Rosacea: Ukuqonda Ukukhanya Okuphakeme Kwezinhliziyo OkungamaMiliyoni Okuthathwa Njenge-Acne

I-Rosacea iyisimo sokukhathazeka kwesikhumba esiqhubekayo esithinta ikakhulukazi ubuso obuphakathi — amajuku, iphondo, umphimbo, kanye nekhanda — okwenza ukukhanya okuqhubekayo, imithambo yegazi ebonakalayo, futhi kwesinye isikhathi izikhukhula ezifanayo ne-acne. Ithinta cishe u-5% wabantu emhlabeni, enezinga eliphezulu phakathi kwabantu abavela eNyakatho yeYurophu, nakuba ivela kuzo zonke izinhlanga futhi ivame ukungaxilongwa kahle ezikhumbeni ezimnyama lapho ukukhanya kunzima ukukuthola ngamehlo. Lesi simo sivame ukuvela phakathi kweminyaka engu-30 kuya kwengu-50 futhi siqhubeka siba sibi ngaphandle kokwelashwa.

Enye yezinselelo ezinkulu nge-rosacea ukuxilongwa okungalungile. Njengoba ama-papules ne-pustules angafana ne-acne, abanye abagulayo bachitha iminyaka besebenzisa izindlela zokwelapha ze-acne ezithuthukisa i-rosacea yabo. Ngokwehlukile ne-acne, i-rosacea ayikhiqizi ama-blackheads noma ama-whiteheads, ivame ukugcina indawo ezungeze amehlo, futhi ihambisana nokukhanya okujolile kobuso nokushisa.

I-Rosacea iphinde ixhunywe ne-eczema, i-lupus, i-contact dermatitis, nokuthi ngisho ne-sensitivity elula. Umsebenzi ophakathi uthinta ukuhlanganiswa kokuphazamiseka kwe-neurovascular (imithambo yegazi evuleka kalula futhi ihlale ivuliwe), ukuhamba kwe-immune system okwandile okuhlanganisa ama-peptides e-cathelicidin kanye nama-mast cells, kanye nendima engaba khona ye-Demodex mite, etholakala ezikhumbeni ezithintekile ze-rosacea. Ukuhamba kwezakhi zofuzo kudlala indima ebalulekile, futhi izifundo zakamuva zokuhlola izinhlelo ze-genome-wide zikhombisile izindawo eziningi zokuphila ezabelana ngezimo ze-autoimmune. Umthelela wezomqondo ubuhlungu: izifundo zikhombisa njalo ukuthi i-rosacea ithinta kakhulu ukuzethemba, ukuzethemba komphakathi, kanye nokuxhumana kwezobuchwepheshe, abaningi abagulayo baphawula ukuhamba kude nezimo zomphakathi ngesikhathi sokukhanya.

I-Rosacea ayiyona isifo esisodwa kodwa iyisikhumbuzo sezinhlobo ezihlobene ezihlukaniswe zibe izinhlobo ezine, nakuba abaningi abagulayo bezwa izici ezingaphezu kweyodwa. I-Subtype 1, i-Erythematotelangiectatic Rosacea (ETR), ibonakala ngokukhanya okuqhubekayo kobuso obuphakathi kanye nemithambo yegazi ebonakalayo (ama-telangiectasias). Abagulayo bahlushwa njalo ngezikhathi zokushisa ezivela ngenxa yokushisa, utshwala, ukudla okunezithako ezishisayo, noma ukucindezeleka.

Isikhumba sivame ukuzizwa sithambile, sishisa, noma sishaywa, futhi singase sibe sikhulu futhi sibe nezinhlayiya. Abaningi abagulayo be-ETR baphawula ukuthi ama-moisturizers kanye nezivikeli zelanga akhiqiza ukushisa, okwenza ukunakekelwa kwesikhumba kube nzima. I-Subtype 2, i-Papulopustular Rosacea, ifaka izikhukhula ezifanayo ne-acne ekukhanyeni okuqhubekayo.

