

That is why, when you use Soolantra, a medicine that kills Demodex mites, the roe-like bumps often get worse at first. As they die, the dead bodies pile up all at once.6 How to use Soolantra and the initial flare-up are covered in the Soolantra article.

Having Many Demodex Mites Does Not Always Cause Problems

In the standard skin-surface biopsy, 1 cm² of the skin surface is lifted off with cyanoacrylate (instant) glue and the mites are counted. More than 5 mites is considered a high count. 98% of healthy people have fewer than 5.7

The mites in the video above were all lifted from my forehead with this method. I am well into the top 2% for Demodex mites, the equivalent of a 7,000-unit apartment complex. Even so, my forehead looks this clear.

A photo of the doctor's forehead, where the mites in the video lived, looking clean with no redness or bumpy lesions

The Reason You Stay Clear Despite Many Mites Is the Skin Barrier

The skin barrier is a kind of filter. The finer the filter, the more of the things that irritate you it catches. So as long as the filter is intact, having somewhat more Demodex mites is not a big problem.

On the other hand, if the filter is weak, even slightly more mites can cause trouble. The skin of people with rosacea actually has a markedly weakened filter.8

Malassezia in Seborrheic Dermatitis Works Similarly

Rosacea, caused by many Demodex mites, and seborrheic dermatitis, caused by many Malassezia, have something in common here. Malassezia is also a fungus that lives on everyone's skin, and the number of Malassezia does not line up neatly with the severity of symptoms. With the same amount of Malassezia, symptoms differ depending on how sensitively the skin reacts.9

The redness and roe-like bumps that come with Demodex mites continue in the rosacea article, and the story of Malassezia continues in seborrheic dermatitis. You can check how many Demodex mites are on your face with a Demodex mite test.

참고 문헌

  1. Chang YS, Huang YC. Role of Demodex mite infestation in rosacea: A systematic review and meta-analysis. J Am Acad Dermatol. 2017;77(3):441-447.e6.
  2. Thoemmes MS, Fergus DJ, Urban J, et al. Ubiquity and diversity of human-associated Demodex mites. PLoS One. 2014;9(8):e106265.
  3. Smith G, Manzano-Marín A, Reyes-Prieto M, et al. Human follicular mites: Ectoparasites becoming symbionts. Mol Biol Evol. 2022;39(6):msac125.
  4. Lacey N, Russell-Hallinan A, Zouboulis CC, Powell FC. Demodex mites modulate sebocyte immune reaction: possible role in the pathogenesis of rosacea. Br J Dermatol. 2018;179(2):420-430.
  5. Paichitrojjana A. Demodex: The worst enemies are the ones that used to be friends. Dermatol Reports. 2022;14(3):9339.
  6. Rychlik K, Sternicka J, Nowicki RJ, et al. Significance of Demodex folliculorum and Demodex brevis in Pathogenesis of Dermatological Diseases: Current State of Knowledge. Medicina (Kaunas). 2025;61(4):660.
  7. Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol. 1993;128(6):650-659.
  8. Medgyesi B, Dajnoki Z, Béke G, et al. Rosacea Is Characterized by a Profoundly Diminished Skin Barrier. J Invest Dermatol. 2020;140(10):1938-1950.e5.
  9. DeAngelis YM, Gemmer CM, Kaczvinsky JR, et al. Three etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity. J Investig Dermatol Symp Proc. 2005;10(3):295-297.