Table 1.
Descriptive characteristics of included laboratory Demodex studies (n = 8).
| Study Setting | Study Design | Method/Assay | Intervention | Outcome Measure(s) | Treatment Outcome(s) | Quality Score |
|---|---|---|---|---|---|---|
| Bulut and Tanriverdi, 2021 [70], Turkey | In vitro (n = 4.8 (mean) Demodex (no report on species type) randomly assigned to each group) | In vitro killing assay: direct application of test solutions onto epilated eyelashes with mites placed on the glass slides and microscopic examination of their non-viability for 360 min |
n = mean number of 4.8 mites in each group TTO (2 %, Osto®) solution (n = 5) TTO (7.5 %, Blefaritto®) solution Terpinen-4-ol (T4O, 0.5%, Blefastop plus®) wipe Saline solution (Control) |
Mite survival time (MST): from treatment to non-viability (absence of limb and body movement during an observation period of 1 min) | MST (Mean ± SD): 95.9 ± 25.2 min for TTO (2%) vs. 67.1 ± 21.8 for TTO (7.5%) vs. 27.3 ± 6.0 for T4O (0.5%) vs. 323.5 ± 21.1 for Saline (p < 0.001) MST (Mean ± SD): T4O (0.5%) vs. TTO (2%) vs. TTO (7.5%) (p < 0.001); TTO (7.5%) vs. TTO (2%) (p < 0.001) |
17 (Reliable without restriction) |
| Yurekli and Botsali, 2021 [71], Turkey | In vitro (n = 35 D. folliculorum randomly assigned to each group) | In vitro killing assay: direct application of test solutions onto diagnostic Standardized Skin Surface Biopsy samples with mites placed on glass slides and microscopic examination of their non-viability for 240 min | TTO (2.5%) TTO (5%) TTO (10%) (n = 5) TTO (25%) (n = 5) TTO (50%) (n = 11) TTO (100%) (n = 21) solutions Permethrin (5%) solution (positive control) Immersion oil (negative control) |
MST: from treatment to non-viability (absence of body and leg movements during an observation period of 1 min) | MST (Mean ± SD): 54.0 ± 6.1 min for TTO (2.5%) vs. 39.0 ± 3.9 for TTO (5%) vs. 22.0 ± 2.5 for TTO (10%) vs. 13.0 ± 2.5 for TTO (25%) vs. 7.8 ± 0.6 for TTO (50%) vs. 3.3 ± 1.3 for TTO (100%) (p < 0.001) vs. 12.5 ± 1.9 for Permethrin 5% vs. 196.0 ± 23.6 for Immersion oil MST (Mean ± SD): 13.0 ± 2.5 for TTO (25%) vs. 12.5 ± 1.9 for Permethrin 5% (p = 0.628) (no p-value is reported for TTO solutions vs. negative control) |
17 (Reliable without restriction) |
| Cheung et al., 2018 [112], New Zealand | In vitro (n = 93 Demodex (no report on species type) randomly assigned to each group) | In vitro killing assay: direct application of test solutions onto epilated eyelashes with mites placed on the glass slides and microscopic examination of their non-viability for 300 min | TTO (100%) solution (n = 10) TTO (50%) solution (n = 10) Terpinen-4-ol (T4O, 100%) solution (n = 11) Linalool (100%) solution (n = 10) T4O (Cliradex®, 4 mg/mL) towelette cleanser (n = 10) T4O (Oust™ Demodex®, 0.29 mg/mL) cleanser (n = 11) T4O (Blephadex™, 0.03 mg/mL) eyelid foam (n = 10) T4O (0.02 mg/mL) and linalool (76%) (TheraTears® SteriLid®) eyelid cleanser (n = 11) No treatment (n = 10) |
Mite survival time (MST): from treatment to non-viability (absence of limb and body movement over two consecutive observations periods) | MST (Median [range]): 10 (7–24) mins for TTO (100%) vs. 28 (24–75) for TTO (50%) vs. 12 (5–18) for T4O (100%) vs. 7 (5–21) for Linalool vs. 37.5 (15–240) for Cliradex® vs. 90 (30–150) for Oust™ Demodex® vs. 60 (15–240) for Blephadex™ vs. 70 (30–145) for TheraTears® SteriLid® vs. ≥ 300 min for No treatment groups (p < 0.0001) | 17 (Reliable without restriction) |
| Frame et al., 2018 [114], New Zealand | In vitro (n = 52 Demodex (no report on species type) randomly assigned to each group) | In vitro killing assay: direct application of TTO solutions onto epilated eyelashes with mites placed on glass slides or placing the mites onto slides smeared with the honey and microscopic examination of their non-viability for 240 min | TTO (100%) solution (n = 10) TTO (50%) solution (n = 12) Cyclodextrin- complexed manuka honey MGO™ (CyCMH, n = 12) Uncomplexed manuka honey MGO™ (UCMH, n = 10) No treatment (n = 8) |
