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Nearly everyone has skin mites. You get them from your mother the first time you are held. You catch them when you hug or kiss or sleep on someone else's pillow or borrow someone's coat or hat. 

One study of teenagers found that 100 percent had facial infestations of the mite Demodex follicolorum. This mite lives in hair follicles. A closely related mite called Demodex brevis lives in the oil-producing sebaceous glands next to hair follicles. At the age of just seven days, a female lays 18 to 24 eggs packed into the bottom of a skin pore. They hatch into larvae and are brought to the surface of the skin as it oozes oil. (Ironically, if you try to get rid of skin oil, they only come to the surface faster.) The mites quickly mate to produce another generation in a nearby pore, dying within two or three weeks of the mite's equivalent of old age.

Most of the time, these two nearly ubiquitous species of mites are considered commensal, that is, they live with us but don't bother us. They feed on excess skin oil, which is in itself harmless. However, when the mites reproduce too quickly, and their feces builds up on the skin, the skin reacts by growing new follicle cells to produce more sebum to get rid of them. This traps mites, feces, skin oil, and any bacteria the mites brought with them in the pore. Stimulating the immune system doesn't help, because the white blood cells the immune system sends to the skin, called macrophages, are too small to consume the mites or their protein secretions. White blood cells also get "stuck" in the pore. Nearby hair can fall out, and the pore can become red, inflamed, irritated, and itchy.

Mite infestations can result in a condition called demodicosis, usually with the loss of eyelashes or eyebrows. It can also play a role in a form of acne known as rosacea. In rosacea, the presence of mites makes the skin super-sensitive to small changes in temperature. Coming in from the cold or leaving an air conditioned room can cause the skin of the face to break out in "pimples" that aren't really pimples, because they aren't an enlargement of a pore. Other normally harmless stimuli can also trigger an outbreak on the skin.

Mites are also associated with a variety of other hard-to-treat skin conditions, including  pityriasis folliculorum, perioral dermatitis, seborrheic dermatitis, pustular eruption, blepharitis, and seborrheic alopecia.

If you have mites causing one of these conditions, you initially need to see a doctor about the scrubbing that will be needed to get the little bugs out of your pores. Once you do, there are a number of things you can do on your own, some of which your doctor may not have time to tell you:

  • Limit your consumption of alcohol. The more you drink, the oilier your skin becomes, and the more mites it can support.
  • Never, ever use any kind of soap or treatment intended to dry out your skin. Your skin reacts by making even more oil, and excess skin oil fuels mite infestations.
  • Give grandma a kiss, but discreetly wash your face later. People over 70 tend to have higher concentrations of skin mites
  • Use baby shampoo twice a day to help get rid of mites around the eyes. The stronger the concentration of the shampoo (up to equal parts of shampoo and water) the better.
  • Use tea tree oil products to control mites if you don't have rosacea. Tea tree oil also kills acne bacteria. Tea tree oil soap and face wash are helpful.
  • Buy new pillows. Old pillows may harbor mites.
  • Wash bed linens in hot water and dry in a dryer, not on a line, twice a week.
  • Use Cliradex tea tree oil towelettes twice a day to wipe your eyes and kill the mites.

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