It's one thing when the blush on your cheeks appears and quickly disappears, as, for example, after a winter walk. And it’s quite another thing if it spreads across the face, does not go away for a long time and is also complicated by various rashes on the skin. We learned more about such a disease as rosacea at the X National Congress “Plastic Surgery, Aesthetic Medicine and Cosmetology”.
At the congress, many issues of dermatology were raised, including diagnosis, mechanisms of development and treatment of rosacea (rosacea). In this article we present excerpts from the report of dermatologist, cosmetologist, doctor of medical sciences Elena Arabian, which will help to better understand what rosacea is, what factors can provoke the appearance of this disease and how it is treated today.
When to sound the alarm
The main symptoms for diagnosing rosacea are persistent erythema (redness of the skin), which usually appears in the central part of the face and lasts more than two months, and is also characterized by concomitant dilation of small vessels of the skin and the formation of inflammatory elements, rosacea.
Previously, rosacea was said to be a vascular disease of unknown etiology, and it can be triggered by many factors. “Now there is a completely definite evidence base that rosacea is a chronic inflammatory dermatosis,” says Elena Arabian.
Studies show that rosacea in our country is less common than diabetes, but more common than asthma and psoriasis. And, for example, in the USA every tenth patient comes to the clinic with symptoms of rosacea to a dermatologist.
Carrying out the procedure
The possibility of using Phyllex products during anti-aging skin procedures will be determined by a cosmetologist. To do this, the doctor must conduct a preliminary consultation. During the conversation, an anamnesis is collected, contraindications are identified, and the upcoming intervention is detailed.
Products for intradermal administration of Phyllex are sold packaged in hermetically sealed syringes. The substance is completely ready for use. The doctor opens the package, breaking the seal of the blister in front of the patient. To control compliance with expiration dates, packaging is provided to the client.
The cosmetologist connects a needle or cannula to the syringe and gets to work. The patient's skin is pre-cleansed and disinfected with an antiseptic.
Important point! The use of anesthesia is carried out in agreement with the patient. Phillex gels contain lidocaine. Anesthesia is often excluded.
A cosmetologist works using a pre-selected technology. The principle of action depends on the tasks being solved. The amount of drug for the procedure and the depth of gel injection depend on the filler used. After distributing the filler under the skin, the doctor gently massages the treated areas with his fingers. This helps the product to disperse more evenly. To complete the procedure, the patient's skin is wiped with an antiseptic. A filling session lasts from 20 minutes and can last for 1.5 hours.
First roles
In recent years, it has been believed that the leading roles in the appearance of rosacea are played by innate immunity, microbiota and the inflammatory process. Innate immunity triggers the production of antimicrobial peptides and proinflammatory cytokines. “With rosacea, their levels increase sharply. For example, the activity of antimicrobial peptides cathelicidins increases 10 times, and the level of peptidase increases 10 thousand times! - continues Elena Arabian. — Flora also works in a special way. Staphylococcus is of great importance here, but the leading role is played by mites of the genus Demodex. Together with bacteria, fungi and viruses, they are a representative of the microbiome, but with rosacea their increased density is noted: it has been proven that they provoke inflammation. One of the reasons why this microscopic mite becomes pathogenic is low skin moisture.
Factors that provoke exacerbation of chronic rosacea are considered to be stress, extreme cold or heat, alcohol intake, hot and spicy foods. Recently, soy sauce and vanilla have been added to the list of food provocateurs. But coffee and drinks containing caffeine have been rehabilitated.
Concomitant diseases play a major role in the development of rosacea. First of all, we are talking about gastrointestinal problems, celiac disease, Crohn's disease, infection caused by Helicobacter pylori, irritable bowel syndrome - these are all background conditions. Recent studies have shown a connection with hypertension, cardiovascular pathology, anxiety disorders, depression and diabetes. Considering all these factors, it is clear that patients with rosacea require a multidisciplinary approach.”
Clinical symptoms of rosacea are redness of the skin, the appearance of telangiectasia (dilation of small vessels) and various rashes: papules, pustules, fimas (inflammatory elements, rosacea, bumpy formations).