Ama-papules abomvu kanye nama-pustules agcwele umphimbo avela ebusweni obuphakathi, ngokuvamile ezikhathini zokukhanya nokuphuma. Le yisigaba esivame ukudideka ne-acne vulgaris, kodwa ukungabi khona kwama-comedones (ama-blackheads nama-whiteheads) kanye nokuba khona kokukhanya okujolile kuhlukanisa. I-Subtype 3, i-Phymatous Rosacea, ihlanganisa ukujula kwesikhumba, ikakhulukazi emaphondweni (rhinophyma), lapho ama-glands e-sebaceous enza kube mkhulu futhi izicubu ezithambile ziqoqeka, kudala ukubukeka okukhulu, okunezici.

I-Rhinophyma ivame ukuvela kubantu besilisa futhi ithuthuka kancane eminyakeni. Ingase iphinde ithinte umphimbo (gnathophyma), ikhanda (metophyma), izindlebe (otophyma), kanye nezihlathi (blepharophyma). Izinguquko ze-Phymatous zenza ukuba kube nzima futhi ngokuvamile kudinga ukungenelela kokuhlinzwa noma i-laser.

I-Subtype 4, i-Ocular Rosacea, ithinta amehlo nezihlathi, ikhiqiza ukoma, ukungakhululeki, ukushisa, ukuhamba, kanye nemithambo yegazi ebonakalayo ku-sclera. Ingaholela ku-blepharitis, i-conjunctivitis, futhi ezimweni ezinzima, ukulimala kwe-cornea okuthinta ukubona. I-Ocular rosacea ithinta kuze kube ngu-50% wabaguli be-rosacea futhi kwesinye isikhathi ibonakala ngaphambi kwezimpawu zesikhumba iminyaka. Ukukhomba i-subtype yakho kubalulekile ngoba izindlela zokwelapha zihluke kakhulu — i-ETR ithola inzuzo enkulu ezindleleni zokwelapha ezihlosiwe, i-papulopustular rosacea iphendula emithini yokulwa nokukhathazeka, izinguquko ze-phymatous zidinga ukungenelela kwezokwelapha, futhi i-ocular rosacea idinga ukunakekelwa okukhethekile kwezokwelapha.

Enye yezinyathelo ezinamandla ekuphatheni i-rosacea ukukhetha nokugwema izimbangela zakho — izinto ezithile ezibangela ukushisa, ukukhanya, nokwenzeka kwezimpawu. Nakuba izimbangela zihluka phakathi kwabantu, izigaba ezithile ziqashelwa emhlabeni jikelele. Ukushisa phakathi kwezinto ezivamile: isimo sezulu esishisayo, ama-sauna, izigubhu ezishisayo, izindawo ezishisayo, futhi ngisho neziphuzo ezishisayo zingabangela ukushisa ngemizuzu.

Ukukhanya kwelanga kuyisizathu esisodwa esibhalwe kakhulu, lapho ukukhanya kwe-ultraviolet kuthuthukisa ukukhanya, ukukhathazeka, nezinguquko zemithambo yegazi. Ukudla okunezithako ezishisayo ezine-capsaicin kubangela ukushisa ngokusebenzisa ukuvuselelwa okuqondile kwe-TRPV1 receptors emithanjeni yegazi yobuso. Utshwala, ikakhulukazi iwayini elibomvu, kubangela ukuvuleka kwemithambo yegazi futhi kuyisizathu sokukhathazeka kwabantu abaningi be-rosacea.

Ukucindezeleka kwemizwa kubangela ukukhanya ngokukhululwa kwe-cortisol kanye ne-catecholamine, okwandisa ukuphazamiseka kwe-neurovascular okukhona ku-rosacea. Ezinye izinto zokunakekelwa kwesikhumba — ikakhulukazi lezo eziqukethe utshwala, i-witch hazel, iphunga, i-menthol, i-eucalyptus oil, noma i-sodium lauryl sulfate — zikhubaza isikhumba esithintekile se-rosacea futhi zibangela ukukhathazeka. Ukuqeqeshwa kuyisizathu esiphazamisayo ngenxa yezinzuzo zempilo, kodwa ukukhuphuka kokushisa komzimba kanye nokushisa kobuso okwenziwa kungabangela ukukhanya okuqhubekayo; ukujolisa ezindaweni ezibandayo, usebenzisa ama-towels abandayo, nokukhetha imisebenzi enezinga eliphansi kungasiza ukunciphisa lokhu.

