Demodicosis in humans: symptoms and treatment. Effective drugs for the treatment of demodicosis on the face Demodex on the human body treatment

With demodicosis, the skin of the face is primarily affected.

Rice. 1. In the photo, demodex mites under a microscope.

The cause of demodicosis is the acne mite

Demodex tick (D. follicullorum) belongs to the genus demodex, families Demodicidae, suborder Trombidiformes, detachment Acariformes.

Demodex mites feed on epidermal cells and sebum.

At night, ticks crawl out to the surface to mate. Surface skin ticks move at a speed of 8 - 16 mm / h.

At the head end (gnathosoma) there is a mouth opening equipped with sharp chelicerae that promote the absorption of food (epidermal cells and sebum). Digestion of food occurs under the influence of lytic enzymes.

Rice. 2. Photo of demodex mites under an electron microscope.

Reproduction and development

Rice. 3. In the photo (from left to right) the stage of development of the demodex mite from egg, larva, protonymph and nymph to an adult.

Features of Demodex folliculorum longus (long tick)

The tick of this species is long (0.3 - 0.4 mm), females and males are of the same size. The body is worm-shaped. The head end (gnathosoma), thorax (podsoma), and abdomen (opisthosoma) are well differentiated. Oral chelicerae are more acute.

Podsoma has bristles. The covering (cuticle) is transparent. There are very short three-segmented legs. There is a transverse striation of the posterior part of the body. Live in hair follicles in groups.

Features of Demodex folliculorum brevis (short mite)

The tick of this species has a short body (0.18 - 0.19 mm). The opisthosoma is short with a pointed cone-shaped end. The head end is short and flattened. Males are smaller than females and die after fertilization. Breast broad, devoid of bristles. The cuticle is less transparent. They live in the mouths of the excretory ducts of the sebaceous and meibomian glands one by one, which makes them difficult to detect. They rarely rise to the surface, which makes treatment difficult.

Demodex folliculorum longus is found 4 times more often in men and 10 times more often in women than Demodex folliculorum brevis.

Rice. 4. On the left, Demodex mites are long (Demodex folliculorum longus), on the right, short (Demodex folliculorum brevis).

Rice. 5. In the photo, the demodex mite is short and long.

Epidemiology of demodicosis

Source of infection

The main source of Demodex mites are sick people or carriers.

Constant humidity, darkness and air temperature in the range of 30-40 ° C are optimal conditions for iron mites. Outside the host at room temperature, constant humidity and in the dark, mites live up to 9 days.

Rice. 6. Demodex tick under a microscope.

How the disease develops

Disease development factors

Exposure to ticks of the genus demodexper person in many ways:

Acne mites act as carriers of bacteria and viruses, which complicates the course of demodicosis and makes treatment difficult.

Rice. 7. Histological preparation of a skin section. Arrows indicate the location of demodex mites.

Clinical variants of demodicosis

Demodicosis in humans can develop as a primary independent disease, or develop against the background of existing skin diseases(perioral dermatitis, rosacea, acne, seborrheic dermatitis, etc.), aggravating their course.

Primary demodicosis

Secondary demodicosis develops against the background of diseases accompanied by a sharp depression immune system(HIV infection, leukemia, etc.), long-term use of corticosteroids and cytotoxic therapy, or develops against the background of acne and rosacea, complicating their course. This form of the disease is recorded in 33% of patients with acne.

Secondary demodicosis is characterized by:

• the disease appears at any age;
• lesions are widespread;
• history and clinical picture relevant diseases.

Papulo-pustular rashes on the skin of the face are the reason for the diagnosis of demodicosis.

Rice. 8. Demodicosis on the face of a woman.

Signs and symptoms of demodicosis

The disease always occurs gradually, tends to spread and progress.

The main localization of demodex mites

Short mites live in the mouths of the excretory ducts and secretions. sebaceous glands facial skin, ear canal, chest and back, sometimes on the scalp, as well as the meibomian glands, which are modified sebaceous glands opening at the edges of the eyelids. Long mites live in hair follicles. Ticks were found on the penis, buttocks, in the area of ​​ectopic sebaceous glands.

Rice. 9. Demodicosis on the face in the area of ​​nasolabial folds.

Rice. 10. Demodicosis on the face of a woman in the chin area.

Rice. 11. Demodicosis on the skin of the cheeks, nose and around the mouth.

Rice. 12. Demodicosis on the face in women on the skin of the forehead, cheeks and nasolabial folds.

Rice. 13. Demodicosis on the face of women.

Rice. 14. Demodicosis century.

