Demodicosis is a disease caused by mites of the genus Demodex (Demodex), which can affect either the skin of the face or spread on the eyelids and especially in the eyelash hair follicles , concentrating on the eyelash follicles. Unlike cutaneous demodicosis, which is relatively easy to treat by treating with various external preparations, the treatment of demodicosis of the eyelids must be approached with caution.
It is necessary that large quantities of medications do not come into contact with the eyes (this can cause irritation).
Note! The main treatment for such cases is ointments against demodicosis.
General information
An ointment based on sulfur is widely used for various diseases of the dermis. The simple composition makes the ointment accessible to different segments of the population, because prices per jar start at only 28 rubles.
The drug is used not only to relieve unpleasant symptoms, but also as the main medicine that can eliminate the cause of the disease. The main component, which is sulfur in its pure form, better known as a chemical element, is supplemented by the following auxiliary substances:
- petrolatum;
- water;
- emulsifier.
In the pharmacy you can find sulfur ointment packaged in glass jars with a plastic lid or in aluminum tubes.
Folk remedies
Non-traditional remedies in the treatment of ophthalmodemodecosis are used as often as traditional drugs. Raw materials for effective recipes are purchased at the pharmacy and prepared at home. The most effective folk remedies include:
- Wormwood decoction
. 40 g of herb are steamed in 1 liter of boiling water, simmered over low heat for 2-3 minutes and left for 24 hours. After straining, take 50 ml 6 times a day. On the first day, take the drink every hour, then every 2 hours, and on the third day every three hours. - Aloe leaf compress
. The castings of the plant are washed, cut and the pulp is applied to the eyelids for 10 minutes.
A decoction of oak bark is popular and quite effective. 10 g of raw material is steamed in a glass of boiling water and left for half an hour. Soak a cotton pad in the strained broth and apply it to the eyelids, changing the lotion every 10 minutes.
Parasitic infection in adults and children appears against the background of tonsillitis, ARVI, HIV, gastritis, gastric ulcer, taking immunosuppressive drugs, and stress.
You can get rid of ticks and other parasites that have settled on the skin and hair of the body if you start cleansing the body from the inside. For this, a decoction of birch leaves is prepared. 20 g of the plant are steamed in a glass of boiling water, wait half an hour, filter and take 20 ml three times a day.
Pharmacology
The ointment exerts its antimicrobial and antiparasitic effect upon contact with the skin. It interacts with substances of organic origin, resulting in the formation of sulfides and pentathionic acid. They make sulfur ointment a natural antiseptic.
When in contact with the skin, the components of sulfur ointment are not absorbed into the blood, which means they do not have a systemic effect on the body: they do not put a strain on the liver, do not require filtration by the kidneys, and do not affect the functioning of other internal organs.
What is demodicosis on the eyes?
Ophthalmodemodecosis (eye demodicosis) is an infectious disease of the organs of vision caused by Demodex eyelash mites. These are opportunistic parasites that can stay on human skin for a long time without showing anything. As soon as the immune system fails, the pathogen begins to rapidly multiply, activating the pathological process. The disease can be recognized by the following symptoms:
- severe itching, irritation, burning;
- inflammation, redness, swelling of the eyelids;
- sensation of a foreign body in the eyes;
- eyelash loss;
- peeling of the skin.
As the pathology progresses, scales form at the base of the eyelashes and purulent discharge along the edges of the eyelids. In advanced cases, acne appears on the patient's face. Sometimes a runny nose develops that is not accompanied by additional signs of a cold.
Ocular demodicosis occurs mainly in women.
There are two types of Demodex mites that develop in the human body: Demodex folliculorum and Demodex brevis. The former reproduces in or near the ciliary bulbs, while the latter is found only in the sebaceous ducts of the eyelids. However, both of them provoke an inflammatory process in the area of the edge of the upper and lower eyelids, feeding on sebaceous secretions and particles of the epidermis.
