The Demirci Phenomenon: A Novel Finding of Ivermectin Molecules on Eyelash and Demodex Folliculorum in the Lipid Environment

Purpose: This study aimed to investigate the acaricidal mechanism of ivermectin against Demodex folliculorum and observe its behavior in lipid media, focusing on its movement and selective interaction with the Demodex parasite.

Methods: Eyelash epilation was performed on an ocular rosacea patient, and 8 eyelashes were extracted, 4 from the lower eyelid and 4 from the upper eyelid. 4 eyelashes were exposed to 1% ivermectin solution under a coverslip, while the other 4 served as the control. A high-resolution digital microscope with a noncontact digital thermometer was utilized to monitor the entire process. The behavior of ivermectin molecules and their redistribution towards the Demodex parasite were recorded and analyzed.

Results: Upon exposure to 1% ivermectin solution, intriguing behavior of the drug molecules was observed. The ivermectin molecules moved towards the Demodex parasite, forming distinctive bubbles that effectively covered both the eyelash and the body of the Demodex. Saponification of the lipid within the Demodex and eyelashes occurred within 10 minutes. After one hour, the ivermectin bubbles and the empty, shrunken body of the Demodex remained. The acaricidal effect of ivermectin was rapid, predictable, and highly selective.

Conclusion: The study provides valuable insights into the acaricidal mechanism of ivermectin against Demodex folliculorum and demonstrates the unique behavior of ivermectin molecules in lipid media. The "Demirci Phenomenon" highlights the selective and targeted interaction of ivermectin with Demodex parasites. These findings may have implications for the development of anti-demodex medicine and suggest alternative therapeutic approaches for managing demodicosis.