Hot compresses - ideally, a hot washcloth soaked in a tincture of hot water and a few drops tea tree oil are most effective as a routine to prevent and treat blepharitis. Many patients do not follow a strict protocol and end up buying store bought "eye wipes" or use the washclothes only once in a while. These patients often return complaining that their eyes still feel itchy, irritated and with debris or crusty matter on the lashes. When applied diligently and correctly, however, the hot washcloth with essence of tea tree oil works great for most. Medications - it used to be quite common to see a variety of antibiotic drops, ointments and even tablets used to treat blepharitis. Unfortunately, none worked well. Now, there is a medication that addresses the primary underlying cause of blepharitis, the demodex skin mite. For patients who are not able to achieve sufficient resolution of blepharitis, the topical medication XDemvy (Lotaniler) is a useful adjunct. This is prescribed for a six week period and results in a substantial elimination of the demodex parasite resulting in substantial improvement in patient symptoms.