Indications for the use of sulfur ointment
Due to its antiseptic properties, sulfur ointment is actively used for various dermatoses:
- fungal;
- bacterial;
- parasitic.
Therefore, with the help of ointment alone, if used correctly, you can cure skin diseases such as:
- lichen;
- foot fungus;
- scabies;
- seborrheic dermatitis;
- acne;
- pigmentation;
- acne;
- demodicosis
It is separately noted that such a complex and untreatable disease as psoriasis can be stopped through the use of sulfur ointment. Psoriasis is a skin disease that is not associated with parasites or fungal infections. It is classified as a genetic disease. As a result of disturbances in the rate of cell division, growths appear. They are filled with small capillaries. When they are mildly affected, bleeding begins, which is difficult to stop.
In this case, sulfur ointment reduces the risk of secondary infection of psoriasis wounds, which, in turn, reduces the incidence of itching. Without touching the growths to scratch, the patient does not tear them until they bleed and does not increase the wounds. Thus, sulfur ointment helps to minimize the spread of ulcers throughout the body.
Acne complicated by demodicosis. Part 2
Acne complicated by demodicosis. Part 2
Author: Doctor of Medical Sciences, Professor of the Department of Skin and Venereal Diseases of the Institute of Postgraduate Education of the First Moscow State Medical University named after. I. M. Sechenova V. I. Albanova. The contents of the first part of the article can be found here.
VERA ALBANOVA
Professor of the Department of Skin and Venereal Diseases of the MMA named after. I.M. Sechenova (Moscow) Treatment prescribed on 03/04/14:
■ orally: special dragee “Merz” (Merz, Germany) 1 pill 2 times a day after meals for up to 2 months; ■ externally: – gel “Baziron AS” (contains benzoyl peroxide 5%; Laboratoires Galderma, France) – to suppress the growth of propionibacteria, only on pustules and areas of inflammation in the morning; – retinoic ointment 0.05% (contains isotretinoin 0.05%; FSPP “Retinoids”, Russia) - to normalize sebum secretion and keratinization, on the entire face (except for the area around the eyes and corners of the mouth) at night; ■ the following Christina products (Israel) have been added to home care: – Unstress Stabilizing tonic, contains extracts of cucumber, arnica, panthenol, glycolic and lactic acid) – for wiping the skin in the morning, refreshes the skin, tightens pores, relieves inflammation; – Unstress Replenishing Mask (contains B vitamins, wheat germ oil, St. John’s wort and plumeria leaf extracts, panthenol, hyaluronic acid) – in the evening every other day, soothes and nourishes the skin.
The treatment lasted for one and a half months. During this time, comedones, papules and pustules became isolated, faint spots and scars were noticeable at the sites of resolved rashes, the skin remained dry in places, but there was no peeling.
Treatment prescribed on April 29, 2014:
■ orally: dietary supplement "Omegatrin" (contains omega 3-6-9 fatty acids; Newman Nutrients, Switzerland) - to strengthen the barrier structures of the stratum corneum and reduce inflammatory manifestations, 1 capsule 2-3 times a day for 2 months;
■ externally: – local masking corrector when new rashes appear (no more than a day); – gel “Baziron AS” (Laboratoires GALDERMA, France) - only on pustules and areas of inflammation in the morning; – retinoic ointment 0.05% (FNPP “Retinoids”, Russia) - on the area of rashes daily, on the entire face (except for the area around the eyes and corners of the mouth) in the evening every other day; ■ it is recommended to add professional care to home care. The goal of professional care is to eliminate post-acne phenomena (scars and spots on the cheeks) and provide more intense hydration. Cosmetological procedure (07/19/14) and recommendations
of a cosmetologist The patient contacted a cosmetologist (already her third) two and a half months later. The first cosmetic procedure he performed was as follows: skin cleansing, ultrasonic cleansing, pigment tightening mask, brightening mask, serum with a-hydroxy acids and hyaluronic acid. The cosmetologist recommended excluding seafood and salt from the diet.