Characteristics of the rash

• Initially, erythematous (red) spots appear around the mouths of the follicles. The rash is located asymmetrically and is accompanied by lamellar peeling.
• The appearance of a rash is accompanied by a feeling of heat, burning, crawling and fullness.
• Very quickly, pink or red papules with a cone-shaped top and gray scales appear in the area of ​​redness. Often there are papulovesicles (a vesicle is a vesicle filled with a clear liquid) or a papulopustule (a pustule is a vesicle filled with purulent fluid).
• Inflammatory infiltrates and granulomas form in the dermis. The skin over the affected areas thickens, its elasticity decreases. There is a feeling of constriction. The affected areas are covered with serous, serous-bloody or purulent crusts. Over time, hyperpigmentation develops: the skin acquires a brownish or yellowish-brown color.
• With the massive development of a pyogenic bacterial infection, large follicular pustules (purulent elements) appear at the site of inflammatory infiltrates. Over time, they spread into the deeper layers of the dermis, which leads to facial disfigurement.
• The clinical picture of demodicosis with different types mite is somewhat different from each other. So, with the defeat of Demodex folliculorum, erythema and peeling (desquamation of the epithelium) are more often recorded, with the defeat of Demodex brevis - papulo-pustular elements, which are often located symmetrically.
• With a long ( chronic course) demodicosis marked thickening of the skin, loss of elasticity, there is a feeling of contraction. Against the background of hyperemic skin, bloody-purulent crusts are located. When a pyogenic infection is attached, pustules and microabscesses appear. Dense infiltrates form in the deep layers of the dermis, disfiguring the face.

Rice. 15. Demodicosis on the face of a woman, severe course.

Deterioration of appearance creates aesthetic discomfort for the patient and leads to the development of neurosis and depression.

Forms of demodicosis in humans

Depending on the nature of the manifestations on the skin, several forms of demodicosis are distinguished, the symptoms of which are characteristic of the corresponding diseases. Not to be confused with these diseases!

Acneform form

Acneform type of demodicosis is characterized by the appearance of papules and pustules on the skin of the face, similar to acne.

Rice. 16. Demodicosis of the face in women. Acneform form of the disease: papular (left photo) and papulo-pustular (right photo).

Rosacea-like form

The rosacea-like type of demodicosis is characterized by the appearance of papules against the background of diffuse erythema. Demodex brevis (short mite) causes inflammatory infiltrates and granulomas in the deep layers of the dermis, similar to the granulomatous form of rosacea.

Rice. 17. Rosacea-like form of demodicosis: in the form of diffuse erythema (photo on the left), granulomatous form (photo on the right).

Seborrheic (erythema-squamous) form

The seborrheic form of demodicosis is characterized by the appearance of redness and rash on the skin of the face, accompanied by lamellar peeling.

Ophthalmic form

The ophthalmic form of demodicosis occurs with a lesion eyeballs and age. Redness, dryness, irritation, sensation foreign body in the eye, fatigue are the main symptoms of eye demodicosis. Itching of the eyelids, redness and swelling of their edges, the appearance of scales or crusts on the eyelids are the main symptoms of demodicosis of the eyelids.

Read the article for details "Demodicosis of the eyelids and eyes"

Rice. 18. Demodicosis century. Lamellar peeling is clearly visible (photo on the left). On the ciliary edge of the eyelid, scales form a “collar” around the eyes (photo on the right).

The role of demodex mites in the formation of androgenetic alopecia

There is an assumption that the presence of mites in the hair follicles exacerbates the development of androgenetic alopecia. During inflammation, T-lymphocytes are activated, which induce collagen synthesis, resulting in fibrous degeneration of hair follicles.

Rice. 19. Demodicosis of the scalp.

Demodicosis on the background of rosacea

Demodicosis complicates the course of rosacea in 88.7%. The disease is more common in women over 30 years of age. The phymatous form of the disease is more common in men. The pathological process is characterized by reddening of the skin of the face, associated with the expansion of small superficial vessels, the appearance of papules and pustules. Papules increase in size over time and merge, forming dense infiltrates. The sebaceous glands are hyperplastic. fibrosis develops. Persistent redness and fibrous seals on the nose are called rhinophyma.

There are many reasons for the development of diseases. Factors contributing to the development of the disease can be divided into endogenous and exogenous.

Rice. 20. Erythematous-telangiectatic form of rosacea. Multiple telangiectasias (dilated subcutaneous arterioles) are visible on the skin.

Rice. 21. The photo shows a papulo-pustular form of rosacea. Against the background of erythema (redness), multiple rashes are visible, which are papules with thin scales on the surface. The affected areas are infiltrated and swollen.