Umoya kanye nesimo sezulu esibandayo kungabangela ukukhanya ngokuphazamiseka kwesikhumba nokuvuleka kwemithambo yegazi. Ezinye imithi, kuhlanganise nemithi yokuvuleka kwemithambo yegazi kanye nezidakamizwa ezitholakala phezulu (ezihlinzeka ngcono okwesikhashana okulandela ukukhanya okukhulu), kuthuthukisa i-rosacea. I-Demodex folliculorum mite, umkhiqizo omncane ophila ezindaweni zokukhula, utholakala ezikhumbeni ze-rosacea, futhi ukufa kwawo kukhulula izinto ezibangela ukukhathazeka ezingase zibe nomthelela. Ukugcina i-diary ye-trigger enembile — ukubhala phansi imisebenzi yansuku zonke, ukudla, isimo sezulu, imikhiqizo, nezinga lokucindezeleka kanye nezithombe zesikhumba sakho — kukhombisa amaphethini ezinyangeni eziningi ezivumela ukuthi wakhe isu lokugwema elihlukile.

Ukwelashwa kwe-rosacea kuhlobene ne-subtype futhi ngokuvamile kuhlanganisa ukugwema izimbangela, ukunakekelwa kwesikhumba okuthambile, kanye nezindlela zokwelapha ezihlosiwe. Ku-erythematotelangiectatic rosacea, i-topical brimonidine (Mirvaso) kanye ne-oxymetazoline (Rhofade) yizithako ze-alpha-adrenergic ezivimba imithambo yegazi, zinciphisa ukukhanya isikhathi esingama-8-12 amahora ngemuva kokufaka. Zihlinzeka ngcono ebonakalayo kodwa kufanele zisetshenziswe ngokucophelela — abanye abagulayo bahlushwa ukukhanya uma umuthi uphela.

Ukuze kuncishiswe ukungabonakali kwemithambo yegazi, ama-lasers e-vascular (i-pulsed dye laser) kanye ne-intense pulsed light (IPL) therapy kuyasebenza kakhulu, ngokuvamile kudinga izikhathi ezi-2-4, nemiphumela ihlala izinyanga kuya eminyakeni. Ku-papulopustular rosacea, i-topical metronidazole, i-azelaic acid, kanye ne-ivermectin (Soolantra) yizindlela zokuqala zokwelapha ezinciphisa ukukhathazeka kanye nenani le-Demodex mite. I-Ivermectin ivele ibonakale ikakhulukazi, ibonisa ukuhamba phambili kune-metronidazole ezivivinyweni zokuqinisekisa.

Ku-rosacea ye-papulopustular ephakathi kuya kwenzima, i-low-dose oral doxycycline (40mg modified release, ethengiswa njenge-Oracea) ihlinzeka ngenzuzo yokulwa nokukhathazeka ezingeni eliphansi, igwema ukukhathazeka kokuphikisana nemithi. I-Oral isotretinoin ezingeni eliphansi igcinwe ezimweni ezinzima. Ku-rosacea ye-phymatous, izindlela zokwelapha zinefuthe elilinganiselwe ekuthuthukiseni izicubu ezijulile — ukuhlinzwa kokunciphisa, i-CO2 laser ablation, noma i-electrosurgery kudingeka ukuze kuhlangatshezwane nezicubu ezithintekile futhi kubuyiselwe izimo ezijwayelekile.

Lezi zindlela zingathola ukuthuthukiswa okukhulu ku-rhinophyma kodwa zidinga abaphathi abanolwazi. Ku-ocular rosacea, ukwelashwa kuhilela ama-compresses afudumele, ukuhygiene kwezihlathi nge-shampoo ye-baby ethile noma ama-wipes akhethekile, ama-tears okwenziwa, futhi ngokuvamile i-oral doxycycline noma ama-cyclosporine eye drops. Ezimweni ezinzima, kungadingeka ukuhlinzekwa kwezokwelapha.

Kuwo wonke ama-subtypes, uhlelo lokunakekelwa kwesikhumba oluthambile luyisisekelo: i-cleanser engenapunga, engakhubazi; i-moisturizer yokulungisa ibhodi equkethe ama-ceramides noma i-niacinamide; kanye ne-sunscreen ye-mineral enobubanzi (i-zinc oxide noma i-titanium dioxide) nsuku zonke, njengoba ama-sunscreens emithi angakhubaza isikhumba se-rosacea. Ukwelashwa kudinga ukubekezela — imithi eminingi yokwelapha idinga ama-8-12 weeks ukuze ibonise inzuzo ephelele.