The cosmetologist suggested making changes to the treatment: ■ orally: retinol palmitate 8 drops 1 time per day with meals for a month;
■ externally: instead of retinoic ointment 0.05% every other day, cream with adapalene is prescribed daily, as well as gel with metronidazole for 2 weeks every 3 months; ■ cosmetic procedures: – plasma lifting – in September; – yellow peeling Retises CT-Yellow peel (sachet – retinol 4%, retinyl propionate 1%; ampoule solution – ascorobyl glucoside 10%, niacinamide 5%, pH 5.0; Mediderma/SesDerma, Spain) – in October; – Comodex Alpha Beta Peel peeling (contains glycolic, lactic, salicylic acids, green tea and tomato extracts, pH 2.5; Christina, Israel) - every 2-3 weeks; ■ enhancing home care with porcelain masks Christina (Israel) based on kaolin: – Porcelan Mask Astringent mask (contains kaolin, camphor, triclosan, eucalyptus leaf oil) – to tighten pores; – Porcelan Mask Moisture mask (contains kaolin, marine collagen, hyaluronic acid, amino acid complex, urea, thyme extract) – to moisturize the skin. Discussion
Often the first specialist whom patients with acne turn to is a cosmetologist. This is what happened in this case.
Despite the obvious diagnosis and active inflammation, the first cosmetologist resorted not to drug treatment, but to cosmetic mechanical cleansing and peeling, and seeing an insufficient clinical effect, he increased the intensity of the peeling, which resulted in a skin burn. In the summer, mites of the genus Demodex multiplied in damaged skin with increased sebum secretion, which gave symptoms of deterioration of the skin condition and itching.
The second cosmetologist did not conduct any tests for demodex, but judging by the prescribed treatment, the idea of demodicosis still occurred to him. Metronidazole and calendula tincture, which have acaricidal properties, were prescribed, but the treatment was short-term and insufficient to eradicate mites. To reduce itching, the antiallergic drug Cetrin was prescribed (according to the patient, the cause of the itching was assumed to be an allergic reaction to cosmetics). Itching with demodicosis does not require the use of antihistamines; it is eliminated by eradication of the pathogen. Therefore, it is understandable why the antihistamine was ineffective. Judging by the many prescribed cosmetic procedures, the main hope was placed on them, although injection mesotherapy and biorevitalization, associated with skin trauma, is not only doubtful, but unacceptable against the background of active inflammation. Carrying out hygienic cleaning 2 times a week in this case, in our opinion, is too frequent; cleaning 1 time a week would have been enough. As for laser therapy, it does not have a pigment-constricting effect, but it soothes inflamed skin. However, against the background of constant trauma to the skin with injection procedures and frequent cleansing, the anti-inflammatory effect was not as pronounced as would be desirable.
After laboratory confirmation of the presence of demodicosis, external treatment was prescribed with an ointment similar in composition to the well-known recipe for “Yam” ointment (Unguentum Yam). This treatment turned out to be quite effective, and after eradication of the mites, external anti-acne agents were prescribed - benzoyl peroxide (Baziron AS gel) and isotretinoin (retinoic ointment 0.05%). Benzoyl peroxide has a bactericidal effect, isotretinoin reduces sebum production and eliminates hyperkeratosis. Both products, when used for a long time, weaken the barrier properties of the skin and cause dryness, so additional protection of the skin from water loss and sun exposure is necessary. For this purpose, it is necessary to regularly use special cosmetics. After a significant improvement in the skin condition, the patient is gradually transferred to maintenance therapy - benzoyl peroxide is applied only to isolated inflammatory elements, and retinoic ointment 0.05% is used less and less (optimally during the period of remission, 2 times a week).