Rice. 22. Demodex brevis (short tick) causes inflammatory infiltrates and granulomas in the deep layers of the dermis, similar to the granulomatous (phymatous) form of rosacea. The photo shows a phymatous (papular-nodular) form of rosacea.

Rice. 24. eye shape rosacea is registered in 50% of patients. Inflammation of the eyelids, redness of the conjunctiva, iritis and keratitis are the main manifestations of the disease.

Demodicosis on the background of acne

Demodicosis accounts for 10.5% of acneform dermatoses. Acne (acne vulgaris) is a chronic relapsing disease that affects the sebaceous glands and hair follicles. Most often, acne occurs in males during puberty at the age of 14 - 16 years. Juvenile acne is caused by propionobacteria acne, epidermal staphylococci, pitirosporum oval and orbital, which constantly live on the skin of the face. Many factors contribute to the development of acne.

Rice. 25. Demodicosis is registered in 10.5% of patients with acne. In the photo on the left, papular acne. When joining staph infection pustules (abscesses) and microabscesses develop - pustular and abscessed acne (photo on the right).

Rice. 26. With the indurative form of acne, inflammatory infiltrates appear in the deep layers of the dermis. The skin has a bumpy appearance.

Demodicosis on the background of perioral dermatitis

In half of the cases, perioral dermatitis is complicated by demodicosis. Perioral dermatitis is rare - in 1% of the population, more often in women aged 20 - 40 years. There are many reasons for the development of diseases. Factors contributing to the development of the disease can be divided into endogenous and exogenous. With a disease on the skin around the mouth, chin and in the nasolabial fold, small papules of pink or reddish color appear. Hyperemic skin over time becomes brown in color, which creates aesthetic discomfort for the patient.

Rice. 27. In the photo, perioral dermatitis. The disease in half of the cases is complicated by demodicosis.

Demodicosis in humans, as an independent disease, is rare. With persistent rosacea, acne and perioral dermatitis, it is necessary to diagnose the disease by standardized biopsy of the surface layers of the skin in order to detect mites, which should be taken into account in the subsequent treatment.

Demodex is an acne mite that lives in the sebaceous glands and human hair follicles. This mite is conditionally pathogenic, so many people do not notice its presence in their skin at all.

However, it often begins to actively multiply and causes a skin disease called demodicosis, or in common parlance demodex. A painful reaction of the skin is caused by the waste products of the tick.

Why does the disease occur? Many problems inside the body can serve as a trigger. Diseases and malfunctions of the endocrine system, nervous system, gastrointestinal tract can cause pathological development subcutaneous tick.

The use of hormonal cosmetics leads to the activation of demodex.

Uncontrolled use of hormonal creams and ointments, cosmetics containing hormones can also lead to activation of the demodex mite.

Most often, signs of the disease appear on the skin of the nasolabial triangle, auricles, for centuries. In advanced cases, it is possible to spread to the skin of the neck and chest; quite rarely, demodex spreads to the back.

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Demodex symptoms

Symptoms of demodex are in many ways similar to acne, often accompanied by increased oiliness of the skin.

• Acne, pustules or sores,
• enlarged pores,
• bumpy skin,
• Loss of hair and eyelashes
• Sensation of a foreign body in the eyes.

Symptoms and treatment of demodex - PHOTO Before and After

The photographs show the symptoms of demodex facial skin disease - type BEFORE treatment and AFTER:

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How to treat demodex on the face

How to cure demodex on the face? The healing process can be quite lengthy. In advanced cases, it will take from six months to two years for the skin to clear and return to normal.

Treatment only with external means will not give a stable result. For effective treatment demodex, a person also needs an “internal” recovery, which consists in the normalization of metabolic processes in the body, and an increase in immunity.

You should establish a diet, excluding spicy, salty and fatty foods. Treatment of demodex should be comprehensive, there are two main goals: to destroy the tick and strengthen the body's defenses.

Be sure to strictly observe the rules of personal hygiene during the treatment (and after it). Demodex is a disease that can be transmitted from one person to another, in addition, repeated self-infection occurs.

Therefore, it is important to have an individual towel that is changed every day and ironed with a hot iron after washing, and should also be done with a pillowcase. Cosmetics must also be individual. For washing it is better to use liquid soap.

Treatment of demodex during pregnancy

A special approach to the treatment of demodex in pregnant women. They should not use drugs containing metronidazole.

It's better to refuse altogether. drug treatment if the symptoms are tolerable, because the harm to the child during treatment will be much higher than the damage to the skin as a result of the vital activity of the tick.

