Comparing the in vitro effects of MGO Manuka honey and tea tree oil on ocular Demodex viability


      • In vitro anti-parasitic efficacy study of 52 Demodex mites.
      • Mites were randomised to cyclodextrin-complexed and uncomplexed Manuka honey, tea tree oil, or no treatment application.
      • Mite viability was assessed for 240 min following treatment application.
      • Cyclodextrin-complexed Manuka honey demonstrated comparable anti-demodectic efficacy to 50% tea tree oil (TTO).
      • Complexed honey with proven in vivo tolerability shows promise as possible alternative to TTO for demodex eradication.



      To compare the in vitro antiparasitic effects of MGO Manuka honey and tea tree oil against ocular Demodex.


      Fifty-two viable Demodex mites were acquired from the epilated eyelashes of 9 participants with blepharitis and symptomatic dry eye. Viable mites were randomised to one of five treatment groups: cyclodextrin-complexed and uncomplexed Manuka Honey, 100% and 50% tea tree oil, and no treatment. Following treatment application, mite viability was assessed for 240 min, based on limb and body movement and/or the development of a crenated/translucent appearance. Kaplan-Meier survival analysis was then performed.


      The log-rank test demonstrated a significant treatment effect on the survival distribution of Demodex mites (p < 0.001). Bonferroni-corrected post-hoc pairwise analysis showed that all treatments except for uncomplexed honey effected lower survival probabilities than the untreated group (all p < 0.001). Among the four treatments, survival probabilities were lowest with 100% tea tree oil (all p < 0.001), and highest with uncomplexed honey (all p ≤ 0.001). No difference was observed between complexed honey and 50% tea tree oil (p = 0.81).


      The in vitro efficacy of cyclodextrin-complexed Manuka honey was comparable with 50% tea tree oil, an established treatment for ocular Demodex. The findings support future clinical trials investigating the therapeutic effects of complexed honey in demodectic blepharitis patients.


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