Ukudala uhlelo lokunakekela isikhumba nge-rosacea kubonakala njengokuhamba emkhakheni wezinsiza — imikhiqizo esebenza kahle kwesikhumba esijwayelekile ingabangela ukushisa, ukushaywa, nokukhanya kubaguli be-rosacea. Umgomo oyisisekelo ubalulekile: imikhiqizo embalwa, izithako ezimbalwa, indawo encane yokukhubazeka. Ukuhlanza kufanele kusebenzise i-cleanser ethambile, engenapunga, engakhubazi — amanzi e-micellar noma ama-cream cleansers afanelekile.

Gwema noma yini ethinta kakhulu, equkethe i-sodium lauryl sulfate, noma eshiya isikhumba sizizwa 'sihlanziwe kahle,' njengoba le tightness ibonisa ukuphazamiseka kwesikhumba. Ukushisa kwamanzi kubalulekile: amanzi afudumele kuphela, hhayi ashisa. Pholisa kancane; ungakhethi.

Ukunakekelwa kubalulekile ku-rosacea ngisho noma isikhumba sakho sizwakala sishisa, ngoba ukuhamba kwesikhumba okuphazamisekile kuholela ekukhathazekeni. Bheka ama-moisturizers aqukethe ama-ceramides, i-niacinamide (eyinciphisa ukukhanya futhi iqinisa ibhodi), i-hyaluronic acid, kanye ne-squalane. Gwema ama-moisturizers anama-punga, amafutha abalulekile, utshwala (denatured/SD alcohol), i-retinol (eyokukhubaza kakhulu kwesikhumba se-rosacea ngaphandle kokwethulwa ngokucophelela), ama-alpha-hydroxy acids, kanye ne-witch hazel.

Ukuvikelwa kwelanga akuphikiswa — ukukhanya kwe-UV kuyisizathu esivamile se-rosacea futhi kuthuthukisa isimo isikhathi eside. Ama-sunscreens e-mineral aqukethe i-zinc oxide kanye/noma i-titanium dioxide ngokuvamile akwamukeleka kangcono kunezivikeli zelanga zemithi, ezingabangela ukushisa. I-formulations e-tinted inikeza inzuzo ezimbili zokuvikela kanye nokufihla ukukhanya.

I-SPF 30 noma ngaphezulu, efakwe ngokweqile futhi ifakwe kabusha njalo ngemva kwezinsuku ezimbili ngesikhathi sokukhanya, ibalulekile. Ngemikhiqizo yokwenza, imikhiqizo eyakhiwe ngensimbi incane kakhulu ukuba ibangele ukukhathazeka. Ama-primers anombala oluhlaza anciphisa ukukhanya ngaphambi kokufaka isisekelo.

Faka noma iyiphi imikhiqizo emisha eyodwa ngasikhathi, uvivinya endaweni encane ye-jawline ezinsukwini ezimbalwa ngaphambi kokufaka ubuso bonke. Isikhumba se-rosacea singase sibe ne-react unpredictably, futhi ukufaka imikhiqizo eminingi ngasikhathi sinye kwenza kube nzima ukukhomba umthombo uma ukukhathazeka kwenzeka.

Ngenkathi i-rosacea uqobo ingeyingozi, ezinye izimo zidinga ukunakwa kwempilo ngokushesha. Uma uhlushwa ukushisa okukhulu, okukhulu kobuso (angioedema) kanye nezimpawu ze-rosacea, funa usizo ngokushesha njengoba lokhu kungase kube uphawu lokuphendula kokuhlasela noma enye isimo esibucayi. Izimpawu ze-ocular rosacea — ukukhanya okuqhubekayo kwamehlo, ukungakhululeki, ukucasuka kokukhanya, ukubonakala okuphazamisekile, noma ukuzizwa kokuthi kukhona okungaphandle emoyeni — kudinga ukuhlolwa kwezokwelapha, njengoba i-ocular rosacea engalashwa ingaholela ekulimazeni kwe-cornea nokuphazamiseka kokubona.

