Rosacea
Rosacea, also known as rosacea, is a skin disease characterized by redness of the nose with papules, pustules and dilated capillaries, resembling strawberries or ripe tomatoes. Rosacea is the name given to this disease because the lesions are often rose-red and resemble acne. It is most commonly seen in adults and is common in people with high facial oil production. The lesions are usually found in the center of the face, especially on the nose and sides, cheeks, between the eyebrows and chin, and are often distributed in five points (i.e., tip of the nose, between the eyebrows, cheeks, jaw, nasolabial folds, etc.). The lesions can be aggravated in spring and during emotional stress and fatigue.
Five factors that trigger rosacea
The occurrence of rosacea is not unexplained, the causes of rosacea are as follows.
1, climate change: In order to live a healthy life in daily life, you must adapt to the changing climate, but if the climate is harsh or cold, it will lead to vascular damage and hoof tissue degeneration, inducing chronic inflammation, the long-term stagnation of blood and passive expansion of the venous plexus under the dermal papillae will lead to rosacea.
2.Sunlight and heat: 80% of rosacea patients complained of aggravation or recurrence after sunlight, bathing and heat, which means that external temperature stimulation makes blood vessels dilate, causing peripheral vascular exudation and degenerative changes of elastic fibers due to potential inflammatory substances.
3, improper diet: busy life makes many people in the diet is only haphazard, this practice not only can not ensure the body’s nutrition, but also lead to gastrointestinal dysfunction, long-term words will lead to facial vasomotor nerve dysfunction, the long-term expansion of capillaries will lead to rosacea.
4, worm mite: worm mite and rosacea is one of the hot spots of research, many domestic scholars believe that rosacea is related to mite infection. Two kinds of worm mites are found in human skin, namely hair follicle worm mites and sebaceous worm mites, which reside in hair follicle sebaceous glands. In the rashes of rosacea patients, the prevalence of worm mite infection was significantly higher than that of healthy facial patients, with the highest density of mites on the cheek. Mite counts were significantly higher during the erythematous and capillary dilatation phases of rosacea and the papulopustular phase, so it is believed that a large number of follicular worm mites may play a role in the pathogenesis of rosacea. Especially in the papulopustular phase and granulomatous rosacea, it may be a delayed hypersensitivity reaction of the organism to follicular helminth mites. The mites rely on their own enzymes to break down epithelial proteins and sebum as nutrients for their survival, and their breakdown products can lead to inflammatory reactions around the hair follicles. The mites can also participate in rosacea attacks through cellular immunity and humoral immunity.
5, follicular worm mite infection: through a long period of research, it was found that follicular worm mites will appear in the hair follicles of all rosacea lesions, and there is a 100% chance that this may be very much related to the inflammation caused by the metabolites and excretions of follicular worm mites.
Differentiation of rosacea
The differential diagnosis of rosacea is mainly based on the symptoms of rosacea and other diseases with similar symptoms differential diagnosis, generally need to differential diagnosis of some of the following diseases.
1, rosacea should be differentially diagnosed with acne, acne is usually seen in adolescence, mostly on the cheeks and upper chest and back, a few can also involve the nasal area, acne generally has typical blackheads, which is an obvious difference from rosacea.
2, rosacea should be diagnosed differently from seborrheic dermatitis, seborrheic dermatitis is also easy to hair on the nose and both sides of the nose, there are more obvious symptoms of more oil, generally seborrheic dermatitis surface with greasy scales of red spots, often with varying degrees of itching. And rosacea mostly shows the symptoms of oily shine.
3, general dermatitis symptoms, some common dermatitis will also cause redness of the nose symptoms, but dermatitis has a significant feature, generally through anti-inflammatory treatment after the inflammation subsides dermatitis symptoms can be reduced, while the onset of rosacea symptoms generally will not soon subside.
The pathological period of rosacea is divided
The symptoms of rosacea are mainly erythema, papules, pustules, nose hypertrophy and capillary dilation. Rosacea is mostly seen in middle-aged people, more in women than in men, but male patients are more severely affected, and the lesions tend to occur in the center of the face and are symmetrically distributed. It is common on the nose, cheeks, between the eyebrows and chin. The symptoms of rosacea are divided into three stages according to their development process.
1. Erythema stage
The erythematous phase of rosacea starts with temporary erythema, especially after eating irritating food or when emotionally excited, the erythema is more obvious, the erythema persists for a long time and the capillaries expand in a dendritic manner. The general treatment of the erythematous phase only requires some pure Chinese medicine skin Manqing to treat it.
2.Papular phase
In the papular phase of rosacea, on the basis of erythema, the symptoms of rosacea can appear as papules or pustules, and the lesions are not consistent with the hair follicles. For the treatment of the papular phase, you need to use pure Chinese medicine Skin Manqing to treat it, and add some internal medicine to treat it, such as metronidazole and vitamins.
3.Nasal superfluous stage
If you have rosacea than the superfluous stage, multiple nodules can appear on the nose, fusing with each other, the surface is uneven, the nose is enlarged, the pores are obviously enlarged, the capillaries are significantly dilated, longitudinal and transverse, forming a nasal superfluous, at present there is no medicine that can treat it well, only laser surgery can be taken.
