Cosmetology clinic patients with such dermatological pathology as rosacea present some difficulty in their work, since in order to provide them with high-quality and effective care, it is necessary not only to possess the technical skills of a cosmetologist, but also to have deep knowledge of dermatology. Usually, patients who are diagnosed with rosacea undergo a course of treatment with systemic and topical drugs, after which they complain of a constant burning sensation, increased dryness of the skin and a decrease in its elasticity.

On how to correct these consequences of therapy with redermalizants, especially for readers, estet-portal.com shares her experience Natalya Makisha - dermatovenereologist of the highest category, cosmetologist, certified trainer Institute Hyalual

Why do patients with rosacea need specific cosmetic care?

According to the generally accepted definition of T. Fitzpatrick, rosacea (rosacea) is a chronic disease of the sebaceous glands and hair follicles of the skin of the face and decollete, combined with increased sensitivity of the capillaries of the dermis to heat.

The following risk factors for the development of the disease are distinguished:

  1. Age 30-50 years: in this age period, the first signs of skin aging and aging begin to noticeably appear.
  2. Gender: Women are more likely to get sick, but men are more severely affected.
  3. Skin phototype: most often people with the 1st and 2nd phototype get sick.
  4. Gastrointestinal diseases: often revealed hyperacid gastritis associated with Helicobacter pylori, as well as duadenogastric and gastroesophageal reflux, in addition, gallbladder bending and the formation of biliary dyskinesia of the hypomotor type.
  5. Disorders of the endocrine system: ovarian failure, menopausetheric syndrome, diabetes mellitus, and thyroid diseases (autoimmune thyroiditis with subsequent hypofunction, as well as nodular hyperplasia of the thyroid gland), cases of diagnosis of adenocarcinoma of the thyroid gland in such patients have become more frequent.
  6. Vascular pathology: is characterized by spasm of arterioles and dilation of venules, especially along the innervation of the trigeminal nerve, and there is also a slowdown in the redistribution of blood flow and venous stasis in the outflow area venoe facialis sive angularis, which corresponds to the topography of rosacea.
  7. Ticks of the genus demodex folliculorum: a course of antiparasitic treatment shows a significant clinical improvement.
In addition to the indicated (endogenous) risk factors for the development of rosacea, exogenous factors are distinguished:

  1. Smoking.
  2. Drinking alcohol.
  3. Excessive sun exposure: an ongoing effort should be made to educate patients in a safe tanning culture.
  4. Long exposure to high temperatures (this also applies to lovers of saunas and baths).
  5. Eating hot (over 60 degrees Celsius) and spicy food.
Rosacea disease has a chronic progressive course and is characterized by a certain staging.

There are many classifications of rosacea, but the most popular is the classification of J. Wilkin 1994, which takes into account pathogenetic and clinical changes in the skin, namely:

  1. Pre-rosacea: characterized by transient erythema and hyperemia, patients are subjectively disturbed by a sudden reddening of the face with a feeling of heat. At this stage, the dermatocosmetologist needs to conduct a differential diagnosticstick with blushing syndrome (erythrophobia) and, if necessary, recommend consultation and treatment with a psychiatrist-psychoanalyst. As a rule, at this stage, the diagnosis of rosacea is made extremely rarely (associated with the rare visit of patients to the doctor at this stage), which leads to the onset of the next stage. Vascular rosacea:
  2. persistent erythema (cyanosis during the cold season) and telangiectosis develop. Specialists in the cosmetology industry often regard these signs as ordinary rosacea and do not provide patients with a full-fledged treatment, underestimating the complexity of the situation, which already leads to the onset of the third stage. Inflammatory:
  3. clinically manifests as papular and pustular eruptions. Often, it is at this stage that the diagnosis of rosacea is no longer in doubt with the specialist observing the patient. Although there is still a need for a differentialdifferential diagnosticssticks with acne. It is very important to make a correct diagnosis and carry out appropriate treatment at this stage, avoiding the inexorably advancing fourth stage of the disease – lateher rosacea. Late rosacea:
  4. leads not just to a cosmetic problem, but to the formation of irreversible defects that disfigure the patient (rhinophyma, gnathophyma, otophyma, etc.). After the diagnosis of rosacea is established, patients who value their health and beauty undergo a full course of treatment according to the protocols for managing patients with this nosology, which includes both systemic and local drugs.

After a full course of treatment, it is very important for patients with rosacea to undergo skin rehabilitation courses in a beauty parlor (clinic).

The main complaints in such patients are manifested in the form of a constant burning sensation, itching and dryness of the skin of the face. Objectively, upon examination, their skin tone and elasticity are significantly reduced, often the skin has a rather thinned appearance, single or multiple telangiectasias are visible, the skin is dehydrated (regardless of skin type).

Such a serious condition of the skin is due to a number of reasons

During local treatment, quite aggressive external agents are often used: azelaic acid, benzyl benzoate, sulfuric ointment, combined preparations, which include zinc propionate and methyl alcohol sulfate, etc.
  1. In this disease, the constant spasm of arterioles and expansion of venules leads to disruption of microcirculation in the dermis and, as a result, disruption of oxygenation and metabolism in cells. All this is aggravated by chronic progressive damage to the lymphatic vessels, which leads to dysfunction of the lymph and contributes to the formation of chronic edema of the dermis.
  2. According to the widely used theory of Claudio Francesco, the theory of inflaming, chronic inflammation of the skin leads to a decrease in the amount of endogenous collagen, elastin, glycosylation of dermal proteins. As a result – premature wrinkles, and patients with rosacea – this is the age category that enters into a natural biological process called aging.
    4. Considering the above, as a skin rehabilitation for such patients, the use of
redermalizants from  Institute Hyalual
.

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