How to treat rosacea on the face? Rosacea (rosacea)

In addition to the above pathologies, rosacea occurs more often in patients with chronic cholecystitis, cholelithiasis, reflux esophagitis, pancreatitis, enterocolitis, etc.

Dysfunction of the adrenal glands, ovaries and thyroid gland leads to excessive release of histamine and bradykinin into the blood - biologically active substances that cause the expansion of arterioles, mainly of the skin of the face. Normally, these substances are secreted locally as part of the inflammatory process and contribute to its limitation. In rosacea, these inflammatory mediators circulate in the bloodstream at increased concentrations.

Rosacea during physiological hormonal adjustment ( perimenopausal period, pregnancy, puberty, etc.)

During periods of hormonal changes ( perimenopause, pregnancy, lactation, oral contraceptives, etc.) the body is under stress. When the body is under stress, its systems prepare to fight the environment. This mechanism has been developed in the process of many millions of years of evolution and, in fact, is its driving force. In particular, there is an increase in heart rate, blood pressure rises, and the concentration of glucose in the blood increases. All these measures are aimed at improving the blood supply and nutrition of the brain, muscles and other vital organs.

Along with the above changes, the kallikrein-kinin system of the blood is activated. As part of this process, biologically active substances are released ( bradykinin, histamine, serotonin, etc.), activating the blood coagulation system, specific and non-specific immune responses, secretion of adrenal hormones, etc. Also, mediators of the kallikrein-kinin system improve peripheral microcirculation, that is, lead to a plethora of the skin vascular network. However, with rosacea, this process aggravates the outflow of blood and lymph from the skin of the face and complicates the course of the disease.

In fairness, it should be noted that the appearance of rosacea in young people during puberty is not typical, but it does occur periodically. People over the age of 40 are more susceptible to it. By this age, the connective tissue stroma of the skin usually undergoes pathological changes that cause disturbances in blood circulation in it. In young people, the skin is more elastic and the stroma is usually fine, so they do not develop rosacea.

Rosacea due to carcinoid syndrome

A carcinoid is a malignant tumor that produces and releases biologically active substances into the blood. The most common carcinoid products are serotonin and bradykinin. These substances lead to the expansion and increase in the permeability of the wall of arterioles of the skin, mainly of the face. The fullness of the skin of the face, in turn, leads to stagnation in it, provoking the appearance of rashes characteristic of rosacea.

Rosacea symptoms

External manifestations of rosacea depend on the stage and clinical form of the disease. As a rule, rosacea is manifested by a papulo-pustular rash of varying severity and telangiectasias ( spider veins). Subjective sensations of patients, as a rule, are scarce. Sometimes at the site of the rash, patients experience a slight burning sensation and itching, although usually even these symptoms are absent. Formation of pustules ( pustules) slightly increases pain due to more pronounced inflammatory changes. As fim develops, some stiffness of the skin may be felt. However, due to the fact that this process is long in time, patients gradually get used to new sensations and do not notice them.

The severity of rosacea

Severity	External manifestations	Histological picture
*Prerosacea, rosacea-diathesis*	Slight reddening of the skin in the form of a network under the influence of factors provoking their plethora. Interruption of the action of provoking factors leads to the disappearance of redness.	The histological picture at this stage is practically indistinguishable from the histological picture of healthy skin.
*Rosacea* *I degree* ()	The redness of the skin becomes permanent. Characteristic is the localization in the cheeks, forehead, chin and neck. Areas of redness do not rise above the surface of the skin. There are single telangiectasias ( spider veins).	In the histological section at this stage, dilated blood and lymphatic vessels are noted, around which lymphocytes can accumulate.
*Rosacea* *II degree* *(papulo-pustular)*	The area and intensity of redness is greater than in the first stage of the disease. Areas of especially strong stagnation of blood and lymph are bluish in color. The number and size of telangiectasias increases, and they can form a semblance of a capillary network. In the most red and cyanotic areas, single or grouped elevations appear ( papules), which eventually fill with fluid and turn into pustules ( pustules).	Numerous accumulations of leukocytes are noted around the hair follicles and the sebaceous and sweat glands located next to them. The areas of destroyed connective tissue fibers are determined, indicating the process of destruction of the skin stroma. The distance between cellular elements increases due to tissue edema. The contents of the pustules may be purulent or sterile.
*Rosacea* *III degree* *(pustular-nodular)*	There are external signs of the previous stage of the disease. There is a significant thickening of the skin in the area of inflammation due to the accumulation of connective tissue nodes that have formed around the hair follicles. The follicles themselves atrophy, as do the adjacent sebaceous and sweat glands. The mouths of the glands expand and take the form of funnels. When pressing on these glands and nodes, a thick white secret is released from the altered follicles. As a result of the above changes, fimas are formed - areas of asymmetric deformation of a certain area of the face. Rhinophyma develops in the area of the nose, gnathophyma develops in the chin area, metaphima develops in the forehead, otophyma develops in the ears, blepharophim develops in the eyelids, etc.	At this stage, in addition to the above changes, there are numerous connective tissue nodes located around the hair follicles. The follicles themselves atrophy.

In addition to the typical clinical picture of rosacea described above, at various stages of this disease, there are atypical forms of it.

Atypical forms of rosacea are:

ophthalmic rosacea;
lupoid ( granulomatous) rosacea;
steroid rosacea;
conglobate rosacea;
gram-negative ( gram negative) rosacea;
rosacea-lymphedema ( Morbigan's disease).

