RU2734841C1 - Rosacea treatment method - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dermatology, cosmetology, physiotherapy. For 6 sessions, a neodymium laser with wavelength of 1064 nm is exposed directly to the inflammation center on a clean skin. Focal lens with d=2 mm is used with a skin exposure area of 1.5–2.5 mm for 3 pulses with duration 0.6 ms to the center of each inflammation center. From the first to the fourth session, exposure is performed at radiation power of 158–160 J/cm². At fifth session – 125–130 J/cm². At the sixth session – 94–98 J/cm². First to third session after processing each local inflammatory focus is performed throughout a single treatment of the skin faces the same surface one neodymium laser pulse duration of 0.6 ms at a radiation power of 94–98 J/cm².

EFFECT: method enables fast clinical improvement in a short course of treatment without using additional therapeutic methods.

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Description

The invention relates to medicine, in particular to dermatology, cosmetology, physiotherapy, and can be used in dermatovenerologic dispensaries, cosmetic clinics, in various medical and prophylactic and sanatorium institutions, including in a specialized dermatological clinic.

Rosacea is one of the most common dermatoses in people over 35 years old and occurs equally in both sexes, and can also develop in children, adolescents and young people. (Wilkin J et al: Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 46: 584, 2002 [PMID: 11907512], Kroshinsky D, Glick SA: Pediatric rosacea Dermatol Ther 19: 196, 2006 [PMID: 17004995]). But in modern times, this pathology in patients over 40 years old is accompanied by a higher resistance to standard therapy, the duration and severity of clinical manifestations (Powell F: Clinical Practice. Rosacea. N Engl J Med 352: 793, 2005 [PMID: 15728812]).

Rosacea is also considered as angioneurosis, which develops mainly in the zone of innervation of the trigeminal nerve. The prerequisites for development are constitutional angiopathies, neurovegetative disorders, emotional stress, dyshormonal states, infectious processes, dysfunction of the gastrointestinal tract. Associated factors - provocateurs -

these are hot and alcoholic drinks, intense solar insolation and a feature of the anatomical and physiological vascularization of the facial skin (large veins are located superficially, have a short length and go vertically into a deep dermal network), which provide prerequisites for congestion, especially in the cheeks, nose, forehead, chin. (GN Ponomarenko. Physiotherapy in cosmetology, St. Petersburg, 2002, pp. 260-262).

Facial skin lesions, persistent erythema, multiple telangiectasias, hypertrophic changes in the soft tissues of the face lead to serious psychological problems, a decrease in social activity and the quality of life of people and require further dermato-surgical correction.

The recurrent course of the disease and resistance to existing methods of treatment, as well as the age characteristics of patients, are characteristic, since the presence of concomitant pathology increases by this age, which leads to the limitation of the use of standard therapy and the impossibility of a complete cure for rosacea.

Known (Reference dermatologist / Ed. V.N. Mordovtsev, Yu.K. Skripkin. - SPb .: Hippocrates, 1999. - S. 188-189.) Method of complex treatment of rosacea, including daily administration of sodium thiosulfate 30% 10 ml intravenously, metronidazole 500 mg 3 times a day orally and external treatment with 1% metronidazole gel.

However, the method has low efficiency. In recent years, the number of patients with rosacea with relapses after

the specified treatment, which requires repeated hospitalizations.

Known (US, patent 8415311, publ. 09.04.2013) a method of treating red acne by topical application of ivermectin.

However, it does not specifically disclose the treatment of inflammatory foci of rosacea or papulopustular rosacea.

Known (RU, patent 2640447, publ. 09.01.2018) a method for the treatment of inflammatory rosacea. According to a known source of information, the treatment of pathological foci of the skin of the face is performed on a Dualis SP Spectro Nd: YAG laser with a laser wavelength of 1064 nm, using a scanning handpiece S-11.40 J / cm ² , frequency 3 Hz, pulse length 30-50 ms, at the number of treatments per procedure is from 1 to 3 times, then the oxygen-ozone mixture obtained at the Medozons BM installation at a concentration of 1300-1600 μg / l is immediately injected, both directly under the foci and over the entire surface of the face, maintaining the distance between injections is 2.5 cm, while 6 procedures are performed with an interval of 2 times a week, then 3 procedures with an interval of 1 time a week and 3 procedures with an interval of 1 time per month, the course of treatment is repeated after 1.5-3

The disadvantage of the known method is its complexity in use, the need for a device for the introduction of an oxygen-ozone mixture, invasiveness, the obvious presence of a rehabilitation period, as well as a large number of procedures in the course of treatment (12 procedures)

The known technical solution was adopted as the closest

analogue of the developed method.

