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.
Malar edema: how to get rid of it without surgery
Competent cosmetologists who use the following methods to solve the problem often help to significantly improve the condition of the face on which sufas appear:
Thermage. The procedure makes the fatty tissue in the cheekbone area looser, so less fluid accumulates in it. In addition, after thermage the skin becomes elastic, so the sufas become less noticeable.
Diprospan injections. The drug reduces the volume of adipose tissue, reducing facial contours
But it can only be used in young patients, and then with great caution: an overdose of the drug has disastrous consequences.
Microcurrents. This method allows you to reduce the severity of malar edema.
None of the listed methods gets rid of bags in the cheekbones forever. Many women, tired of the constant struggle with facial contours, turn to plastic surgeons who promise to solve the problem once and for all. However, promises in plastic clinics are often mere advertising that is silent about the negative aspects of the operation.
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).
Bags under the eyes: how to get rid of this annoying problem
For men, this problem is not as pressing as for women, because issues of appearance of the stronger sex are much less of a concern. This ugly defect really ages you a lot, makes your face tired and sad, which is what you want to get rid of as soon as possible. However, it is worth understanding that even surgical intervention may not help to completely get rid of sufas, but you can still significantly improve the appearance.
Many people try to get rid of bags under the eyes using ineffective home-grown methods, but it would be optimal to first contact a professional physician who will accurately determine the nature of the defect and indicate the most appropriate methods for eliminating it. It is imperative to understand that in addition to the effectiveness of treatment for this cosmetic problem, it is also necessary to take into account the impact on the patient’s general health, its safety and accessibility.
Injection blepharoplasty without surgery: correction of paint bags
The simplest and most affordable procedure that will help you get rid of those annoying bags that spoil your appearance is blepharoplasty. Such manipulations can be carried out by almost any cosmetologist in a special salon; it does not take much time, and the effectiveness of such an intervention is quite high.
The gentle removal of paint bags is based on a unique method when special preparations containing natural peptides are injected into the selected area. It is these substances that cause adipose tissue to decrease in volume, and the skin to tighten and become smoother and more elastic. Just one procedure will give an amazing effect, and subsequent ones will only consolidate it.
But this cosmetic procedure is far from being as harmless as it might seem, because there is a whole list of contraindications for it that are worth considering if you do not want to get much more problems than ugly sufas. Inflammatory processes and infections in the injection area, as well as throughout the body, preclude manipulation; it should not be done for pregnant and nursing mothers, those suffering from hemophilia and herpes, allergy sufferers, and those who have fillers in their bodies.
Diprospan injections help remove paint bags
With the help of such a wonderful medicine as Diprospan, you can easily and simply get rid of annoying painting bags. Everything is quite simple here, the drug is simply injected into the desired areas, and due to it, the adipose tissue suddenly begins to “melt”, it seems to dissolve, as a result of which the swelling disappears, the relief of your face is significantly smoothed out, refreshed, and also rejuvenated.
The Diprospan injection procedure is not as safe as that described above, and must only be carried out by a knowledgeable, competent and experienced specialist. The thing is that the body’s reaction can be sharply negative, and the medicine itself can even affect the respiratory system, leading to allergies and even asthma.
Thermolifting, check-lifting and Dermaheal
Thermage or thermolifting works on a completely different principle than the means described above. During the procedure, the adipose tissue is simply broken down, becomes loose, the level of fluid in it is significantly reduced, due to which it decreases in volume significantly. Painting bags are noticeably tightened, and the skin becomes more elastic and fresh.
Check-lifting is an even more complex operation that combines endoscopic lifting, as well as the notorious blepharoplasty. This procedure eliminates the problem and allows us to talk about complete getting rid of the problem once and for all, but no one will give you a 100% guarantee of this anyway.
It also doesn’t hurt to be careful, because the operation is not performed at a young age. It will take several steps, which takes a lot of time, and side effects and consequences can be anything
The third option is injections of a drug called Dermaheal, which is essentially a high-quality and effective mesotherapy cocktail. It is this substance that “can” very effectively thicken and tighten the dermis, contract muscles, and also significantly remove excess fat. At the same time, the drug perfectly nourishes and moisturizes the skin, gives it smoothness, evens out its texture, making it more fresh, youthful and elastic.
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.
How to remove paint bags at home?
- Like any disease, paint bags should be dealt with by eliminating not the consequences, but primarily the causes.