Ophthalmic rosacea

Due to the fact that the anterior tissues of the eye during the growth of the embryo come from the same germ layer as the skin, they are characterized by similar diseases. Rosacea is an example of such a disease. According to statistics, damage to the tissues of the eyes and their appendages is noted in 20 - 60% of cases of rosacea. Changes characteristic of this disease are observed in the tissues of the eyelids ( blepharitis), conjunctiva ( conjunctivitis), cornea ( keratitis) and iris ( iridocyclitis).

Since these tissues are extremely densely innervated, their inflammation is extremely unpleasant. Even in the initial stages of the disease, the patient notes a feeling of sand and burning in the eyes, tearing, redness and severe pain. Progression of ophthalmic rosacea can lead to blindness.

Lupoid ( granulomatous) rosacea

Lupoid rosacea is manifested by multiple shiny papulo-pustules with a brown tint and a radiant surface. Another feature is the dense arrangement of rashes. Applying a glass slide to the elements of the rash reveals their true yellow-brown color.

Steroid rosacea

Steroid rosacea develops in patients who have been treated with glucocorticoid ointments for a long time. The reason is such a side effect of treatment as atrophy of the skin. Thus, these drugs largely stop the inflammatory process, creating the appearance of recovery, but in fact aggravating the condition of the skin. After discontinuation of the drug in the next few days ( sometimes hours) recurrence occurs ( reappearance) rosacea, and with a much brighter clinical picture than before treatment. Usually, patients have all the elements of the rash characteristic of the disease and multiple telangiectasias. The formation of phim occurs relatively faster than in the typical form of the disease.

Conglobate rosacea

This type of rosacea is characterized by the formation of massive nodules in the skin that tend to suppurate. In other words, with this form of rosacea, subcutaneous abscesses form. These abscesses are characterized by self-opening to the outside with the formation of long-healing fistulas. The general condition of patients in connection with abscesses, as a rule, does not worsen. This atypical form develops after taking halogen-containing drugs more often against the background of hormonal dysfunction or gynecological pathology. In connection with the foregoing, conglobate rosacea, and in particular its most severe fulminant form, develops mainly in young women.

Gram-negative rosacea

Gram-negative rosacea develops as a result of the irrational use of antibiotics. As a result, most of the saprophytic ( non-pathogenic) microorganisms, while Gram-negative bacteria persist ( persist) in the body. These bacteria penetrate the pustules, in most cases aggravating the inflammatory process.

Rosacea-lymphedema ( Morbigan's disease)

With this form of the disease, edema of the upper part of the face prevails, caused by stagnation of the lymph and pronounced fibrotic changes. Other signs of rosacea ( telangiectasias, papules, pustules) are expressed moderately or even slightly.

Diagnosis of rosacea

Diagnosis of rosacea is predominantly clinical, meaning it is based on a simple examination by a dermatologist. According to the external signs of the disease, it is usually possible to establish not only the severity, but even diagnose certain atypical forms of this disease.

Nevertheless, according to the generally accepted opinion in the medical community, laboratory and instrumental diagnostics should also be used for this disease. Due to the fact that rosacea is a polyetiological disease, a sufficiently large range of additional studies may be needed to identify the cause of its occurrence.

One of the mandatory methods of research is ultrasound ( ultrasound procedure) pelvic organs, abdominal cavity ( with adrenal glands) and thyroid. The upper gastrointestinal tract must be examined by FGDS ( fibrogastroduodenoscopy), and it is desirable during this study to determine the presence and amount of Helicobacter pylori bacteria in the gastric mucosa. If certain ambiguities arise after the above research methods have been carried out, more sensitive and accurate methods can be used to clarify the diagnosis ( computed tomography or magnetic resonance imaging with a contrast agent).

Often resort to laboratory research methods. For example, in almost all cases of rosacea, a skin scraping should be examined to detect the skin mite, Demodex folliculorum. An increase in the population of this mite in some cases is the direct cause of rosacea, and in others it can aggravate its clinical manifestations. In addition, at the papulo-pustular stage of the disease, it is necessary to examine the content of pustules ( pustules). If it contains pathogenic bacteria, then appropriate antibiotics may be required in the treatment.

A complete blood count and a biochemical blood test with a mandatory study of kidney and liver tests should be performed for any form of rosacea. Urinalysis is also a screening method for diagnosing concomitant diseases. If you suspect the occurrence of rosacea against the background of a hormonal imbalance, it is recommended to examine the level of hormones and their metabolites in the blood. One of the alternative methods for diagnosing Helicobacter pylori is the determination of the titer of immunoglobulins G and M to this bacterium in the blood, as well as the determination of antigens ( fragments) of this bacterium in faeces.

If concomitant pathology of organs and systems is detected, treatment tactics must be developed with the participation of an appropriate specialist ( endocrinologist, gynecologist, gastroenterologist, etc.).

Rosacea treatment

The effectiveness of the treatment of this disease equally depends on both the correct medical recommendations and the discipline of the patient. Medication alone is often not enough. For a lasting and long-term effect of treatment, the patient must change his lifestyle so as to reduce the influence of factors that favor rosacea.

Avoiding triggers for rosacea

Due to the fact that rosacea is a polyetiological disease, the most reasonable start of treatment is the termination of the factors that provoke its occurrence. Since there are many such factors, it is recommended to simultaneously abandon them all. If there is not enough willpower or there are other reasons, then these factors can be canceled in order of priority in order to determine which of them cause the appearance of rosacea to the greatest extent, and to influence them.