The recommendations of the third cosmetologist significantly change the treatment, and some seem very controversial, for example, restricting the diet of seafood and salt. Retinol palmitate at the prescribed dose (25,000 IU/day) does not have any effect on the sebaceous glands and keratinization, does not exhibit anti-acne activity, but simultaneously requires serious double contraception. The drug is prescribed for severe forms of acne at a dose of 300,000 IU/day once a day at night (see instructions for medical use). In a state of incomplete remission, there is no need to prescribe retinol palmitate. It is also not advisable to change isotretinoin to adapalene externally, since isotretinoin ointment is well tolerated and quite effective. The instructions and clinical recommendations do not provide for short courses of therapy with metronidazole gel as an anti-acne treatment. The effectiveness of plasma lifting in the treatment of acne has not been proven, and it is hardly advisable to carry it out at the age of 23 for the purpose of lifting. There are no objections to the use of light peelings.
At all stages of the disease, regular manual facial cleansing to remove comedones is desirable. The most important element of prevention and therapy is proper cleansing of the skin using special soap-free products with a pH of about 5.5. The use of products containing organic solvents (alcohol, acetone) is contraindicated, since they destroy the hydrolipid film and further weaken the skin barrier.
A good auxiliary means for the rapid restoration of the barrier are polyunsaturated fatty acids - omega-3/omega-6 (internally and externally). In case of severe inflammation, medications with retinoids (retinoic acids or adapalene) are prescribed. However, in the remission stage and to correct post-acne, they switch to cosmetic preparations with retinol and its esters. They can be used as a course or regularly in low concentrations.
It should be noted that the patient informed the dermatologist about the appointments of the third cosmetologist, and the further management scheme was agreed upon by two
specialists. The patient remains under observation by a dermatologist, and at the last visit, which was 08/23/14, further improvement in her condition was recorded
skin - absence of comedones, single papules, post-acne in the form of enlarged pores and slight pigmentation (photo 2 from 08/23/14). As a result, morning treatment was canceled and only retinoic ointment 0.05% 2 times a week and cosmetics were left.
Conclusion
Thus, it is advisable to use cosmetics and methods at all stages of treatment. Therefore, contact between two specialists to exchange experiences and develop a common strategy is necessary.
At the beginning of treatment, the leading role belongs to the dermatologist, who prescribes examination, drug therapy and mandatory cosmetological support. As you improve, more and more importance is attached to cosmetic procedures and cosmetic care.
And it depends on the cosmetologist how well the treatment result will be consolidated.
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Instructions for using sulfur ointment
The ointment as a medicine is applied in a thin layer to previously cleansed skin. If water remains on the surface, it will prevent the active components of the product from contacting the infected area. Therefore, be sure to dry the surface with a towel or napkin before applying.
The ointment is used only on the skin, excluding mucous membranes. You cannot rub sulfur ointment into the lacrimal sac, apply it under the lower or upper eyelid, lubricate the mucous membranes of the nasal passages with it, or treat stomatitis. In case of accidental contact with eyes, rinse them immediately with a slightly salted solution of clean water. Accidental ingestion may indicate immediate gastric lavage.
Sulfur ointment is often used as the main remedy for lichen. Apply a moderate layer to the affected area, spreading the ointment evenly over the entire area. It is important to carefully, slowly, rub the product into the upper layers of the skin. The procedure is repeated twice a day. The second application should be in the evening, just before bedtime. The duration of treatment is up to 10 days.
The scabies mite, which causes an itchy sensation on the skin, can be easily treated with sulfur ointment. The difficulty of treatment lies in ensuring that one condition is met: the product must be constantly present on the affected areas. As a result, wearing clothes can be difficult. During treatment, it is better to stay at home, apply a new layer of ointment after each shower, rubbing it into the affected areas. The second mandatory condition is changing bed linen after every night. Sheets and duvet covers must be washed at high temperatures, after which they must be ironed with steam.