The technical problem to be solved by the developed method consists in the development of an improved technique for the treatment of rosacea.

The technical result achieved by the implementation of the developed method consists in using a mono-procedure that does not require additional techniques, oral medications, injections; short course of treatment; lack of a rehabilitation period; the developed method is a "lunch break" procedure: since takes 5-7 minutes, after the procedure there is a slight erythema, if necessary, after the procedure, a foundation can be applied; rapid onset of clinical improvement, already after 1 procedure.

To achieve the specified technical result, it is proposed to use the developed method. According to the developed method, for 6 sessions, a neodymium laser with a wavelength of 1064 nm is applied to the clean skin of the face directly into the center of the inflammation center for 6 sessions using a focal lens with d = 2 mm with an area of the exposure spot on the skin of 1.5 - 2.5 mm, 3 a pulse with a duration of 0.6 ms into the center of each focus of inflammation, and from the first to the fourth session, the exposure is carried out at a radiation power of 158 - 160 J / cm ² , on the fifth exposure, 125-130 J / cm ² , and on the sixth - 94 - 98 J / cm ² , and from the first to the third session after local treatment of each focus of inflammation, a single treatment of the entire surface of the skin of the face is carried out with the same neodymium laser with one

pulse duration 0.6 ms at radiation power 94-98 J / cm ² .

A neodymium laser with a wavelength of 1064 nm was used due to its physical characteristics that determine the effect on body tissues: deep penetration into the skin (up to 6 mm) without damaging the epidermis, absorption of radiation by five chromophores (oxy- and deoxyhemoglobin, protein, water, melanin), homogeneous photothermolysis up to 4 mm, vascular coagulation, a decrease in blood flow in the affected area (Potekaev N.N., Kruglova L.S. Laser in dermatology and cosmetology. - M .: Alkor Pablishere, 2018. - 280 p .; Ponomarenko G .N., Spokoiny LB, Klyuchareva SV. High-intensity laser technologies in dermatocosmetology. - SPb .: Saint Petersburg 21 century, 2012. - 208 p.).

1. Patient T, 15 years old, suffered from rosacea, used long-term topical corticosteroids, which aggravated the severity of the disease. She turned to me at the stage of rhinophyma formation. The neodymium laser treatment method was chosen, given the resistance to all external drugs and the ineffectiveness of systemic antibiotic and tretinoin therapy. After the first session, the face was noticeably cleared, and after the fifth session all traces of rosacea disappeared on the face.

2. Patient A., 3-year medical history. Received treatment with multiple courses of antibiotic therapy, retinoids (were canceled due to severe side effects from the skin), as well as topical metronidazole preparations, without effect. It was decided to carry out the treatment by the monomethod using a 1064 nm neodymium laser. After the second session, the face was noticeably cleared, and after the sixth session, all traces of rosacea disappeared on the face.

The advantage of the developed method consists in the use of a mono-procedure that does not require additional techniques, oral medications, injections; short course of treatment; lack of a rehabilitation period; the developed method is a "lunch break" procedure: since takes 5-7 minutes, after the procedure there is a slight erythema, if necessary, after the procedure, a foundation can be applied; rapid onset of clinical improvement, already after 1 procedure.

Claims (1)

A method of treating rosacea using laser radiation, characterized in that, for 6 sessions, a neodymium laser with a wavelength of 1064 nm is applied to the clean skin of the face directly to the center of the inflammation focus, using a focal lens with d = 2 mm, with an area of exposure to the skin of 1 , 5-2.5 mm, 3 pulses with a duration of 0.6 ms in the center of each focus of inflammation, and from the first to the fourth session, the exposure is carried out at a radiation power of 158-160 J / cm ² , on the fifth exposure 125-130 J / cm ² , and on the sixth - 94-98 J / cm ² , and from the first to the third session after the local treatment of each focus of inflammation, a single treatment of the entire surface of the skin of the face is carried out with the same neodymium laser with one pulse duration of 0.6 ms at a radiation power of 94-98 J / cm ² .