MST: from treatment to non-viability (absence of limb and body movement) | MST (Median (range)): 9 (6–10) mins for TTO (100%) vs. 121 (8–190) for TTO (50%) vs. 141 (34–185) for CyCMH vs. 190 (190–censored) for UCMH vs. ≥ 250 min for No treatment groups (p < 0.001) | 17 (Reliable without restriction) |
| Gao et al., 2005 [97], USA | In vitro (n = 116 D. folliculorum mites randomly assigned to each group) | In vitro killing assay: direct application of test solutions onto epilated eyelashes with mites placed on glass slides and microscopic examination of their non-viability for 150 min | TTO (100%) (n = 21); TTO (50%) (n = 11); TTO (25%) (n = 5) TTO (10%) (n = 5) solutions; Baby shampoo (50%) (BS, n = 9); Mineral oil (MO, n = 5); Povidone-iodine (10%) (PI, n = 4); Alcohol (100%) (Alc, n = 7); Alcohol (75%) (Alc, n = 8); Caraway oil (100%) (CWO, n = 16); Dill weed oil (100%) (DWO, n = 5); and Pilocarpine (Pilo, n = 3) | MST: from treatment to non-viability (absence of limb and body movement) | MST (Mean ± SD): 3.7 ± 0.8mins for TTO (100%) vs. 14.8 ± 9.5 for TTO (50%) vs. 34.7 ± 4.3 for TTO (25%) vs. 150 (no SD) for TTO (10%) vs. 150 (no SD) for BS vs. 150 (no SD) for MO vs. 150 (no SD) for PI vs. 39 ± 1.2 for 100% Alc vs. 150 (no SD) for 75% Alc vs. 4.4 ± 2.5 CWO vs. 14 ± 8.3 for DWO vs. 150 (no SD) for Pilo (no p-value is reported) TTO: 3.7 ± 0.8mins for TTO (100%) vs. 14.8 ± 9.5 for TTO (50%) vs. 34.7 ± 4.3 for TTO (25%) vs. 150 (no SD) for TTO (10%) (p < 0.01) |
16 (Reliable without restriction) |
| Kabat 2019 [100], USA | In vitro (n = 35 D. folliculorum randomly assigned to each group) | In vitro killing assay: immersion of epilated eyelashes with mites placed on glass slides with test solutions and microscopic examination of their non-viability for 90 min | T4O (4%) solution (n = 12) Hypochlorous acid (0.01%) solution (HOCl, n = 14) Mineral oil (100%) (MO, n = 9) |
MST or kill time: from treatment to non-viability (absence of limb and body movement) | MST (Mean ± SD): T4O: 40 ± 0.0 min for T4O vs. 87.9 ± 4.2 for HOCl (p = 0.0005) HOCl: 87.9 ± 4.2mins for HOCl vs. 90 ± 0.0 for MO (p = 0.25) |
18 (Reliable without restriction) |
| Oseka and Sedzikowska, 2014 [64], Poland | In vitro (n = not reported, no report on species type) | In vitro killing assay: immersion of mites in test solutions placed on glass slides and microscopic examination of their non-viability for about 6 days | TTO (50%) solution Sage oil (100%) solution Peppermint oil (100%) solution Aloe oil (100%) solution Seabuckthorn oil (100%) solution Physiological saline (control) |
MST: from treatment to non-viability (absence of limb and body movement) | MST (Mean): 7 min for TTO (50%) vs. 7 min for Sage oil vs. 11 min for Peppermint oil vs. 9 h for Aloe vs. 3 days for Seabuckthorn vs. 82 h for Control (no p-value is reported) | 4 (Not assignable) |
| Tighe et al., 2013 [81], China | In vitro (n = 292, no species type is reported) | In vitro killing assay: immersion of epilated eyelashes with mites placed on glass slides with test solutions and microscopic examination of their non-viability for 150 min |
n = 6 for each group T4O: 100%; 50% 25%, and 10% solutions γ-Terpinene: 100%; 50% and 25% α -Terpinene:100%; 50% 25%, and 10% α-Terpineol: 100%; 50% 25%, and 10% 1,8-Cineole: 100%; 50% 25%, and 10% Mineral oil (100%) control (NB: only the top five major components are considered here) |
MST: from treatment to non-viability (absence of movement of legs) | MST (Mean ± SD): T4O: 3.6 ± 1.1 min for 100% vs. 4.5 ± 1.0 for 50% vs. 8.3 ± 3.1 for 25% vs. 12.3 ± 8.8 for 10% T4O; γ-Terpinene: 8.3 ± 6.2 for 100% vs. 75.9 ± 29.8 for 50% vs. > 150 for 25%; α -Terpinene:13.6 ± 4.4 min for 100% vs. 21.0 ± 2.2 for 50% vs. 61.6 ± 11.6 for 25% vs. > 150 for 10%; α-Terpineol: 3.8 ± 0.8 for 100% vs. 12.5 ± 2.9 for 50% vs. 22.8 ± 3.9 for 25% vs. 43.4 ± 4.3 for 10%; 1,8-Cineole: 13.5 ± 2.0 for 100% vs. 18.8 ± 4.1 for 50% vs. 23.5 ± 3.9 for 25% vs. 44.4 ± 7.2 for 10% vs. no effect for MO (no p-value is reported for each comparison) |
17 (Reliable without restriction) |