Uma i-rosacea yakho iqhubeka ibhujiswa kakhulu ngemuva kokuba ibiyinqaba, cabanga ukuthi uqale imithi emisha (ikakhulukazi ama-steroids, abanga i-rosacea eyenziwe ngama-steroids ethinta kakhulu) noma uthole ukutheleleka okuphindaphindiwe. Isikhumba se-rosacea sithinteka kalula ekuthelelekeni kwe-bacterial, futhi ukuvela kokukhanya, ukuhamba, noma ukukhathazeka okwandayo kukhombisa ukutheleleka okudinga ama-antibiotics. I-Rhinophyma noma ezinye izinguquko ze-phymatous kufanele zihlolwe kusenesikhathi — ukungenelela kokuhlinzwa kulula uma izinguquko zezicubu zingakathuthuki.

Uma izindlela ezithengiswa ngaphandle kanye nokunakekelwa kwesikhumba okuthambile kungalawuli izimpawu zakho ngemuva kwezinyanga eziyi-8-12, bheka udokotela wezokwelapha esikhundleni sokuphindaphinda ukuvivinya imikhiqizo engase ithuthukise isimo sakho. Uma i-rosacea ithinta kakhulu impilo yakho yengqondo, ubudlelwano, noma impilo yakho yobuchwepheshe, lokhu kuphela kuyi-ndlela eyanele yokufuna ukwelashwa okuqinile — umthwalo wezengqondo we-rosacea uyaziwa ngokomthetho futhi ungatholakala. Ekugcineni, ngoba i-rosacea ingase ibonakale noma ihambisane nezinye izimo ezihlanganisa i-lupus, i-carcinoid syndrome, kanye ne-polycythemia vera, ukukhanya okuqhubekayo noma okungajwayelekile kobuso kudinga ukuhlolwa kwezeMpilo okujulile ukuze kuqinisekiswe izifo ezithinta umphakathi.

Ukuphathwa kwe-rosacea kuncike kakhulu ekulandeleni impendulo yesikhumba sakho ezimbangeleni, ezindleleni zokwelapha, nakwezinguquko zemvelo ngokuhamba kwesikhathi — umsebenzi lapho imibhalo eqondile ibalulekile. I-Skinscanner inikeza indlela elula yokuthwebula izithombe nokuhlaziya isikhumba sakho sobuso njalo, idala umkhankaso wezithombe ovezayo amaphethini umqondo womuntu kuphela ongawaphuthelwa. I-AI yethu ifundiswe ukuhlukanisa i-rosacea ezimweni ezivame ukuyiphinda — i-acne vulgaris, i-seborrheic dermatitis, i-contact dermatitis, kanye ne-lupus — ikusize uqonde ukuthi uthintwa yini ngaphambi kokufuna ukwelashwa.

Ngokulayisha izithombe masonto onke, wakhe irekhodi eliqondile lokuthi imithi yakho yamanje iyanciphisa ukukhanya nezikhukhula, ukuthi izinguquko zesizini zithinta kanjani isikhumba sakho, nokuthi izimo ezithile zendawo zixhumene kanjani nezikhukhula ezibhalwe phansi. Le mibhalo ibalulekile ikakhulukazi ezihlanganisweni ze-dermatology, lapho isikhumba sakho singase sibe ngcono noma sibe sibi kunezimo zaso ezijwayelekile ngosuku lokuvakasha. Uchungechunge lwezithombe ezine-timestamp lunikeza udokotela wezokwelapha umbono ophelele kakhulu kunencazelo yezwi kuphela, kuholela ezinqumweni zokwelapha ezinhle.

Kubantu abavivinya ukugwema izimbangela, ukuhlanganisa izithombe zansuku zonke ne-diary ye-trigger kudala idatha enamandla — ungase uthole ukuthi izikhukhula zakho zeMgqibelo zihlala zilandela ama-dinner ewayini eMsombuluko, noma ukuthi isikhumba sakho sithuthuka kakhulu ezinyangeni ezibandayo. I-Skinscanner ayithathi indawo yokunakekelwa kwezokwelapha, kodwa ikunika imibhalo nezinsiza ezithuthukisa ukuxhumana kwezokwelapha kube nemiphumela engcono futhi ukuphathwa komuntu kube nokusebenza kahle.