Thus, for rosacea of all degrees of severity, it is recommended:

completely eliminate alcoholic beverages;
avoid spicy, smoked, hot and irritating food;
exclude spices from the diet, even the most harmless at first glance;
eliminate or minimize the time of wearing makeup;
wear hats that prevent direct sunlight from reaching the skin of the face;
use sunscreen ( only if they do not exacerbate rosacea);
dress wisely so as not to overheat and not get cold;
protect the skin of the face from the wind;
do not stay head down for a long time, instead it is better to sit down with a straight back;
avoid heavy physical exertion, instead it is better to do the work in several approaches;
care for the skin, nourish it, maintain its hygiene;
if a combined pathology of the upper gastrointestinal tract, endocrine system or pelvic organs is detected, contact the appropriate specialist and undergo a course of treatment.

Medical treatment for rosacea

Regarding the use of any of the following medicines, a dermatologist should be consulted due to the significant risk of side effects.

Medical treatment of rosacea in various degrees of severity

Stage of rosacea	Recommendations	Important additions
*Prerosacea, rosacea-diathesis*	Cold lotions with weak solutions of chamomile, string, St. John's wort, boric acid, etc. Massaging the skin of the face several times a day. The use of drugs that potentiate the action of the parasympathetic nervous system ( eglonil, novo-passit, glycine, etc.).	For a more pronounced effect, it is recommended to massage various parts of the skin of the face in a circular motion, using pieces of ice. With local exposure, cold constricts peripheral vessels, reducing swelling.
*Rosacea* *I degree* *(erythematous-telangiectatic)*	To the above methods, a broad-spectrum antibacterial drug is added - metronidazole, which destroys most pathogenic and conditionally pathogenic pathogens located on the surface of the skin. Plasmapheresis is allowed extracorporeal method of blood purification from toxic substances).	To begin with, you should use metronidazole topically in the form of a gel. If the effect is insufficient, then it is recommended to switch to intravenous drip administration of this drug. Before starting treatment, it is necessary to conduct a skin test for a possible allergy to this antibiotic.
*Rosacea* *II degree* *(papulo-pustular)*	In addition to the above methods, sulfur and zinc preparations in the form of gels and creams should be used. These drugs have a pronounced anti-inflammatory, bactericidal and acaricidal ( designed to kill ticks) action. After reducing the signs of inflammation, the local use of azelaic acid preparations is recommended, which normalizes the processes of keratin formation ( ground substance of the epidermis). If necessary, expand the spectrum of antibiotics used ( erythromycin ointment, clindamycin gel, etc.). A good therapeutic effect is achieved with the use of roaccutane and other topical retinoids.	Roaccutane and topical retinoids are teratogenic ( cause congenital malformations). In connection with the foregoing, these drugs are absolutely contraindicated for systemic use by pregnant women, breastfeeding mothers and those who plan to become pregnant in the near future. Topical application to these categories of patients is allowed, but not recommended, since about 3% of the substance penetrates into the blood. With caution, these drugs are used in liver failure. It is absolutely impossible to combine roaccutane ( isotretinoin) and tetracycline. Despite the pronounced anti-inflammatory effect of glucocorticosteroid ointments and creams, their use in rosacea is strictly limited due to the sharp withdrawal effect. They are used in a short course ( 7 - 10 days) as a non-greasy cream or aqueous emulsion.
*Rosacea* *III degree* *(pustular-nodular)*	Treatment of rosacea at this stage is reduced mainly to surgical methods. The first method is a wedge-shaped resection of hypertrophied tissues with their subsequent stitching. The second method involves subcutaneous curettage of connective tissue growths, followed by wedge resection and comparison of the ends of the wound. The third method consists in the deep removal of phim tissue down to the cartilaginous or bone base using surgical lasers. The fourth method is dermabrasion - mechanical or laser destruction of the surface layers of the skin, followed by smooth healing.	The first and second methods belong to classical plastic surgery and are quite traumatic ( especially the second method). The high invasiveness of the operation implies a long recovery period and a high likelihood of side effects. The last two methods are more modern and practically bloodless, however, they require special laser equipment and training of specialists able to work with it.

Rosacea, or as they are also called, rosacea, is a chronic disease that occurs due to improper functioning of the sebaceous glands. Redness and swelling of the skin, its inflammation, itching and peeling are factors that significantly affect the quality of human life. However, identifying the cause of the disease, treating it at an early stage, and following certain skin care rules can change the situation for the better.

At-risk groups

Rosacea is a fairly common ailment. The risk group is representatives of the Caucasian race, mainly people belonging to northern peoples who have fair skin and hair. Women of this type are most susceptible to the disease, especially those belonging to categories I and II of photosensitivity. Risks increase with age 60 for both sexes.

Causes

The development of this disease, as well as its exacerbation, occurs for several reasons:

hereditary factor. If rosacea is observed in parents, most likely the child will also suffer from this ailment.
Excessive hypothermia or overheating of the skin, insolation in natural conditions or in a solarium.
Long-term use of glucocorticosteroid drugs.
Severe stress, general weakened state of the body.
Violations in the work of the endocrine system.
Improper skin care, in particular, the use of highly abrasive scrubs, aggressive chemical peels.
The presence of an allergy that has a skin manifestation, for example, contact dermatitis.
Allergy to skin care products.
Wrong nutrition. Excess consumption of fried, spicy, spicy foods.
Some doctors attribute the onset of the disease to gastritis, believing that in both cases the causative agent of the disease is the bacterium Helicobacter pylori.
Bad habits. A high risk of developing the disease is observed in smokers, as well as in those who abuse alcohol.
Taking hormonal drugs, such as birth control pills.