Demodex treatment regimen

• Taking Trichopol tablets (it suppresses the activity of the tick) and applying an ointment containing metronidazole to the skin, or treating Demodex with benzyl benzoate.
• Trichopolum intake and antihistamines, application to the skin of ointments containing sulfur: sulfuric, sulfuric-salicylic ointment or Wilkinson's ointment.

Note!
At the very beginning of treatment, there is often an increase in rash, burning. This is a normal skin reaction and treatment should be continued.

Effective external agents against subcutaneous mites are Birch tar, streptocide, which are applied to the affected areas of the skin. ethnoscience offers treatment of the skin with a solution of copper sulphate.

One of the most effective means today, about which many positive feedback for the treatment of demodex on the face, it is considered "DEMODEX COMPLEX".

This is not one drug, but a whole set that eliminates the symptoms of the disease, suppresses the vital activity of ticks. The skin becomes less oily, smoothed, pores are narrowed. It can be applied long time. But this should be done under the supervision of a doctor.

Treatment of demodex eyes, eyelids, eyelashes

For the treatment of demodex on eyelashes and eyelids, ointments and creams Demalan, Demazol, Blefarogel No. 2 are used. Means are applied to the edges of the eyelids once or twice a day. When applied once, it is better to do it at night. Be sure to clean the skin of the eyelids and eyelashes with a cotton swab before applying medications.

In cases where the disease is accompanied by a purulent lesion of the mucous membrane of the organs of vision, drops are prescribed for the treatment of eye demodex with an antimicrobial effect, for example, Tsipromed, Tobrex.

Other treatments for demodex

• Physiotherapy(mainly electrophoresis with moisturizing preparations).
• Ozone therapy. It acts as a bactericidal, immunomodulatory agent, but cannot be considered as an independent treatment, but only in combination with the use of special preparations.
• TCA peeling cleanses the skin of the infected layer of cells.
• Cryotherapy helps to quickly get rid of itching and burning, but not for a long time, because it does not kill ticks.

After treatment, laser therapy brings good results in skin rehabilitation and prevention of complications.

So, you can treat demodex various means. Ordinary tar soap helps someone easily, while someone undergoes several courses of treatment, and the results do not satisfy him.

Treatment of demodex requires thoroughness and thoroughness.

This is understandable: the treatment of demodex requires thoroughness and thoroughness. Moreover, it should be manifested not only in the use of medicines, but also in compliance with hygiene requirements. In addition, the state of immunity is strongly affected. constant stress, infectious diseases- an extra "provocation" for the tick.

Today, a popular method of rejuvenation -

Content

Demodicosis or the so-called acne gland is an infectious skin lesion that causes a microscopic demodex mite. Outwardly, it manifests itself in the form of itching, acne, blackheads. Treatment of demodicosis on the face includes adherence to a diet, certain rules of hygiene, the use of specific drugs, medical and cosmetic procedures and folk methods.

Causes of the disease

• long-term treatment with hormonal drugs;
• endocrine disorders;
• malnutrition;
• increased activity of the sebaceous glands;
• decreased immunity;
• chronic diseases;
• depression, stress;
• solarium abuse;
• smoking, regular alcohol consumption.

The scheme of treatment of demodicosis of the face

1. Refuse scrubs, fatty creams, decorative cosmetics.
2. Use cleansers that do not irritate the skin when washing. They are recommended to be selected together with a dermatologist.
3. Carry out thorough washing in the morning, evening and before each application of local remedies for the treatment of demodicosis.
4. Wipe your face not with an ordinary towel, but with high-quality disposable wipes. Do not apply medication to wet skin.
5. Apply a good sunscreen before going outside.

special diet

When treating demodicosis on the face, it is important to adhere to a dietary nutrition system. It will reduce the load on the intestines, regulate its work, cleanse itself of toxins and toxic contaminants of the body. During therapy, you should completely avoid alcohol, packaged foods with chemical components, dishes with a lot of salt, sugar and animal fats.

Carrying out cosmetic procedures

Subcutaneous mite on the face is treated using a number of effective cosmetic techniques. They help to eliminate the manifestations of the disease, but at the same time they are considered only auxiliary methods of therapy, and are always selected individually. Modern procedures, prescribed for the treatment of demodicosis of the face, are represented by the following list:

• microdermabrasion - mechanical peeling;
• laser photocoagulation - treatment of areas affected by demodicosis with pulsed light, a laser is used;
• ozone therapy - treatment of demodicosis with oxygen-ozone mixtures;
• cryomassage - exposure to the skin with cold (liquid nitrogen).

The use of local preparations for the destruction of the demodex mite

For the treatment of demodicosis on the face or eyelids, ointments, eye drops and creams for topical treatment are necessarily used.