For demodicosis, sulfur ointment acts as an auxiliary component of complex therapy. The main therapeutic agent, as a rule, is a drug for systemic use. In this case, sulfur ointment helps to avoid secondary infection and prevents the spread of the affected area throughout the body.
If a pimple on the skin has a purulent body, this indicates that it was caused by a bacterium. Pus is formed as a result of the activity of bacteria. To get rid of acne or pimples with white contents, you can use sulfur ointment. There is no need to open the rash elements first. The product is applied in a thin layer to dry, previously cleansed skin.
Indications for the use of ointments and gels for demodicosis of the eyelids
Ointments for demodicosis should be used at the first symptoms of this disease, namely the following signs:
- swelling of the edges of the eyelids;
- eye fatigue against the background of developing inflammatory infectious processes;
- loss of eyelashes that lose their strength;
- redness of the eyelids.
Such inflammatory reactions can be noticed already in the first days of the development of the disease.
And if inflammation affects only the eyelids and practically does not spread to the conjunctival membrane, it is necessary to use ointments and gels for demodicosis.
Contraindications
The main contraindication to the use of sulfur ointment is individual intolerance to the active substance. If the skin reacts sharply with allergic rashes to contact with sulfur, treatment with the ointment will have to be canceled and another remedy used.
In addition, with extensive damage to the body by fungal or bacterial infections, there is a high risk of getting sulfur poisoning - if more than 30% of the skin is covered with the drug. If scabies spreads throughout the body, use less dangerous sprays.
If the patient has not previously had experience with sulfur ointment treatment, it is recommended to first test it on the wrist by applying a small amount of the product. If redness or burning occurs, you will have to stop using sulfur ointment.
Side effects
Such drugs have common side effects , which, according to patients, develop quite rarely when used correctly.
The most common side effect is allergic reactions.
They occur due to individual intolerance or sensitivity to certain components of the drug.
Allergies can manifest as itching, burning and redness of the treated areas of the eyelids.
Additional symptomatic treatment in such cases is not required, but the use of the drug should be discontinued and treatment with any of the analogues should be continued.
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Read further:
Metronidazole for demodicosis: treatment regimen, instructions for use
Soap for demodicosis (tar, laundry): how to use for treatment
Benzyl benzoate for demodicosis (ointment, emulsion): treatment regimen, instructions for use
Demodex on the face: reasons for its appearance, how to get rid of it, the best ointments
Thiabendazole: instructions for use, active ingredient, price and analogues
Demodectic mange in cats: symptoms and drug treatment regimen
Causes of demodicosis
As mentioned above, the main reason for the development of this disease is the active reproduction of the iron mite. There are several possible reasons that can lead to increased activity of these opportunistic microorganisms. These are internal and external factors. The first category includes:
- A significant drop in immune defense and exhaustion of the body caused by poor nutrition, autoimmune pathologies, previous diseases, constant stress, etc.;
- Viral and microbial diseases that occur in chronic forms (hepatitis, tuberculosis, etc.);
- Helminthiases. The vital activity of helminths contributes to the weakening of the immune system;
- Malignant neoplasms. With many types of oncology, the body becomes exhausted, making it more difficult for it to cope with infections;
- Damage to the gastrointestinal tract. There is a proven relationship between the bacterium Helicobacter pylori and demodicosis;
- Other skin diseases. These are seborrheic dermatitis, rosacea, acne, etc. In the presence of inflammatory processes or integrity disorders on the skin, the risk of pathogenic activation of opportunistic flora increases significantly;
- Hormonal imbalance associated with illness or natural condition (for example, pregnancy or breastfeeding).
Skin demodicosis can also develop as a result of exposure to unfavorable external factors. As a rule, they are combined with internal ones, but in some cases (for example, choosing the wrong skincare products) they can be the main etiology. Among them:
- Temperature effect. This parasite multiplies especially actively in warm conditions;
- Unhealthy Lifestyle. This includes poor nutrition, frequent stress and bad habits;
- Use of low-quality cosmetics for care. This is especially true for cosmetics that do not have quality certificates and do not meet legal requirements;
- Poor environmental conditions. High levels of environmental pollution lead to a weakening of the barrier function of the skin.