An interesting fact: representatives of Asian and African countries never get rosacea, although they are most susceptible to insolation

Symptoms and stages of the development of the disease

The development of rosacea occurs in stages. First, a person pays attention to sudden flushes to the skin of the face, feels hot. The skin of the face turns red. The blush is quite bright and clearly defined, reminiscent of flames in shape. As a rule, such redness appears on the face, covering the cheeks, chin, forehead and nose. Also, rashes on the chest, shoulders and back are not uncommon. The sebaceous glands begin to work more actively, you can notice the increased fat content of the affected areas of the skin.

Further, pinkish tubercles form in the areas of redness, these papules then transform into blackheads and purulent pimples. The next stage of the disease is thickening of the skin. The vascular network expands, the skin remains permanently red, looks somewhat edematous and more dense compared to healthy areas.

Possible Complications

In 50% of people diagnosed with this disease, eye damage occurs, which is expressed in profuse lacrimation, a feeling of sand in the eyes, dryness and cramps. The retina of the eye turns red, there is discomfort when blinking. In addition, the disease is often complicated by demodicosis. To prescribe the correct treatment, a dermatologist must check the patient for the presence of Demodex mite.

Can you get rid of rosacea?

Unfortunately, it is not possible to completely cure this disease. As a rule, the disease proceeds in waves: periods of remission are replaced by exacerbation phases, which provoke the above factors (allergies, smoking, eating spicy foods, etc.).

The chances of a successful outcome are higher if treatment for rosacea is started at an early stage of the disease, when a person notices redness of the skin and feels hot after drinking hot or alcoholic drinks. If the disease has moved to the third stage, then it is also possible to achieve a stable remission, but scars may remain in place of acne.

Medical treatment

Treatment of rosacea is prescribed by a dermatologist depending on the stage of the disease and taking into account the causes of its occurrence.

At the first stage of rosacea, drugs are prescribed that strengthen the walls of blood vessels. Subcutaneous injections of nicotinic acid, vitamins A, B and C have a good effect. At this stage, home treatment can help, for example, washing with infusion of horse chestnut and chamomile reduces skin inflammation.

If the disease has passed into the second or third stage, the doctor prescribes topical gels containing antibiotics, as well as hormonal ointments. They have a powerful anti-inflammatory effect and help relieve itching and flaking by cooling the skin. Popular remedies for the treatment of rosacea are Epiduo, Doxycycline, Skinoren. Also, the doctor may prescribe oral antibiotics, for example, "Tetracycline".

Modern hardware procedures can make acne scars almost invisible

After the removal of inflammatory processes, procedures such as laser, photo- and electrocoagulation come to the rescue, which eliminate excessive branching and expansion of the vascular network. Also, cryomassage has proven itself well, in which exfoliation of superficial skin structures occurs with the help of liquid nitrogen. An analogue of the procedure is dermabrasion - mechanical resurfacing of the face.

Treatment with folk remedies

lemon,
cucumber,
calendula flowers,
chamomile flowers,
sage,
rose hip,
sophora japonica,
plantain juice,
cabbage juice,
cranberry juice (necessarily diluted with water),
rhizomes of madder dye,
series,
parsley,
nettle,
burdock stem,
yarrow.

You can also apply lotions to damaged skin, for this, extracts of the above plants or their juice are used. To prepare lotions, you will need gauze folded in several layers or a soft cloth made from natural materials. Soak the cloth in a decoction or juice of the above ingredients, squeeze lightly and apply to the affected skin for 10 minutes. Then make a new lotion and leave for another 10 minutes. In total, you need to make 4-5 lotions. They should be either cool or at room temperature.

Very effective treatment with propolis. You will need a low concentration alcohol tincture. The face is smeared with a brush dipped in the product. Within a month, the procedures are performed daily, then every other day.

To relieve inflammation, you can use those products that absolutely everyone has in the kitchen. For example, ordinary kefir. It is applied to the face for 15-20 minutes and then washed off with water. Also good for oatmeal. It is brewed with warm water and gruel is applied to the face for half an hour, like a mask. Oatmeal gently cleanses the skin, absorbs excess sebum and relieves inflammation.

Junk foods rich in artificial sweeteners and monosodium glutamate should be avoided when treating rosacea

Prevention

In order to reduce the risk of developing the disease, the following rules should be followed:

Avoid sun exposure, overheating or hypothermia. Eliminate winter sports in which the face suffers from strong gusts of frosty wind (running, skiing).
Don't walk in cold weather.
Try to refrain from going to the bath and sauna.
Before going outside in both summer and winter, use a cream with a high level of UV protection.
Strengthen the immune system, harden the body, observe the sleep regimen.
Give up alcohol, avoid smoking.
Eat foods that improve bowel function: plant foods rich in fiber, dairy products. Eliminate coffee and chocolate, spicy and spicy foods, too hot (over 60 degrees) and too cold drinks, sweet soda, canned food.
Wash yourself with decoctions of medicinal herbs. Then dry your face with disposable soft paper towels.
Herbal tea has a beneficial effect on the body.
Do not use facial skin care products containing alkalis, acids and alcohol, highly abrasive particles, parabens, oils (including essential oils), acetone.
Men are advised to use an electric razor instead of a blade.
You can not make face masks that have a vasodilating effect. These include masks, which contain honey, badyaga.

