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Swabs Containing Tea Tree Oil and Chamomile Oil Versus Baby Shampoo in Patients With Seborrheic Blepharitis: A Double-Blind Randomized Clinical Trial.

  • 2021-07-21
  • Eye & contact lens 47(11)
    • Burak Mergen
    • Burak Mergen
    • Ceyhun Arici
    • Ayse Yildiz-Tas
    • Hrisi Bahar-Tokman
    • Edip Tokuc
    • Yesim Ozturk-Bakar
    • Zekayi Kutlubay
    • Afsun Sahin

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 26
Population
patients with seborrheic blepharitis (BS, n=23; swabs, n=26)
Methods
randomized, double-blind, parallel-group, active control, multicenter clinical trial; patients were treated with BS or swabs for 8 weeks followed by 4 weeks of treatment withdrawal
Blinding
Double-blind
Duration
8 weeks

Purpose

The comparison of the efficacy of swabs containing tea tree oil and chamomile oil and baby shampoo (BS) in the treatment of seborrheic blepharitis was aimed.

Methods

This randomized, double-blind, parallel-group, active control, multicenter clinical trial included patients with seborrheic blepharitis using block randomization (BS, n=23; swabs, n=26). Patients were treated with BS or swabs for 8 weeks followed by 4 weeks of treatment withdrawal. Change in Blepharitis Symptom measure (BLISS), Demodex count, Ocular Surface Disease Index (OSDI) score, Schirmer test, tear breakup time (TBUT), noninvasive TBUT (NI-TBUT), corneal staining, and meibography at different visits (baseline, fourth, , and 12th week) were the main outcome measures.

Results

Patients in both groups showed similar baseline parameters (P>0.05). Patients using swabs showed significantly lower BLISS scores compared with patients using BS at the 4th, 8th, and 12th week visits (3.6±6.1 vs. 6.3±4.5 P=0.011; 1.1±2.8 vs. 6.6±6.7, P<0.001; 0.9±2.8 vs. 5.7±6.6, P=0.002, respectively). Patients using swabs showed improvement in OSDI scores after 8 weeks of treatment compared with the baseline visit (P<0.001). Despite a similar Demodex reduction effect in both treatment arms even after 4 weeks of treatment (P<0.001), both treatment modalities did not show any effect on the other parameters.

Conclusion

Although both swabs and BS showed efficacy for the treatment of seborrheic blepharitis in terms of the Demodex reduction and symptomatic improvement, swabs may provide better symptomatic improvement. Four weeks of treatment discontinuation may not cause any recurrence in the symptoms or Demodex infestation.

Research Insights

  • Tea Tree→Improved Meibography Grade

    both treatment modalities did not show any effect on the other parameters

    Effect
    Neutral
    Effect size
    Small
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)
  • Tea Tree→Improved Ocular Surface Disease Index

    Patients using swabs showed improvement in OSDI scores after 8 weeks of treatment compared with the baseline visit (P<0.001).

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)
  • Tea Tree→Improved Schirmer Test Result

    both treatment modalities did not show any effect on the other parameters

    Effect
    Neutral
    Effect size
    Small
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)
  • Tea Tree→Improved Tear Breakup Time

    both treatment modalities did not show any effect on the other parameters

    Effect
    Neutral
    Effect size
    Small
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)
  • Tea Tree→Increased Tear Breakup Time

    both treatment modalities did not show any effect on the other parameters

    Effect
    Neutral
    Effect size
    Small
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)
  • Tea Tree→Reduced Blepharitis Symptoms

    Patients using swabs showed significantly lower BLISS scores compared with patients using BS at the 4th, 8th, and 12th week visits (3.6±6.1 vs. 6.3±4.5 P=0.011; 1.1±2.8 vs. 6.6±6.7, P<0.001; 0.9±2.8 vs. 5.7±6.6, P=0.002, respectively).

    Effect
    Beneficial
    Effect size
    Large
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)
  • Tea Tree→Reduced Corneal Staining

    both treatment modalities did not show any effect on the other parameters

    Effect
    Neutral
    Effect size
    Small
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)
  • Tea Tree→Reduced Demodex Count

    Despite a similar Demodex reduction effect in both treatment arms even after 4 weeks of treatment (P<0.001)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    swabs containing tea tree oil and chamomile oil (not further specified)

Adverse Events Reported

  • Tea Tree→Overall tolerability

    Both treatment modalities did not show any effect on the other parameters.

    Finding
    Reported
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