When you have Blepharitis and Meibomian Gland Dysfunction, its critical to clean your lid margins and reduce the amount of Demodex mites, bacterial overpopulation and dead skins cells that might be present on your eyelids contributing to reduced oil secretion and ultimately dry eye. Today we’re talking about a product called Cliradex that can be used on the eyelids, lashes and face to achieve optimal ocular comfort.
You’ve made it to the eye school blog, with me Dr. D. I’ve recently partnered with Bio-Tissue, the makers of Cliradex which is a cleansing solution for Blepharitis and Demodex that we will be discussing today. I’m so excited to share more information about this option, as I know many of you have asked my opinions on the wipes and cleanser before.
Before we get started, if today’s information is helpful to you I would encourage you to check out my Dry Eye and Blepharitis playlists. I’ve compiled all of my videos related to this topic there so you can binge watch and learn about all the latest Dry Eye therapies.
As an eye doctor and Dry Eye Specialist I recognize the importance of clean lashes and lids. I’ve talked on my Youtube channel and in this blog before about the impact of Demodex mite overpopulation, bacterial biofilms and their impact on the very important meibomian glands of the eyelids. Here are links to my videos about Demodex and my playlist of videos about Meibomian Gland Dysfunction and its treatment.
There are many approaches to altering and improving the meibomian glands. I’ve talked a lot about new light therapies like Intense Pulsed Light and Photobiomodulation on my Youtube channel, and the difference between the two.
I want you to know I’m also actively clearing gland obstruction with Heat and expression therapies like Tearcare. One of the mainstays of treatment that I feel will never change is the need for great at-home care in between the advanced therapies your dry eye doctor is performing in their clinic. Forming habits around your lid care will make a huge difference in how your eyes feel from day to day.
I have seen firsthand that my patients who are diligent about their at-home care like warm compresses, lid hygiene, diet and supplements have better outcomes than those who are not as compliant with their at-home routines. Ocular irritation, inflammation, and lid margin disease are all associated with poor eyelid hygiene so it’s especially important to include lid cleansing as part of your routine.
All About Cliradex and Tea Tree Oil
Cliradex is a natural, preservative free lid, lash, and face cleanser formulated with 4-Terpineol. Now I know I’ve talked about Tea Tree Oil and its potential harm to the meibomian glands in the past, so let’s cover 4-Terpineol today and why we might consider using it, even in light of the 2020 study that showed tea tree oil can damage the epithelial cells of the meibomian glands.
Scientific studies have shown that 4-Terpineol, or Terpinen-4-ol (T4O), is the most important ingredient found in Tea Tree Oil, with even greater miticidal effects than tea tree oil itself. This is because some of Tea Tree Oil’s ingredients are antagonistic, meaning the efficacy of one component is canceled out by the presence of another component.
Terpinen-4-ol, the most abundant ingredient in tea tree oil, was more potent than tea tree oil at equivalent concentrations and its killing effect was even observable at a mere concentration of 1%.
The problem with not eliciting Terpinen-4-ol is that allergic reactions are observed when tea tree oil was used as a topical formulation. In addition, some of tea tree oil’s ingredients neutralize each other rendering them ineffective.
Ocular irritation is a chronic problem for patients who seek relief from Demodex Mites. Patients are often frustrated and looking for a long-term solution. The key is in realizing that long term solutions usually mean a change in daily hygiene habits
Ocular hygiene is important to maintain a clean and healthy ocular surface environment and tear film. Long term neglect can have implications related to Blepharitis, Dry Eye, and other more severe Ocular Surface Disease.
A recent study by Dr. Al Kabat shows that Cliradex with 4-Terpineol, on average, kills organisms in less than half the time it takes for HOCl to have an effect and that HOCl performs nearly the same as mineral oil.
All About Cliradex Eyelid Wipes or Cliradex Towelettes and Cliradex Light Foam
Cliradex is available in two forms: Cliradex Light foaming cleaner as well as cliradex towelettes for severe ocular irritation.
So I have been very open and honest in the past about tea tree oil and its derivatives and how they can be damaging to meibomian glands per the 2020 Harvard study. Personally I feel that tea tree oil and especially a purified natural form of it like is present in Cliradex can be very useful in managing bacterial biofilms and demodex infestations to reduce the symptoms of Blepharitis in my patients.
The wipes are quite strong, and so should be used initially at diagnosis to quickly eradicate bacterial microorganisms and reduce demodex overpopulation. I like to use light therapies like Low-level laser (light) therapy and intense pulsed light in conjunction with the traditional Cliradex lid scrub approach. Then, once demodex and bacterial populations are controlled we maintain by switching over to a foaming cleanser mostly applied to the face and not directly over the meibomian glands.
Advanced or severe blepharitis occurs with an OVERPOPULATION of bacteria and demodex. The homeostasis or balance is disrupted. So you don’t have to aggressively treat with 4-terpin-ol forever, just initially to eradicate the populations and then as a maintenance. There will be times you may have an inflammatory flare, and the towelettes can be used again.
So this is how I am truly using 4-Terpineol in my practice. I do like the science behind Cliradex in particular and have had success with it in my patients. Please feel free to comment here on my blog or on any of my videos, I would love to know if you have used Cliradex with success or what has and hasn’t worked for you.