Rosacea is not the most pleasant disease. Acne and inflamed skin will not add external attractiveness to anyone. However, a careful and responsible attitude to your own health allows you to achieve a long-term remission, and compliance with the above rules will bring you closer to a healthy lifestyle.

Rosacea on the face, the treatment of which is a long process, is presented as a chronic non-infectious skin disease. It manifests itself as persistent redness, pustules and capillary asterisks. A neglected problem can lead to the fact that the skin on the forehead, nose, eyelids and chin becomes thick, the appearance of a person suffers greatly at the same time. This condition causes psychological and emotional disorders.

The second name of the disease in question is rosacea, and its chronic nature is manifested by frequent relapses. Treatment requires an integrated approach. The course of therapy lasts from a week to several months. Such therapy allows you to eliminate external manifestations, quickly curing concomitant diseases.

Acne is usually treated with antibiotics, especially in the paputopustular form of the disease. Among these drugs, Tetracycline and Erythromycin are especially effective. They are taken orally, several tablets per day. The duration of the course is 3-6 weeks. After that, the patient's condition improves markedly.

A more expensive alternative is the drug Minocycline, which is taken 1 time with meals. If a person is resistant to antibiotics, then you can take Metronidazole (3 times a day). Before treating rosacea with this drug, it is recommended to consult a doctor. During the course of therapy, it is necessary to refrain from drinking alcoholic beverages, as this can cause serious side effects. A person develops severe headaches, disruption of the digestive system, hot flashes. In order to avoid complications on the nervous system, this drug should not be taken for a long course.

Depending on whether rosacea is treated successfully with antibiotics, their dose is adjusted. If the effect has come, then it is gradually reduced, and then the drug is stopped. If at the same time a relapse of the disease occurs, then the dose must be increased back. In some cases, the disease returns within a couple of weeks after the end of the course, but the vast majority of patients begin a long-term remission.

To overcome rosacea, the systemic drug Isotretinoin is widely used. Its reception is prescribed for severe forms of the disease. Due to the fact that this medication leads to dryness of the skin and mucous membranes of the eyes, which are undesirable in rosacea, its dose should be 2 or 4 times less than in the treatment of diseases such as acne. To prevent side effects, agents are prescribed to soften and moisturize the eyes. Taking Isotretionin brings improvement in the patient's condition, but long-term remission rarely occurs. In addition, there remains a problem with hyperplasia of the sebaceous glands of the skin, leading to rhinophyma.

Considerable difficulties are experienced by doctors in the treatment of patients with intense and frequent hot flashes. To do this, they resort to beta-blockers and drugs such as Neproxen and Spironolactone. In menopausal women, treatment with hormonal drugs and venlafaxine is used. Despite the frequent side effects, rosacea can be cured with selective sypatectomy.

Therapy of the disease in the eyes

Rosacea can show its symptoms in front of a person. It causes burning, dryness of mucous membranes and unpleasant tingling. Methods for the treatment of this form of rosacea are based on the use of antibacterial drugs of the same type as in skin rosacea. Before starting a course of treatment, an examination by an ophthalmologist is necessary.

To combat the ophthalmic form of the disease, tetracycline antibiotics are used:

Oxytetracycline;
minocycline;
Tetracycline hydrochloride.

Eliminate swelling, pathogens and subcutaneous mites will help Metronidazole, which has a positive effect on the recovery processes of the digestive tract. Various antihistamines are taken from irritation and itching, and Ascorutin is suitable for dealing with broken capillaries. If it is necessary to treat the nervous system, remedies of natural origin (valerian, motherwort) are prescribed. In severe cases, it is necessary to resort to strong antidepressants.

Local therapy

Treatment of acne with antibiotics is usually supplemented with topical preparations containing substances that act on bacteria. At the initial stage of therapy, compresses are used from a solution of boric acid and talkers. Of creams and ointments, Skinoren-gel is effective. It is based on azelaic acid, which reduces puffiness and inflammation. This remedy helps to remove the rash and dries the skin. Apply the drug to the skin of the face should be 2-3 times a day with a clear regularity. This tool actually has no contraindications, it is approved for use during pregnancy and lactation.

Ovante cream is a preparation of natural origin, prepared on the basis of extracts of medicinal plants and crystalline sulfur. The use of this tool, like Sinkor-gel, is absolutely harmless to health and brings a noticeable cosmetic effect.

Often, hormonal medications are used for local treatment of rosacea on the face. The result from their use is obtained in a fairly short time, but long courses are categorically not recommended. Hormonal ointments and creams do not always lead to long-term remission. On the contrary, very often the disease returns very soon, in even more severe manifestations, and can even flow into a steroid form, which is very difficult to treat. Such a treatment regimen can only be prescribed by the attending physician, who controls the use of drugs.

Physiotherapy and Diet

Physiotherapeutic procedures can be effective for facial rosacea, which give a noticeable result after the first sessions. In patients, reddening of the skin of the face decreases, discomfort disappears, and the vascular networks fade. Among such procedures, such modern methods of treatment as coagulation, cryodestruction, dermabrasion, laser treatment and photocoagulation are common. To consolidate the effect, patients are recommended to use creams that prevent the action of direct sunlight. Conglobate rosacea, leading to the appearance of spherical formations, requires surgical intervention, through tissue excision.

Hardware acne treatment can be carried out in beauty salons and clinics.