Antibacterial agents:

• Gel "Baziron". Lubricate the skin 1-2 times a day for 3 months.
• Erythromycin ointment. 1-2 times a day for no more than 14 days.
• Eye drops"Tafazol". A weekly course is optimal, 1 drop 1-3 times a day.

Taking medications

In the treatment of demodicosis on the face, several categories of systemic drugs are used.

Antihistamines:

• Tablets "Tavegil". 1 mg 2 times a day until relief of allergy symptoms.

Immunomodulating agents, sorbents:

• Immunomodulator "Detox". 1 capsule 2 times a day. Optimal time reception in the treatment of demodicosis - 3 months.
• Sorbent "Rekitsen". 1 tablespoon 3 times a day, diluted in a glass of kefir. Treatment involves taking the powder for a month.

Effective folk remedies for home treatment

1. Birch tar. It must be mixed in half with sulfuric ointment and rubbed daily into areas of the face damaged by demodicosis. The duration of treatment is 2-4 weeks. If necessary, the course is repeated.
2. Tar soap. For a month, you should thoroughly wash your face with the product after waking up and before going to bed, rubbing the soap foam well into the skin.
3. Tincture of calendula. After the usual cleansing procedures, wipe the face with a ready-made pharmacy solution. Treatment with this remedy should be continued for at least 40 days.

Preventive measures against subcutaneous ticks

To get rid of demodicosis and forget about it forever, patients who have achieved stable remission are advised to adhere to proper nutrition maintain hygiene, avoid bad habits. In spring and autumn, you need to eat more plant foods, take multivitamin preparations, and undergo preventive laser treatments.

For any skin changes that resemble the beginning manifestations of demodicosis, you should immediately contact a specialist and take appropriate tests. Symptoms can be long-lasting acne, blackheads, rashes, redness, inflammation, "asterisks". Upon confirmation of re-infection, the doctor will prescribe a sparing, simpler and shorter program for the treatment of demodicosis than with advanced cases.

Rice. 1. Demodicosis on the face and eyelids.

Rice. 2. Ointments, creams and gels are the best means for the treatment of facial demodicosis.

Difficulties in the treatment of demodicosis

When using the most effective acaricidal preparations ( chemical substances that reduce the number of ticks) often the treatment is ineffective, which is associated with the special structure of the external integument of ticks, their larvae and eggs.

Rice. 3. Demodex mites (view under a microscope).

Features of therapy for demodicosis of the face

Complex treatment of demodicosis

Treatment of demodicosis should be comprehensive and include acaricidal, anti-inflammatory (including antibacterial), desensitizing drugs and immunomodulators. Be sure the patient's body must receive the required amount of vitamins, minerals and amino acids. If demodicosis occurs against the background of existing skin diseases, they are treated.

Treatment of demodicosis is long. Depending on the form and stage of demodicosis, treatment can be extended from 4 weeks to 1 year.

Criteria for the effectiveness of the treatment of demodicosis on the face

The criterion for the effectiveness of the treatment of demodicosis on the face is the reduction or disappearance clinical manifestations diseases and decrease in the number of ticks according to the results of the analysis.

Rice. 4. Long mites Demodex folliculorum longus live in hair follicles in groups (left picture), rise to the surface at night for mating. Short mites Demodex folliculorum brevis (picture on the right) live in the mouths of the excretory ducts of the sebaceous and meibomian glands one by one, rarely rise to the surface, which makes them difficult to detect and treat.

Anti-inflammatory therapy

• At the first stage of treatment, it is necessary to use drugs that suppress the microbial population. For this purpose, anti-inflammatory drugs for external and systemic use are used. Ointments, creams and gels with antibiotics for external use have a good effect: Metronidazole, tetracycline, or erythromycin.
• With advanced forms of the disease antibacterial drugs applied internally. Showing Metronidazole (Trichopolum), Tetracyclines, Ornidazole, Monocycline, Doxycycline, Roxithromycin, Erythromycin.

Rice. 5. Metronidazole and Trichopolum are widely used for demodicosis.

Metronidazole for demodicosis

Metronidazole inside applied for 2 - 4 weeks, 250 mg 3 times a day (standard scheme). Analogues of the drug for internal use are Trichopol, Klion, Flagyl and etc.

The drug of choice for demodicosis is Ornidazole (Ornizol). It is stronger than metronidazole, well tolerated, has fewer side effects. It is used in courses of 10 days, 500 mg 2 times a day.

Rice. 6. Rosamet cream and Metronidazole gel - preparations for external use.

Rice. 7. Zineryt powder contains erythromycin and zinc acetate dihydrate.