Treatment of rosacea
Different methods should be used for different periods.
I. Early stage strategy
Early rosacea patients have flushed nasal skin and an oily surface. At the beginning, the red spots appear and disappear, and later they turn into persistent congestion or superficial capillary dilatation (also called red blood), and the pores are enlarged. Occasionally, there are papules and pustules, and the erythema becomes more obvious when there is emotional stress, anger, fatigue or menstruation. As long as the treatment measures are proper, the condition can be maintained for several years or even a dozen years without developing to the middle stage.
1.Adjust the lifestyle, avoid all kinds of triggers that aggravate the skin lesions, such as avoiding the stimulation of strong alcohol and spicy food, drinking less strong tea and coffee, eating more fresh vegetables and fruits, keeping the bowels open, paying attention to the combination of work and rest, and ensuring sufficient rest.
2.Patients with long-term constipation and persistent facial flushing can take herbal medicines to clear heat and detoxify the body.
3.Patients with more facial greasiness can take capsules internally under the guidance of a doctor to inhibit excessive sebum secretion.
4.Warm water can be commonly used to wash the face and apply anti-inflammatory topical drugs.
5.For persistently dilated blood vessels, laser or photon irradiation treatment can be used to make the blood vessels close and the erythema subside.
Second, the mid-term strategy
Most of the patients in this period come from the development of the disease without timely treatment in the early stage. Initially, there is a single papule and pustule, which will subside after 5-7 days, and after 2-3 weeks, the papule and pustule will grow again and gradually increase and fuse into larger cysts, making the lesion develop deeper into the skin. Due to repeated stimulation, the skin of the nose becomes rough, pores are enlarged, and the skin color is dark red. At this time, patients should pay attention to cooperate with the doctor’s treatment and take the medicine on time.
1, timely oral antibiotics under the guidance of the doctor, inflammation can be controlled, with the use of topical anti-inflammatory drugs, the effect is better.
2.Patients whose infection is controlled for more than two months can consider doing rosacea scratching. The surgery can cut off the small blood vessels that have been dilated so that they will no longer be dilated and congested, and can also do the removal of the rough epidermis after the recurrence of inflammation. The surgery can be done on an outpatient basis, and the patient can go home after a short break. 7 to 10 days later, new epithelium will grow on the operated area of the nose and crust over naturally. After surgery, the new epithelium is slightly red, but the dilated capillaries can no longer be seen, and the repeatedly inflamed pustules and papules are also eliminated. About two months after surgery, the epidermis can return to normal skin color.
3.For simple vasodilated rosacea, specific wavelength dye laser or photorejuvenation treatment can also be applied to achieve the purpose of shrinking blood vessels and removing red spots.
Third, late stage strategy
In the late stage of rosacea, the local connective tissue proliferates and a huge nasal superfluous can be formed. The largest nasal superfluous is like the size of a child’s fist, not only seriously affects the patient’s appearance, and when the patient lies down, it will cover the nostrils, affecting the sleep whistling, very painful.
For this kind of nasal redundancy which is obviously thick and hyperplastic, surgery becomes the only desirable method. The surgical method is a kind of nasal superfluous trimming developed on the basis of scratching technology, this surgical method has the following characteristics.
1, through surgery, can remove the hypertrophic nasal superfluous tissue, so that the nose shape basically restored to normal.
2, the trauma does not need to implant skin, completely relying on the original normal dermal middle layer tissue under the nasal superfluous tissue to repair, so there is no trace of surgical stitching after surgery, and no regrettable pigmentation after implantation.
The rosacea excision can destroy the dilated capillaries and hyperplastic sebaceous glands and connective tissue, so that the epithelial cells of hair follicles can be regenerated and the wound can be healed to form normal or near-normal epidermis, thus achieving the purpose of treatment.
Rosacea excision is a surgical treatment for rosacea. Due to the obvious expansion of capillaries, sebaceous glands and connective tissue hyperplasia in the nose of patients with mid- to late-stage rosacea, the skin of the nose is flushed and hypertrophied, and there are elevated nodules of varying sizes on the surface, called nasal redundancy. It is difficult to achieve the purpose of treatment by medication alone, and the shape of the nose must be restored by surgical methods.
The surgical method is routine disinfection of the skin, local infiltration anesthesia, according to the size of the nose, the shape of the choice of 3 peak or 5 peak knife, and then with appropriate strength and speed, in the affected area of the longitudinal and horizontal repeatedly cut, so that the skin surface is hairy, and finally compressed with gauze to stop bleeding, and dressing with petroleum jelly gauze, bandage can be. Vaseline gauze falls off by itself 7 to 10 days after surgery, and the traumatic surface is crusted and healed.
If there are pustules on the nose, antimicrobial agents should be taken first, and the surgery should be performed after the pustules have subsided. After surgery, antibiotics can also be used to prevent infection, generally it takes 3 months after surgery to gradually return to normal. If the patient is not satisfied with the first surgery, a second surgery can be performed after the wound has healed for 3 months.