Laser therapy is carried out exclusively by qualified specialists in a clinical setting. The beam of light heats the tissues, destroying bacteria, which leads to cleansing of the skin. The cryodestruction procedure involves short-term freezing of the affected tissue with liquid nitrogen.

To remove rosacea, you must follow a strict diet, and in severe forms, even resort to curative fasting for 5 days. During illness, you can not eat citrus fruits, grapes and pears. It is necessary to refrain from fried foods, canned food, sausages, spices, spicy foods, pickles and pickled foods. You should limit the diet of animal fats, sweets, alcohol, tea, coffee and chocolate.

The nutrition of a patient with rosacea on the face should be based on the use of fresh vegetables and fruits, low-fat fish and meat products, salads seasoned with vegetable oil and sour-milk products. Among vegetables, potatoes, cucumbers, carrots and beets are welcome. You can eat cereals, unleavened bread, different types of greens, fresh berries. Frying and stewing should be replaced by boiling, steaming, baking. It is recommended to drink plenty of fluids, mineral water is especially good in this case.

Folk remedies

There are many folk methods to combat rosacea on the face. They successfully relieve swelling and rash, improve the condition of patients. Propolis tincture is considered an effective remedy for rosacea. It is applied to clean skin of the face before going to bed, and in the morning the resulting film is washed off with warm water. Such a remedy can be prepared at home, or bought at any pharmacy. The effect is achieved due to the ability of propolis to kill bacteria, relieve inflammation, nourish and soften the skin. It does not cause dryness of the skin, saturates it with essential vitamins, and is effective for many skin diseases.

Before you treat rosacea with a decoction of rose hips, you will need to boil water. Lotions are applied to the face for 15-20 minutes. This tool enhances immunity at the cellular level, eliminates inflammation, swelling and brings recovery closer. In addition, it contains a huge amount of vitamins.

Effective treatment of rosacea can be carried out with aloe leaf juice, which is mixed in equal proportions with water and applied as compresses for 20-25 minutes. After a few weeks, the patient's redness and rash will disappear.

A good method of treating the disease is to spray thermal water on the affected areas, which perfectly moisturizes the skin of the face, relieves irritation and redness, and accelerates regeneration. Before you get rid of rosacea with a mask of fresh cucumbers, you must first chop the vegetable with a grater. Aloe juice is added to the resulting gruel. With rosacea, you can prepare a decoction of chamomile flowers, sage and rose petals.

Before treating rosacea with any of the folk recipes, you should consult a dermatologist who will tell you the most suitable remedy in each case and give information on whether the disease can be cured in any way without harm to health.

If a person has rosacea, he should not visit places with high humidity - saunas and baths. When going outside in strong wind and cold, you need to cover your face with a scarf. From exposure to direct sunlight, which can provoke an exacerbation of the disease, you should use special protective creams without any flavors. The most suitable in this case are products that take zinc and titanium dioxide as a basis.

It is strictly forbidden to use scrubs and peelings, as they can cause additional irritation of the skin of the face. Patients are advised to lead a healthy lifestyle, maintain proper nutrition, give up cigarettes and alcoholic beverages. It is contraindicated to use drugs that dilate blood vessels, self-medicate without consulting a doctor.

Description:

Rosacea is a disease of the sebaceous glands caused by constitutional angiopathy, neuroendocrine disorders and dysfunction of the digestive system.

Symptoms:

There are 3 stages in the development of rosacea. At stage I, hyperemia appears, which is aggravated by the action of heat, excitement, and the intake of spicy food. Telangiectasias gradually develop (erythematous stage). At stage II, against the background of congestive erythema with telangiectasias, plaques with many pustular elements are formed from confluent red nodules, upon opening of which purulent exudate is released, shrinking into crusts (papular-pustular stage). At stage III, the skin thickens, inflammatory infiltrates, voluminous nodes are formed, from which pus can be released when pressed (infiltrative stage). The process is localized on the nose, cheeks, rarely on the forehead. If the growths in the nose area become significant, then a pineal nose (rhinophyma) is formed.

Causes of occurrence:

Occasionally there is a hereditary predisposition to rosacea.
4-5% of patients who consult a dermatologist have primary elements of rosacea. The disease often occurs in women over 30 years of age.
Risk factors for the development of rosacea are insolation, overheating, stressful situations.
The disease is based on endocrine and vegetative-vascular disorders. Sometimes the chronic course of the disease is supported by a mite that lives in the sebaceous glands - the gland (demodex folliculorum).
In the pathogenesis of rosacea, an important role belongs to diseases of the digestive system, neuroendocrine disorders leading to angioedema with peripheral circulatory failure.

Treatment:

For treatment appoint:

Treatment of rosacea should be comprehensive and pathogenetically justified, taking into account the stage of the process and concomitant diseases.
The main directions in the treatment of rosacea: 1) restoration of microcirculation in the skin, 2) normalization of the function of the sebaceous glands, 3) correction of disorders of the digestive organs, as well as the nervous system.
As an antibacterial therapy, Trichopolum is used at a dose of 0.25 mg 2 times a day for 10-14 days. With a large number of pustular elements, broad-spectrum antibiotics are prescribed (ampicillin, ampiox, doxycycline, etc.). To improve the processes of digestion, enzyme preparations are used (festal, digestal, mezim, panzinorm, solizim, nigedase), with dysbacteriosis of the large intestine - eubiotics (hilak-forte, bifidumbacterin, acylact, etc.). In order to restore microcirculation processes in the skin with rosacea, vascular preparations containing nicotinic acid (sodium nicotinate, teonikol) are used. Course treatment with multivitamins with a predominant content of vitamins A, E and group B contributes to the rapid regression of elements. With severe infiltrates accompanied by acute inflammatory phenomena, it is advisable to prescribe corticosteroid drugs (prednisolone) at 25-30 mg / day for 1-2 weeks with a further gradual decrease in dose until complete withdrawal or diprospan in the form of intramuscular injections of 1 ml 1 time in 15 -20 days (1-3 injections until persistent clinical improvement). In torpid and severe cases, when therapy was unsuccessful, it is possible to use synthetic retinoids (retinol palmitate, roaccutane). Roaccutane for rosacea is used in mini-doses (0.l-0.5 mg/kg) for 4 months. However, these drugs are the drugs of choice due to the likelihood of hepatotoxicity and their teratogenicity.
Local therapy is carried out taking into account the stage of the disease. In an acute process, resorcinol, boric, tannin lotions are used, after the process subsides, pastes with tar, ichthyol, and sulfur are used. Corticosteroid ointments should be used with caution; ointments that do not contain fluoride (locoid, elokom) are recommended. With a large number of pustular elements, polcortolone or oxycyclosol aerosol is used. As local antibacterial therapy, a 10% benzyl benzoate ointment or suspension, 1% trichopolum cream or metrogil is used.

Rosacea on the face requires mandatory treatment, but only after finding out the causes. In addition to the beautiful name, there is nothing attractive in this disease. Rosacea (or rosacea) refers to skin dermatosis, has a chronic relapsing course; is not infectious.

Translated from lat. rosaceus means "pink" or "made of roses". This disease has been known since ancient times, since the Renaissance. Since the appearance of patients is similar to that of people who have been drinking for a long time, it was called the disease of the red nose, in France - "wine acne", and was attributed only to persons with active libations. 10% of people in the world have this problem; Symptoms often appear after the age of 30, but may appear as early as 12-20 years of age. In Russia, the number of sufferers is estimated at 5%, but, according to beauty salons, it is 21%. The fact that among patients, according to statistics, women aged 40 to 65 years predominate, can be explained by the fact that they are very zealous about their appearance and turn to doctors much more often. Some severe forms of rosacea, like rhinophyma, are the prerogative of men. The type of patients can be confused with the face of a chronic alcoholic: extensive redness, swollen nose, network of blood vessels on the face, swelling of the face. Rosacea definitely spoils the aesthetics of the face and creates psychological problems for patients.

Etiology of the phenomenon

Endogenous factors: endocrine causes (DM, menopause, metabolic syndrome, disorders in the pituitary-adrenal-gonadal system); psychovegetative disorders; weakening of the immune system; pathology of the gastrointestinal tract - the relationship between diseases of the gastrointestinal tract and rosacea has been established accurately; increased sensitivity of the epidermis to external influences; skin infections; detection of the bacterium Helicobacter pylori; hereditary predisposition in 40% of cases: if there are women or men in the family who suffer from a dermatological disease, their descendants are more likely to have the disease.

The risk group includes: peoples of the Scandinavian type of appearance are more prone to this disease; women who have thin vascular walls, therefore, at the slightest external irritation, capillaries break; women whose facial skin is constantly exposed to hot, dry air.

Symptomatic manifestations

Symptoms and treatment are determined by the stage of the disease and the severity of the problem. The face is most often affected in a T-shape: forehead, nose, cheeks and chin. The eyes (half the cases) and ears may be affected. There are many variants of the course of the disease, so there is no single classification. But 3 main stages are distinguished: erythematous-telangiectatic; papulo-pustular; pustular-nodular:

Erythematous-telangiectatic stage - here, at the onset of the disease, the patient periodically experiences, for various reasons, sensations of heat on the face, which themselves disappear after a few minutes or hours. With repeated provocateur factors, such hot flashes can be repeated, in the place of erythema, the skin gradually thickens. This can go on for many months or even years. Then, at the sites of erythema, edema and telangiectasia appear - a vascular network. Erythema from red is already becoming purple-cyanotic, spreading to other parts of the face. Vessels under it are dilated.
Papulo-pustular stage - pink-red papules (abdominal elements of altered skin) appear on dense areas of erythema. They can be single or in groups; covered with thin scales. They remain on the skin for several weeks. Gradually, they begin to fester, increase to 3-5 mm, turn into papulopustules (cavities filled with pus). There is a burning sensation of the skin, itching, a feeling of constriction. When examining the contents of pustules, it turns out that they do not contain pathogens; suppuration occurs just because of the demodex mite. Papulopustules occur behind the ears, on the forehead, neck. The face becomes pasty-edematous, puffy.
Pustular-nodular stage - further progression of the process without treatment leads to the appearance of inflamed nodes, infiltrations and growth of tumor-like structures. This is due to the persistent expansion of blood vessels, the growth of connective tissue and sebaceous glands. The main localization is the nose and cheeks. Appearance is not changing for the better, and the impression of an “alcoholic face” is created. This is all the more unpleasant because many people around misinterpret the changes that are taking place. Rhinophyma is so specific that it is recognized as a separate form (see photo). Men are more often affected. With this form, the nose is infiltrated, it already has tumor-like growths, the sebaceous glands hypertrophy, the nose becomes asymmetrical and thickened. Sometimes such thickenings appear in the area of the eyelids - blepharophyma, earlobes - otophyma, a pillow in the forehead and bridge of the nose - metaphima, a thickening on the chin - gnathophyma. The vascular network becomes larger, the enlarged sebaceous glands begin to produce an increased amount of sebum, which is squeezed out when the skin is compressed in the form of a pasty mass; the nose begins to shine and shine. This mass consists of dead cells of the epidermis, sebum, bacteria and mites, often it has an unpleasant odor. Rosacea is easily distinguished from acne by the absence of blackheads.