Permethrin for demodicosis

4% Permethrin ointment applied to the affected areas of the skin and rubbed with massaging movements. After 24 hours, the ointment is washed off with warm water and soap. Often a single procedure is sufficient. But sometimes the procedure needs to be repeated, which is allowed after 14 days.

Other insecticidal preparations:

In some cases good effect with demodicosis, insecticidal preparations such as Crotamiton(cream), Malathion(emulsion concentrate), (emulsion), benzyl benzoate(emulsion, ointment, cream and gel). Benzyl benzoate is applied at night to the affected areas of the skin after washing. The course of treatment is 2 - 3 weeks.

Rice. 8. Insecticides Permethrin and Crotaderm. Used in the treatment of demodicosis.

Rice. 9. Insecticides Lindane and Benzyl Benzoate are used in the treatment of demodicosis.

Rice. 10. Spray Spregal has a pronounced effect against iron mites.

Tar and sulfur ointment from demodicosis

In the treatment of demodicosis, preparations containing sulfur and tar are used.

Manting, Xin fumanling and Mefule- Chinese drugs. On the Internet, there are many positive reviews about them in the treatment of demodicosis, which is due to the fact that they contain sulfur in their composition. Products Demodex Complex is a complete copy of the above drugs, but it costs much more.

Rice. eleven. Sulfuric ointment widely used in the treatment of demodicosis.

Rice. 12. Demoten and sulfur-tar ointment for the treatment of demodicosis.

Features of the treatment of some forms of demodicosis

Treatment of resistant strains

Despite receiving positive results in the treatment of demodicosis with classical means, treatment-resistant and recurrent forms of the disease are increasingly common in recent years. So with the development of resistance, it is recommended to use cryotherapy in combination with the use of cream Rozamet containing 1% metronidazole.

Treatment of papulo-pustular lesions

In the treatment of papulo-pustular rashes, it is recommended to use classical reducing (restoring) agents - ointment zinc-ichthyol, 1 — 2% tar and ichthyol ointments, 1% pasta ichthyol-resorcinol. Contains zinc hyaluronate gel Curiosin.

Treatment of acne form of demodicosis

Rice. 14. Preparations of the retinoid group are used in the treatment of demodicosis in case of development of resistance. Pictured is 0.1% Retin-A cream.

Rice. 15. Acneform form of demodicosis: papular (left photo) and papulo-pustular (right photo).

Rice. 16. The effectiveness of the treatment of acne form of demodicosis.

Rice. 17. Rosacea-like form of demodicosis: in the form of diffuse erythema (photo on the left), granulomatous form (photo on the right).

Demodicosis and rosacea

Demodicosis in humans complicates the course of rosacea in 88.7% of cases. This mainly occurs in the later stages of the disease - erythematous-papular, papulo-pustular and nodular. The basis of the therapy of demodicosis and rosacea is the correction of pathology internal organs and the use of external treatments.

• For the treatment of demodicosis in rosacea, the use of sulfur-containing drugs and benzyl benzoate is recommended. An aerosol preparation has a good acaricidal effect. "Spregal".
• For external use, when papules and pustules appear, the use of salicylic acid, resorcinol, adrenaline, etc. is recommended.
• Prevents the appearance of seals in the outer layers of the skin and eliminates redness gel and ointment with azeloic acid gel and cream .

Rice. 18. In the photo, Skinoren gel and Azix-gel cream. Contains azeloic acid.

Demodicosis on the background of seborrheic dermatitis

With the appearance of demodicosis against the background of seborrheic dermatitis, the use of Retinoic ointment. It prevents the development of increased proliferation of the epithelium of the excretory ducts of the sebaceous glands, reduces the production and evacuation of sebum, helps reduce the inflammatory component and promotes skin regeneration. The simultaneous use of antibiotics of the tetracycline group and glucocorticoids is not recommended.

Rice. 19. When demodicosis appears on the background, the use of Retinoic ointment is indicated.

Demodicosis for acne

Demodicosis in humans complicates the course of acne in 33% of cases. In its treatment, only an integrated approach and long-term pathogenetic therapy are used against the background of basic facial skin care.

Rice. 20. In the photo, acne on the face.