Types of gels
Filler manufacturer Phillex offers a line of drugs consisting of 3 options:
- Fine Lips. Gel of the greatest softness. This option is suitable for young patients (25–35 years old), working with delicate areas (eyes, lips), natural shaping of the lip contour, affecting neck wrinkles, combating changes in the skin of the hands. The drug is injected into the superficial and middle layers of the skin. The result is guaranteed to last 6–9 months.
- Deep Plus. Gel with medium elasticity and viscosity. This option is suitable for patients aged 35–45 years. The drug is actively used to create volume in the lips, work on nasolabial and other folds and wrinkles of moderate severity. The filler perfectly complements the correction after work with botulinum toxin. The product is used to tighten the cheeks. The gel is injected into the middle layers of the skin. The result lasts 9–12 months.
- Sub-Q Plus. High density gel. The option is suitable for patients 45–65 years old. The substance is used to model and restore the volume of the cheekbones, cheeks, and temporal cavity. The product helps to perform non-surgical plastic surgery of the nose and chin. The substance is ideal for filling large skin irregularities. The filler is injected into the deep layers of the skin. The result lasts 12–18 months.
The age and zonal purpose of each type of gel is conditional. The doctor will choose a drug to solve specific problems after a personal conversation with the patient.
Treatment algorithm
“Today, the understanding of the causes and mechanism of development of rosacea is different than 5-10, and even more so 20 years ago,” states Elena Arabianskaya, “therefore, the approach to treatment is different. The diagnosis is made on the basis of prolonged erythema and fim. Therapy depends on the clinical manifestations of the disease and the nature of the rash. For treatment, we already had good drugs: we had azelaic acid, metronidazole, but now topical ivermectin is becoming the leader. It gives a double effect. Its pronounced antiparasitic effect allows you to reduce the population of skin mites, but at the same time (which is very important) it has anti-inflammatory properties. This drug works great in the presence of inflammatory elements (papules, pustules), but redness may still remain. Therefore, it is recommended to act on receptors to blood vessels. For this purpose, brimonidine tartrate was used, which was used to treat some forms of glaucoma. It starts working in 30 minutes and wears off in 12 hours.”
Laboratory tests for microorganisms and demodex mites are not carried out for either acne or rosacea!
As for hardware techniques, so-called vascular lasers are relevant here. They not only have an anti-inflammatory effect, but also reduce the density of mites. Diode, alexandrite, neodymium lasers and broadband pulsed light (IPL) can be used for the same purpose.
Auxiliary methods of treating the disease are microcurrent therapy for lymphatic drainage, cryotherapy for vasoconstrictor and anti-inflammatory effects. Treatment of concomitant diseases also plays an important role. In general, combination therapy gives good results.
ART FILLER UNIVERSAL
A dermal filler designed to eliminate facial and deep wrinkles, ART FILLER UNIVERSAL can also be used for lip augmentation. Highest quality, allergen-free hyaluronic acid ingredients help create (or restore) facial contours and volume.
Like all drugs of this type, the unique pyrogen-free, homogeneous, transparent gel contains lidocaine (3 mg/ml) and hyaluronic acid (25 mg/ml). The concentration of hyaluronic acid allows you to effectively eliminate wrinkles of any depth. Lidocaine reduces pain when injecting the drug, hyaluronic acid regenerates facial skin cells. Taken together, this combination promotes comfortable injections.
Based on the fact that ART filler UNIVERSAL contains 3 types of hyaluronic acid (concentration 25 mg/ml), this filler is considered the best filler available in cosmetology.
The advantages of use include its high tolerance, effectiveness in eliminating deep wrinkles, quick and visible results due to the uniform distribution of the gel, simple injection due to the plastic structure, and long-lasting action.
Strengthen the barrier
“Another important point is the condition of the skin barrier,” continues Elena Arabian. — In patients with chronic rosacea, transepidermal water loss is very pronounced, which leads to increased inflammatory response, degradation of the intercellular matrix and collagen structures — this contributes to early skin aging. The vast majority of people suffering from rosacea have sensitive skin, so they need adequate daily skin care. These products are based on caffeine, which improves microcirculation, glycerretinic acid derivatives, which restore the skin barrier, and sun protection.