Diagnostic measures

Rosacea has such a characteristic appearance that an experienced doctor needs only one examination of the patient to make a diagnosis. Among the characteristic features: rosacea has a typical T-shaped arrangement of lesions; frequent presence in the anamnesis of chronic diseases of the stomach (chronic gastritis); identification of a tick in the contents of pustules; in histological analysis - perifollicular infiltrate of lymphocytes and histiocytes. O.A.K., a biochemical blood test is also taken; urinalysis, bacteriological culture of the contents of acne, lipidogram, coagulogram; Ultrasound of internal organs; skin scraping for demodex. Menopausal women undergo a skin biopsy and determine the level of estrogen.

Principles of treatment

When establishing the diagnosis of "rosacea" treatment should be only complex. Although on the forums you can sometimes find statements and details of treatment from those who have cured rosacea, but experience shows that an absolute cure for rosacea is rare, but almost 90% of patients manage to control the appearance of a rash. It is advisable to start treatment earlier, when there is only stage 1, and while there are no total changes in the skin. Since the cause of the pathology is not precisely defined, it is impossible to predict its exacerbations and remissions. And how to treat the disease - this can be suggested by a dermatologist, taking into account the provoking factors that “helped” the appearance of the pathology.

Treatment begins with the removal of the provoking factor. Since rosacea always has vasodilation, vasoconstrictor drugs are always used, and locally. With increased greasiness of the skin, gels with a sebocidal and anti-inflammatory effect are used - they deeply cleanse the skin, remove dead cells; open clogged pores. Itching and burning are well removed with cold compresses of resorcinol and boric acid.

Rosacea responds well to antibiotic treatment (tetracyclines and macrolides - Tetracycline, Doxycycline, Clarithromycin, Erythromycin, Sumamed, Azithromycin, etc. - they are prescribed in the later stages and during periods of exacerbations), antimicrobials (Ornidazole, Metronidazole), antihistamines (Loratadin, Suprastin, Clemastin). Vitamin preparations are prescribed (synthetic retinoids are synthetic derivatives of vitamin A, which differ from it in structure, but act similarly; nicotinic acid, vit. C, Askorutin, Aevit, Decamevit). It is also used in addition to rotational (circular) massage - carried out at the initial stage, it relieves swelling and improves lymph outflow, as well as minimally invasive surgery - cryotherapy, electrocoagulation, phototherapy, laser therapy.

Cryotherapy - exposure to chilled nitrogen; it is used as a separate type of treatment or in combination. Well cleanses the skin, relieves inflammation, leads to deep exfoliation of the skin.

Electrocoagulation - a point-hair electrode acts on the lesion. It destroys and eliminates telangiectasias, nodules and pustules. Depending on the stage, up to 50 procedures may be required. Laser radiation is the most demanded due to its effectiveness - the laser destroys the damaged dilated vessel without touching the healthy ones. It can be used at any stage, 6 procedures are always enough.

With rhinophyma - surgical treatment: excision of overgrown pathological tissues. Cosmetologists use mechanical skin resurfacing, dermabrasion - they also belong to minor surgery. Dermabrasion is performed with a special device, used for rhinophyma, 3 stages of rosacea under local anesthesia. After such an intervention, a course of local treatment with metronidazole is carried out to prevent relapse. Helicobacter pylori is well treated with tetracyclines; metronidazole - perfectly copes with the demodex mite. Skinorin gel (relieves inflammation and redness), Klenzit-S, Dalocin, Rosex ointments, Differin, Metrogil, Rozamet are widely prescribed for local treatment. Previously, hormonal ointments were used for rosacea, which at first give a good effect. But after that, relapses often and quickly occurred, so now they are not prescribed.

A little more about hardware techniques: they are used in the late stages of the disease, they act pointwise and effectively, without touching healthy tissue. The only condition for the patient after such treatment is to protect the skin from the sun with a cream with a high degree of PPD. A plant-based cream enriched with sulfur, Ovante, gives a very good effect: it normalizes the functioning of the sebaceous glands, eliminates irritation and inflammation, dries up pustules, thereby reducing the number of acne. It contains tea tree oil, primrose, chamomile extract. With rosacea, it is recommended to use creams of the French company Bioderma of the Sensibio series - a cream of the same name.

Folk remedies

Helpful in the early stages of the disease. Phytotherapy will significantly improve the appearance of the face, although, of course, it will not solve the problem. With rosacea, folk remedies recommend: washing with mineral water; cucumber, kefir, oatmeal masks; cold lotions of parsley, rose petals, chamomile, yarrow, succession, sage, aloe. Intake of herbal preparations inside: burdock, horsetail, nettle.

For the purpose of prevention are recommended: a balanced diet; quitting smoking and alcohol; fewer foods with caffeine; protection against temperature extremes, excessive insolation; normalization of sleep and rest; treatment of chronic infections, endocrinopathies, gastrointestinal diseases; exclusion of stress, overvoltage. It is necessary to use only high-quality cosmetics; protective creams, constantly cleanse and nourish the skin.