Skin care during the treatment of demodicosis

• Increased production of sebum and excessive proliferation of the skin epithelium creates good conditions for the reproduction of iron mites, so daily cleansing of the skin is a mandatory manipulation in the treatment of demodicosis on the face and other parts of the body. For this purpose, foams, gels and lotions are used. They remove excess greasiness and do not overdry the skin. Soap is not recommended. The frequency of washing in the treatment of demodicosis should not exceed 1 - 2 times a day. Good skin cleansing gel "Cleanans" medical cosmetics series "Exfoliac", "Clerasil Ultra", "Cetafil", "Sphingogel", "Sebium" and "Zeniac".
• Degrease and disinfect the skin alcohol solutions with antibiotics (5% chloramphenicol alcohol), 2 — 5% salicylic acid solution,2% resorcinol, 5 - 10% alcohol camphor solution.
• Iron mites feed on epidermal cells and sebum, therefore, in the treatment of demodicosis, keratolytic and anti-seborrheic agents should be used. Keratolytic properties have: Benzoyl peroxide (Baziron, OXY-5, OXY-10, Klerasil-ultra), preparations of the retinoid group, Azeloic and salicylic acids, Resorcinol.
• With increased dryness of the skin, the appearance of irritation and peeling, the use of moisturizing creams and gels is indicated. Well proven soothing cream "Klin AK", "Avenfor hypersensitive skin, "Tlerance Extreme".
• In order to regenerate (restore) damaged areas, the use of a regenerating cream is indicated. "Sicalfat" with zinc-copper complex or "A-Derma Epithelial A.N DUO Regenerating Cream" with hyaluronic acid.
• To prevent the formation of atrophic scars after pustules, the use of a gel is recommended. Contractubex. Applies 4 weeks.
• Constant humidity and darkness are optimal conditions for the life of iron mites, so it is better to abandon cosmetics for the duration of treatment.
• Excessive ultraviolet exposure should be avoided. An increase in the production of vitamin D under the influence of UV radiation leads to the activation of the synthesis of cathelicidins, which support the inflammatory process.

Rice. 21. Keratolytic and anti-seborrheic properties Salicylic acid and Resorcinol.

Rice. 22. Baziron is effective in the treatment of inflammatory elements on the skin, has keratolytic properties. The drug is available in a variety of forms (cleansing gel, tonic, scrub, corrective preparations), which makes it convenient to use in various settings (at home, at work, on trips, etc.).

conclusions

In the treatment of demodicosis, both as an independent disease and against the background of skin diseases such as rosacea, acne, perioral and seborrheic dermatitis, only an integrated approach and long-term pathogenetic therapy against the background of basic skin care are used.

Demodicosis is complex problem. It affects not only the health of a person, but also affects his psycho-emotional state.

Demodicosis is a skin disease caused by the microscopic mite Demodex folliculorum. This tick belongs to conditionally pathogenic organisms, that is, it is normally found in a healthy person. Its size is up to 0.5 mm, and it lives in the ducts of the sebaceous glands of smooth skin and in the ducts of the meibomian glands, which are located on the edge of the eyelid. Quite often, acne gland, or subcutaneous mite, as the causative agent of demodicosis is also called, is found in the mouths of hair follicles.

Why does demodicosis occur?

Demodex mite is found in 90% of people, in most of them it does not manifest itself in any way, while some people cannot recover from demodicosis for a long time.

The cause of demodicosis is the rapid multiplication of the pathogen, as a result of which the patient experiences a number of discomfort. Normally, in one hair follicle there are 1-3 individuals of the tick, and with demodicosis, their number can exceed 10 individuals. The exact reason why the tick begins to actively multiply, causing a pathological process, has not been established. Only risk factors have been identified in which demodicosis occurs with a high frequency.

These factors include:

• emotional;
• nervous tension;
• malnutrition with a predominance of fatty and spicy foods in the diet;
• Tan;
• "abuse" of bath procedures;
• use of oily creams and ointments.

All of the above stimulates increased production of sebum, thereby creating favorable conditions for tick breeding. Immunodeficiency of any origin (an elementary cold!) can also lead to illness. In women, the provoking factor is sometimes the reception hormonal drugs that cause metabolic disorders in the skin.

It is interesting! Daily use of eyelid and facial skin care creams from the same container causes demodicosis on the face, as re-infection occurs with ticks that have fallen into the container with the cream.

Demodicosis of the skin itself is not very serious disease. Its danger lies in the addition of a bacterial infection, causing even more inflammation.

More than others, people with loose and sensitive skin, which is prone to redness, are more susceptible to demodicosis. In men, this disease develops much less frequently, as they use cosmetics and shave their faces less often. In the process of shaving, particles of keratinized skin with mites in them are removed, scientifically speaking, insemination of the skin by the pathogen is reduced.

It is extremely rare that demodicosis occurs in people who do not belong to any risk group and do not have any predisposition to it.

