# Acneiform Eruptions Caused by Lithium Treatment May Be Related to Demodex Mites (Prostigmata: Demodecidae): A Hypothesis

## TL;DR

This paper suggests that lithium treatment for bipolar disorder may cause acne by affecting Demodex mites, proposing a new treatment approach.

## Contribution

The paper introduces a novel hypothesis linking lithium treatment to Demodex mites in causing acneiform eruptions.

## Key findings

- Lithium treatment may alter the environment of Demodex mites, increasing their potential to cause acneiform eruptions.
- Acaricidal agents could be a new treatment option for lithium-induced acne by targeting Demodex mites.

## Abstract

Lithium is a treatment for people with bipolar disorder but may be associated with onset acne vulgaris. It is proposed that this adverse consequence of lithium treatment may be related to an interaction between lithium and Demodex mites. It is proposed that the hypothesis can be tested by using acaricidal agents to treat lithium-related acneiform eruptions.

Acneiform eruptions are a common adverse effect of lithium treatment that may impact adherence. It is not clear why lithium may worsen these lesions and treatment has focused on traditional treatments for acne. Demodex mites are known to commensurably exist in a large fraction of humans and are known to cause dermatologic conditions in a minority of individuals. An association with acneiform eruptions is well documented but is generally believed to not be causative. We present a hypothesis that lithium treatment may alter the environment of Demodex mites in a fashion that may increase their propensity to cause disease. If that is accurate, treatment with acaricidal agents may be an additional option.