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Their possible effects include lowering mite counts, relieving\n                    <jats:italic>Demodex<\/jats:italic>\n                    -related symptoms, and modulating the immune system. This review summarizes the current clinical topical and oral treatments in human demodicosis, their possible mechanisms of action, side-effects and resistance in treating this condition. TTO (especially T4O) is found to be the most effective followed by metronidazole, ivermectin and permethrin in managing the disease. This is because TTO has anti-parasitic, anti-bacterial, anti-fungal, anti-inflammatory and wound-healing effects. Furthermore, nanoTTO can even release its contents into fungus and\n                    <jats:italic>Pseudomonas<\/jats:italic>\n                    biofilms. Combinations of different treatments are occasionally needed for refractory cases, especially for individuals with underlying genetic predisposal or are immuno-compromised. Although the current treatments show efficacy in controlling the\n                    <jats:italic>Demodex<\/jats:italic>\n                    mite population and the related symptoms, further research needs to be focused on the efficacy and drug delivery technology in order to develop alternative treatments with better side-effects profiles, less toxicity, lower risk of resistance and are more cost-effective.\n                  <\/jats:p>","DOI":"10.1017\/s003118202000150x","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T01:39:10Z","timestamp":1597023550000},"page":"1587-1613","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":30,"title":["Comparison of the efficacy of tea tree (\n                    <i>Melaleuca alternifolia<\/i>\n                    ) oil with other current pharmacological management in human demodicosis: A Systematic 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