- Therefore, with diseases you should go to a specialized doctor, and under no circumstances try to self-medicate, because only a specialist can make a real diagnosis, and not based on your appearance, but as a result of a comprehensive analysis and examination of the body.
But there are reasons that can be dealt with using medical methods in combination with home cosmetology:
Conducting lymphatic drainage
- This will remove excess liquid. This method is all the more useful because after the fluid drains, it will become clear whether the problem is the accumulation of “water” or something else. If the former, then in the future you can limit yourself to prevention, but if the reason is different, it should be established.
- Lymphatic drainage self-massage allows you to remove existing swelling and swelling, and also increases skin elasticity due to better metabolism and tissue microcirculation. The face is also “pulled up” to the original oval, which was inherent in youth.
- One of the most important rules is a mandatory consultation with a doctor before performing lymphatic drainage, and under no circumstances do it when you are unhealthy, since lymph is an important component of the immune system, and its acceleration will contribute to the spread of infection, adding to the swelling.
Fluid outflow
Restoration of subcutaneous fat tissue
This method is essentially a do-it-yourself facelift. One of the techniques: we create a fold by grabbing the skin with two fingers of one hand and rubbing it with the finger of the other. Another option is to grab the skin with both index fingers and rub it. This should be done starting from the corners of the mouth, moving along the cheek towards the ear. Then, again along the cheek, we move to the ear from the nostrils
We finish this rubbing of the skin by moving our fingers under the eye to the temple. Such movements should be made carefully, without repeating the line of movement several times.
Massage from painting bags
- This is done in several steps. We begin to massage the outer part, placing our fingers on the outer corner of the eye and waiting a little until the skin becomes damp, gently stretching it up and down at the same time.
- Such self-massage also allows you to fight “crow’s feet” around the eyes.
- Then we move on to a sliding massage: we close our eyes and press the eye sockets without pressure, holding our fingers under the eyebrows. We make sliding movements with our fingers, following under the eyebrow from the inner part to the outer part.
Massage
We complete the complex with acupressure massage
- We move our fingers from the cheekbones to the nasolacrimal groove, from there to the eyebrows and return to the cheekbones. We go this way about ten times, each time faster and faster. And now the points - hold your fingers at the bottom of the eye for 7 seconds. And now the same on the top line. We press down quite firmly, but only on the bone, and not on the eye itself.
- You can also include spoons in the massage complex, which can be used instead of fingers. There is a combination of decongestant, lymphatic drainage effects and remarkable muscle stimulation.
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.
⚡Fat bags-hernias
To understand how hernial sacs of the lower eyelid are formed, you need to understand a little anatomy.
Features of fatty formations of the orbital region
A key role in their formation is played by deep fatty bags that are located under the eyeball. Over time, they “pull out” from the expanding eye socket. The stretched ligament and orbicularis oculi muscle cannot keep these bags in place and a pouch grows under the eyes, held underneath by the orbital ligament (ORL+TTL in the picture).
The paint sac is formed according to a similar scheme: the SOOF fat packet in conjunction with the surface fat is “held from below” by the ZCL ligament.
Let us draw your attention once again to the fact that both of these defects are formed from fatty bags that are under our skin from birth! This adipose tissue is denser, the fat cells are stronger, and they are not so easy to break down. Influencing this type of fat with conventional lipolytics is ineffective and often dangerous!
Influencing this type of fat with conventional lipolytics is ineffective and often dangerous!
️ The danger of classic lipolytics.
We mentioned the danger when injecting lipolytics into the infraorbital region. Let us explain: for effective treatment, the drug must be injected into the adipose tissue itself (if the doctor has selected an effective drug for lipolysis).
It would seem, what is the problem? Let's explain:
- The fat packet that makes up the “lower eyelid hernia” is quite small (sometimes it is several small fat formations), and it is difficult to get exactly into the hernial sac. Even experienced plastic surgeons cannot guarantee that the needle will hit the desired area. SOOF is easier to get into, but it all depends on its severity.
- The consequence of the reason is above: the effect of lipolytic on the organs of vision and tissues around can lead to big problems and complications.
- Lipolitics are quite aggressive drugs; doctors’ amateur efforts in independently mixing so-called “cocktails” can result in an unpredictable tissue reaction.