Symptoms of demodicosis largely depend on the number of breeding mites, skin type, general condition patient. The leading symptom is a rash on the skin of the face and eyelids, the rash most often has an inflammatory character. There are several forms of demodicosis, the classification is based on the predominant type of rash. In fact, these forms are also stages of the disease.

All stages and forms of demodicosis are characterized by itching in the affected area, which intensifies in the evening and at night, when the period maximum activity mites, and they come to the surface of the skin.

Symptoms of the erythematous form

It is manifested by hyperemia (erythema) of individual parts of the face. Eruptions are localized on the nose and cheeks, have well-defined borders and raised edges. This form is quite similar to and requires differential diagnosis.

Papular-pustular demodicosis

Against the background of hyperemia, papules and pustules form, their appearance is due to the overflow of hair follicles with fat, since the gland flows are clogged with clusters of mites. Pustules can be up to 2 mm in size and have different colour- from pink to purple-red.

hypertrophic stage

It develops with actively current demodicosis and in the absence of treatment. It is manifested by severe hypertrophy of individual skin areas, more often on the nose, chin and cheeks.

Symptoms of demodicosis of the eyelids and demodicosis of the eyes

The disease can be combined with a lesion of the smooth skin of the face, or it can occur in isolation. The reproduction of the subcutaneous mite in the meibomian glands (located at the base of the eyelashes) leads to their inflammation, which is accompanied by itching. A typical sign of demodicosis of the eyelids is the appearance of a whitish border at the base of the eyelashes, as well as inflammation of the edge of the eyelids.

Lack of treatment leads to hair loss, hypertrophy of the edge of the eyelids, which is accompanied by difficulty in closing them.

Demodicosis head

Demodex mites also live on the scalp, where with the same success, in the presence of provoking factors, they cause demodicosis. A feature of this form is the fact that it is very rarely detected due to the invisibility of papules and pustules under the hair. The main symptoms are itching in the evenings and slight indurations on the skin, palpable on the head.

How to determine demodicosis

The diagnosis can be made on the basis of the patient's typical complaints and the results of an external examination. However, some diseases occur with similar symptoms, such as rosacea. An analysis for demodicosis, which consists in taking a skin scraping with subsequent examination under a microscope, will help to distinguish one disease from another. When diagnosing demodicosis in the scraping material in in large numbers mites are found.

Scraping is usually done with a scalpel from the surface of pathologically altered skin, it is possible to examine fallen eyelashes and material taken from the edges of the eyelids. To make the result more accurate, the patient should not wash himself with soap and do not use cosmetics 2 days before taking a scraping for demodicosis.

Complications

In most cases, demodicosis causes severe inconvenience to patients, but if left untreated, it can lead to unpleasant complications. Itching and irritation force patients to scratch the skin, which leads to injury and the addition of a bacterial infection, so patients with demodicosis often have a pustular rash. In people with initial immunodeficiency, boils and subcutaneous abscesses may develop.

With demodicosis of the eyelids, complications from the eyes often join:

• conjunctivitis,
• blepharitis,
• marginal keratitis,
• dry eye syndrome.

At chronic form disease, abnormal growth of eyelashes is noted.

Treatment of demodicosis

Since the causative agent of this disease is found in 90% healthy people, then not a single patient will be able to completely get rid of it - sooner or later the mites will again fall on the human skin. Therefore, the main goal of treatment is to achieve a long-term remission, when all external manifestations of the disease disappear.

Important: alcohol-based products with prolonged use cause dry skin, which provokes an increased synthesis of sebum. And this, as we know, is one of the causes of demodicosis, so treatment should be strictly controlled by a doctor.

Ointment from demodicosis should also have a moisturizing effect in order to slow down the reproduction of ticks. It is best to treat demodicosis under the supervision of a dermatologist and cosmetologist: the first one will select the most effective etiological treatment, and the second will help to cope with problem skin.

Treatment of demodicosis on the face continues until the skin begins to cope with the pathogen on its own, sometimes this effect has to wait several months. Electrophoresis will help support the skin with medicines. Under the influence of an electric current, therapeutic agents penetrate into the depths of the skin, most effectively affecting ticks.

It is very difficult to treat demodicosis of the eyelids due to the difficulty of applying ointments to the eyelids. In this case, it is recommended to use medicinal eye baths.

The answer to the question of how to treat demodicosis can only be given by a competent dermatologist, it is desirable that he also has a specialization in cosmetology.

Prevention of demodicosis

Prevent this from happening unpleasant disease the following activities will help:

To reduce the likelihood of re-infestation with mites, bed and underwear should be changed daily, followed by washing and ironing. Acne iron is a very “gentle” creature and, when exposed to high temperature dies quickly. Therefore, ironed linen can be used quite calmly.