Acne and rosacea treatment

ACNE VULGARIS (formerly called juvenile acne)

Acne and rosacea are inflammatory skin diseases with different pathogenesis, while the final common effect is a chronic inflammation of the skin manifested externally by the formation of skin lesions. It has also been proven that persistent chronic inflammation, through the presence of inflammatory mediators (interleukin), increases the breakdown of collagen and elastin, accelerating aging and deteriorating skin quality. Acne lesions can heal leaving deep scars. Therefore, causal treatment of acne is very important, with an emphasis on anti-inflammatory treatment.

Adolescent acne and adult acne: Sustained improvement in the most severe cases can be achieved by administering oral retinoids, but this is not without significant side effects. However, it should be remembered that very severe, active acne should be treated by a dermatologist (oral and topical antibiotics, keratolytic and anti-inflammatory drugs) because it is characterised by a tendency to recur. Cavitation peeling is absolutely not recommended and in many patients worsens the skin condition, as does microdermabrasion, which damages the skin without affecting the cause of the problem.

The solution is chemical peelings, which, by penetrating the dermis, have a strong anti-inflammatory effect, destroy bacterial clusters present in the skin and influence cell division, epidermal renewal and the production of fatty substances. Modern chemical peelings also have an anti-ageing effect due to their antioxidant properties. Peelings suspended in liposomes penetrate deep into the dermis with reduced epidermal damage and exfoliation, in the same way retinol can be delivered to the dermis avoiding systemic side effects. It should be emphasised that the selection and application of chemical peels should be the responsibility of the practitioner taking into account:

  • the diagnosis, the symptoms the patient presents with
  • skin type, concomitant treatment (some drugs are contraindications for chemical peels)
  • the degree of exfoliation the patient can afford, taking into account his/her professional and social activities
  • the need for perioperative care and the patient’s ability to comply with recommendations

ROSACEA

Acne rosacea is a common chronic inflammatory skin disease. Classical dermatology offers oral and topical treatments (creams, ointments).

WHAT CAUSES ROSACEA FLARE-UPS?

If you are struggling with rosacea, you may wonder what causes rosacea skin exacerbations and how to avoid them.

Here are the most common causes (according to current medical knowledge):

CAUSES OF ROSACEA EXACERBATIONS:

 

  • physical factors: sun, heat, cold (frost), rubbing the skin (e.g. granular scrubs), air conditioning
  • psychological factors: stress
  • menstruation and menopause
  • medications: vasodilators, chronic steroid ointments
  • alcohol, caffeine and spices
  • cigarette smoke
  • cosmetic ingredients: SLS (often used in cleansers and toothpastes), alcohol (tonics), glycolic acid, lactic acid, camphor and mint oil, urea, fragrances, in some patients: retinoids, vitamin C

Remember, however, that the main triggers are different for each person – it is worth writing them down and, if suspicions are confirmed, eliminating them

The ocular form of rosacea (can occur: inflammation of the eyelid margins, conjunctiva, iris, cornea) requires ophthalmological treatment.

 

WHAT CAN AESTHETIC MEDICINE OFFER IN THE TREATMENT OF ROSACEA?

Which aesthetic medicine treatments for rosacea? In recent years, new treatments have been attempted due to the insufficient efficacy of existing methods.

I list below the methods that are substantiated in the scientific literature:

  • laser therapy (vascular lasers, among which the 577 nm yellow laser stands out for its effectiveness), narrowband IPL
  • platelet-rich plasma or platelet-rich fibrin
  • hyaluronic acid preparations for skin revitalisation – some stabilised or uncross-linked

hyaluronic acid preparations have proven anti-inflammatory effects. This applies to high molecular weight hyaluronic acid chains

chemical peelings (acids) with anti-inflammatory effects, such as azelaic acid, salicylic acid

 

These are used as an adjunct to pharmacological treatment or as a causal treatment – for example of vascular lesions in rosacea

In recent years, vascular lasers such as the 577 nm laser have become the gold standard for treating vascular lesions such as rosacea, among which the German Quadrostar Pro Yellow laser stands out positively. This laser is highly effective yet safe, so it can also be used in the active phase of rosacea. Treatment with the Pro Yellow laser also has a photo-rejuvenating effect, evens out skin tone and reduces post-inflammatory hyperpigmentation. It has an adjunctive effect in the treatment of various types of hyperpigmentation.

 

In some patients in the exacerbation phase of rosacea, a series of treatments with platelet-rich plasma improves the condition, due to the numerous anti-inflammatory proteins present in the plasma. Studies in recent years confirm the anti-inflammatory effects of platelet-rich plasma (there are also reports of use in the treatment of acne vulgaris, burns, alopecia of various aetiologies).

 

Treatments:

(click on the links below to go to selected treatments)