Pharmacodynamics and pharmacokinetics
The medicine for demodicosis affecting the eyelids and skin on the face is affordable, but at the same time it is highly effective for demodicosis. You can find a lot of positive reviews about it on the Internet on forms from real people.
The ointment allows you to achieve the following results:
- effective exfoliation of dead epidermal cells, smoothing out bumps;
- acceleration of skin regeneration;
- noticeable results with shallow lesions within a few days;
- skin softening;
- creating a film on the skin, thanks to which the parasites quickly die without receiving oxygen for life;
- relief of itching and other manifestations of inflammation.
The unique property of the cream is safety. It is permitted during pregnancy, lactation, for newborns and other people who are prohibited from using potent local drugs.
Interaction and storage conditions
Sulfur is a chemical element, therefore, when Sulfur Ointment is distributed over the skin together with other external agents, various reactions begin to occur, leading to the formation of new compounds with unpredictable consequences.
Preparations containing fluorine and iron enhance the absorption of sulfur by the tissues of the human body.
If you use external products with sulfur in parallel with preparations containing barium, selenium or arsenic, then the effectiveness of the former will decrease.
However, in most cases, studies of the interaction of sulfur-based drugs and other external agents have not been carried out.
It is recommended to store the sulfur preparation at room temperature up to 25 °C. The medicine cannot be frozen, as it will lose its pharmacological properties.
It is important to store the product in a place where children do not have easy access . From the moment of manufacture, the ointment can be used for 2 years. After the expiration date indicated on the package, it is unacceptable to use Sulfur Ointment.
Reviews
For a long time I could not get rid of the constantly appearing bumpy acne and pimples on my face. After visiting a dermatologist, it turned out that the skin was affected by subcutaneous mites. The specialist prescribed the use of ointment with sulfur. After a full course I got rid of the problem forever.
Ekaterina, 25 years old
Order an antiparasitic drug directly from the manufacturer
I struggled with severe acne on my face for a long time - about 10 years, but even with varying degrees of success, it did not completely go away. Having decided to visit a dermatologist, I heard a disappointing diagnosis - demodicosis. The doctor prescribed an ointment containing sulfur, and a miracle happened: after using it and following the rules of normalizing my lifestyle, I saw a clean, well-groomed face.
Elena, 32 years old
Diagnostics
Demodicosis on the face and skin is diagnosed by a dermatologist. If the disease is secondary and has developed against the background of the underlying disease, then doctors of other specialties (gastroenterologist, gynecologist, trichologist, endocrinologist, etc.) may be involved for diagnostic and therapeutic purposes. For diagnosis, first of all, visual inspection is used. The doctor evaluates the condition of the skin, eyes and affected areas of the body. In addition, eye biomicroscopy and laboratory examination methods are practiced. The most informative of them are:
- Slit lamp biomicroscopy of the eye is a non-invasive examination aimed at looking for active inflammation. This is an absolutely painless manipulation that does not require special preparation;
- Eyelash test - involves taking freshly removed eyelashes (4 from each eyelid) for further examination under a microscope. Using this method, it is possible to determine the number of parasites (the presence of more than 1 mite on 2-4 eyelashes is pathogenic). This is also a painless procedure, but before it is carried out it is necessary to abandon decorative and skincare cosmetics for several days;
- Biopsy. This is the most informative diagnostic method, but the most traumatic. Diagnosis is carried out under local anesthesia using a tubular knife or scalpel. The taken biomaterial is fixed in a formaldehyde solution for a day and treated with dyes. This makes it possible to fully visualize the gland and adjacent tissues with the pathogenic mite.