Indications, effectiveness of use
The structure of the substance, subject to 4D matrix technology, helps to achieve an instant lifting effect. After injections, the skin is evened out and volume is restored. Phillex gels have the ability to “retain their shape”. After natural destruction and recycling of the material, the fabric retains its acquired density.
Attention! Phillex fillers are used for tissue rejuvenation and general harmonization of appearance. The drugs have a positive effect on skin quality, regenerative capabilities, tissue resistance, and contribute to the launch of one’s own recovery and renewal processes.
Phillex fillers are prescribed by cosmetologists for:
- changes in the contours and volumes of individual parts (lips, cheekbones, nose, chin);
- elimination of wrinkles, folds of different depths (from the superficial “mesh” in delicate areas to the furrows between the eyebrows, nasolabial folds);
- oval tightening, contour modeling;
- improving the condition of the skin in different areas of the face, neck, décolleté, body (combat dryness, sagging).
Phillex is used to work with patients aged 25–30 years. The prescription of the drug variant and methods of exposure are performed by a cosmetologist.
Where and for how much can I buy
You can purchase Highfiller drugs in many online stores. It is recommended to go to the manufacturer’s official website and compare the volume and appearance of the packaging with the product offered. In Russia, fillers have been registered, so it is important to request certificates from the seller to purchase the original.
Hafiller cost:
- FineLines - from 5500 rub. up to 8500 rub.;
- derm - from 4200 rub. for a volume of 0.5 ml, up to 8,000 rubles. for 2 ml;
- sub skin - 7000 rub.;
- aqua - from 2000 rub. up to 5000 rub.
Advantages and disadvantages
Fillers have a number of advantages; it is worth considering the specifics of the procedure, as well as the disadvantages of the drugs.
Pros:
- a needle or cannula can be used for implantation;
- does not migrate to neighboring areas;
- easily distributed in the integument;
- affordable price;
- economical use;
- allows you to work with large volumes of skin flap;
- does not cause addiction or tissue rejection;
- no cases of allergies or side effects have been recorded.
The main disadvantage: the implementation can only be entrusted to an experienced, qualified specialist.
Instructions for administering the drug
The procedure can only be entrusted to a plastic surgeon or dermatocosmetologist. No preliminary dilution of the drug is required, it is available in syringes, the formula is ready for use immediately after opening. Administration regimens and techniques are determined individually. Implantation occurs in the middle, deep layers of the dermis, biorevitalization - in the superficial.
The main areas of influence are the forehead, temples, cheekbones, lips, nasolabial triangle, chin, lower jaw line. The different densities of the preparations make it possible to work with thin, delicate skin of the eyelids, as well as with large volumes of skin flap. The face is prepared according to the standard procedure - it is cleaned of cosmetics, antiseptic treatment is carried out, and an anesthetic ointment is applied.
Administration techniques:
- papular - administration is carried out in small portions, as a result a papule is formed, which resolves on its own after a few days;
- point by point - filler is also injected in small volumes, microinjections form a line along the fold or wrinkle being worked on, the technique is used in areas with thin, sensitive skin;
- linear-retrograde - implantation is carried out at the exit of the needle from the integument, allows you to work on the nasolabial folds, cheeks, chin;
- bolus - administration using cannulas requires precise determination of the puncture sites; the more modern painless technique has a quick recovery time.
Attention! It is not recommended to purchase medications yourself. It is important to comply with the conditions of storage and transportation; savings can lead to unforeseen consequences. The packaging is opened in the presence of the patient; subsequent storage is prohibited by the manufacturer.
Elimination, minimization of the effect
If necessary, eliminate or minimize the effect after the introduction of Phillex gels, this is easy to do. It is enough to perform a subcutaneous injection into the area of the unsuccessful area with a drug that has hyaluronidase activity.
The correction is performed only by a doctor. This will allow you to achieve an optimal result without complications. With the help of a course of physiotherapy, regular visits to the steam room, and increased physical activity, you can get a similar effect over a longer period.
