Pink acne is a chronic dermatosis, which is based on the defeat of the sebaceous glands, hair follicles and capillaries of the skin of the face. The course of the disease is accompanied by persistent erythema of the skin, the appearance of telangiectasias, red nodules that transform into pustules. Thickening of the facial skin can lead to the development of rhinophyma, blepharophyma, gnathophyma, etc. cosmetic defects. Diagnosis includes consultation with a dermatologist, bacteriological seeding of the contents of pustules, examination of non-demodecosis. Treatment of pink acne involves complex local (lotions, antibacterial creams) and general treatment (antibiotics, vitamin therapy, immunomodulators).
Pink acne (rosacea) is a chronic pathology of the sebaceous glands, in the pathogenesis of which angiopathies, various neuroendocrine pathologies and chronic diseases of the digestive tract occupy an important place. Of the women who turned to a dermatologist and dermotocosmetologist. in the age group from 30 to 50 years, about 5% of cases are diagnosed of various forms and severity.
In the pathogenesis of pink acne, skin type and race are of great importance. Thus, persons of Celtic origin, the Irish and representatives of northern nationalities are most susceptible to the disease. According to official data, the incidence among this contingent reaches 40% of the total population. Whereas representatives of the Negroid race and Asians practically do not suffer from pink acne, despite excessive insolation. Blonde women with photosensitivity of types I and II almost always suffer from one form or another of pink acne.
The development of pink acne provokes excessive overheating and hypothermia of the skin, insolation, including exposure to ultraviolet light in a solarium, stressful situations, prolonged local use of glucocorticosteroids. Improper skin care with the use of harsh scrubs and aggressive chemicals, such as chemical peeling at home, lead to persistent expansion of the vascular network, which in itself is a cosmetic problem and in the future almost always ends with pink acne.
The abuse of alcohol, hot drinks, spicy and spicy food, smoking and the use of fizzy drinks provoke pink acne, and with an already established diagnosis complicate the course of diseases. The presence of a history of allergic reactions with skin manifestations (allergic contact dermatitis) is not the last place in the pathogenesis.
The presence of demodex mites in the follicles increases the symptoms, but demodex mites are not their cause, as previously thought, as a result of which incorrect therapy was prescribed, which only complicated the course of the disease. There is no main cause and pronounced pathogenesis in their development, but the combination of several predisposing factors increases the likelihood of their occurrence. In the pathogenesis of pink acne, pathogenic microflora is not a provoking factor, although sometimes the disease is complicated by gram-negative pyoderma.
The prodromal period of the disease development is characterized by sharp and sudden flushes to the skin of the face with a feeling of heat. Hot flashes occur in response to irritants that are insignificant for the majority of people; small doses of alcohol cause persistent expansion of the vascular network on the face. At the same time, the blush at the initial stage of pink acne is more often bright and has a clear border with healthy skin, sometimes such a blush resembles flames or rose petals.
In the first stage, persistent erythema of the facial skin is observed, which occurs without provoking factors and telangiectasia, the fat content of the skin increases and due to the use of aggressive cosmetics aimed at reducing fat content, hydro-exchange is disrupted, seborrhea joins, and, against the background of dehydrated, flaky skin, excessive sebum separation is noted. In the second stage of the development of pink acne, in addition to persistent redness and telangiectasia, papules and small pustules are observed.
At the third stage, pink acne is clinically manifested in the form of pronounced saturated erythema, a dense network of telangiectasias, especially in the area of the wings of the nose and in the chin, papules and pustules. Depending on the type of skin, nodes and extensive dense infiltrates may form in the central part of the face.
The course of the disease is undulating, there are periods of remission and periods of exacerbations, but over time the duration of remissions decreases, and exacerbations of pink acne become more frequent, and each relapse exceeds the previous one in its clinical picture. And as a result, remissions are no longer observed, pathogenic microflora joins or the infiltrative stage occurs, when the entire skin of the face is thickened, edematous and inflamed.
The diagnosis is made by a dermatologist based on a visual examination, an important diagnostic feature is the absence of comedones and black dots on the face. Additional studies are prescribed for a differentiated diagnosis; seeding and bacteriological examination of the contents of the pustules makes it possible to exclude staphylococcal infection and other pyoderma.
Microscopic examination for demodex allows you to adjust the tactics of treatment complicated by demodecosis.
The first stages of pink acne go unnoticed, since cosmetic defects are easily masked by decorative cosmetics, but treatment at this stage is most effective. Drugs that strengthen the vascular wall are prescribed, sedative therapy with herbal preparations can reduce the nervous excitability of patients and reduce the release of adrenaline into the blood, thereby the vascular network does not expand and the symptoms of pink acne subside. Taking vitamins of group B, A, C, subcutaneous injections of nicotinic acid also strengthen the walls of blood vessels and stabilize the autonomic nervous system.
Washing with chamomile and horse chestnut infusion gives a good local soothing effect for pink acne. The presence of demodex mites at these stages of pink acne is not an indication for the treatment of demodecosis, on the contrary, such therapy worsens the condition of patients. Demodecosis takes place after the follicles begin to work in a natural mode and the outflow of sebum decreases.
The second and third stages of pink acne require topical application of gels with an antibiotic and metronidazole, they have an anti-inflammatory effect and cool the skin affected by pink acne. If pink acne did not occur due to the prolonged use of glucocorticosteroid ointments, then short-term local therapy with topical corticosteroids ointments quickly remove the infiltrative and inflammatory manifestations of pink acne. After the inflammatory process is stopped, it is necessary to eliminate the main cause of pink acne – an expanded and branched vascular network. Electrocoagulation, photocoagulation and laser coagulation solves this problem, excessive vessels are thrombosed and gradually disappear.
Complete recovery from pink acne is impossible to achieve, but with timely complex therapy, almost all patients can achieve stable remission. At the same time, if treatment is started in the first stages of the disease, then there are no changes on the part of the skin; complicated pink acne can leave behind small scars and scars.
Persons who fall into the risk group for the incidence should avoid insolation, overheating and hypothermia of the body, take a closer approach to the work and rest regime. Sports such as downhill skiing, running should be excluded or restricted. A rational diet, in which fermented dairy products and plant foods are present, contribute to improving the functioning of the intestine, which means that they reduce the risk of pink acne. Proper facial skin care and the use of creams with a high UV protection factor can help both those who have achieved stable remission and those who fall into the risk group for the incidence of pink acne.