In other words, a doctor who is not familiar with anatomy will not be able to precisely inject the drug into the fat sac. That is why (omitting the fact that the drug is ineffective for this adipose tissue) we do not recommend using classic lipolytics to correct bags under the eyes.
See how the “author’s lipolytic cocktail” can affect facial tissue in the area of paint bags.
Fat packs on the face are not cellulite on the butt to be absorbed with direct lipolytics!
Indirect lipolytics
Recently, a number of pharmaceutical companies have launched the production and sale of so-called “indirect” lipolytics, which are positioned as specially created for the area under the eyes.
In essence, these compounds are mesocotails that do not break down fat cells, but only reduce their size. Their use is recommended in a cycle (there will be no result from 1-2 injections), by promoting dehydration and improving metabolism, indirect lipolytics can slightly reduce the severity of fat bags.
These drugs are less aggressive when they enter normal tissues (if the doctor missed the injection and did not get into the fatty tissue). But their use will not completely eliminate the problem even with a course prescription. Typically, such drugs are used to reduce the appearance of malignant formations.
Diprospan injections
Diprosan is a hormonal drug, the main components of which are betamethasone dipropionate and betamethasone disodium phosphate. They provide a quick and long-lasting effect. The technique is recommended for women under 30 years of age. After the procedure, the volume of adipose tissue noticeably decreases.
An incorrectly administered drug can cause the formation of additional edema. The technique, carried out by a professional, allows you to reduce fat deposits in the cheekbone area. The effect is noticeable immediately.
Ultrasonic lipolysis
This is a non-surgical technique used to remove paint bags. In cosmetology it is referred to as cavitation or ultrasound treatment of problem areas. A special gel is applied to the painting bags. This helps to achieve deeper conductivity of the device.
The specialist moves a special sensor along the designated area, due to which fat deposits are destroyed and their outflow along with lymph is restored. The method is painless.
The top layer of skin is not destroyed, so there is no postoperative or recovery period. The result is visible immediately after the procedure.
Exercises to eliminate paint bags
1) You need to close your eyes tightly and open them wide for 30 seconds, 5-6 times in one exercise.
2) Close your eyes well, but do not wrinkle your face. After five seconds, open them all the way and look up. Count to 5 and give your eyes a rest. To prevent wrinkled forehead skin, place your fingers on your eyebrows. Do this at least 5 times.
3) Holding your head straight, look to the left, after a short while, look straight and close your eyes for a couple of seconds. Then also look to the right side and repeat up to 3 or 4 times.
4) Blinking quickly also helps, then after 10 seconds close your eyes without wincing. After 6 seconds, with your eyes closed, relax and look at any point far from you. Relax and do this about 5 times.
5) Keep your head straight and look up, down and to the sides.
6) Play with your eyes, looking up - to the right, down - to the left, and so on back. Do this about 4 times with a rest of up to two minutes. 2 or 3 times in 24 hours.
After the exercise, apply cotton wool soaked in arnica, parsley or chamomile tincture to your closed eyes for 10 minutes. Afterwards, give your eyes a good rest.
Red and blue swelling, bags on the cheekbones are removed with the following essential preparations: chamomile, lavender, mint, sage, thyme. Non-contact mesotherapy often uses ethereal techniques.
Traditional methods are more healing.
Plastic surgery
Surgical intervention is recommended when it is not possible to change the situation using gentle methods. In plastic surgery it is called a check-lift. The operation is complex and is performed under general anesthesia. It can only be entrusted to a surgeon with experience in this area.
After surgery, the skin becomes elastic and the bags disappear. But no surgeon can guarantee a permanent effect. Cosmetologists recommend performing surgery in conjunction with the blepharoplasty (lift) procedure.
Massage and gymnastics
Special gymnastics and massage will help reduce swelling. Massage restores elasticity to the skin. It is carried out in teaspoons, which must first be cooled. Apply the convex side to the cheekbones, lightly move along the skin from the temples to the corners of the eyes. You shouldn't press too hard. When the spoons are hot, cool and repeat the procedure.
A simple set of exercises will help get rid of bags and become an additional preventive measure for maintaining visual acuity.
All exercises are performed at least 5 times.
- Take a comfortable position and relax. Close your eyes tightly for 5 seconds and open them.
- Keep your head straight, eyes directed up, down, to the sides. Hold your gaze in each position for 5 seconds.
- Perform circular movements with your eyes, try to outline a figure eight in the air or on the wall.
