| Objective:To investigate the changes of skin physiological parameters in patients with rosacea,and to evaluate the efficacy on topical application of moisturizer in the treatment of rosacea.Methods:1.In the first part,we investigated the skin physiological parameters of patients with rosacea and healthy volunteers.Stratum corneum hydration,pH and erythema index were measured in 5 facial regions,including lesional skin in forehead,nasal tip,submaxilla and both cheeks.Sebum level were measured in forehead.2.In the second part,experimental study was conducted succedently to evaluate the effect of topical moisturizer use in patients with rosacea.According to the order of registration,the patients were randomly divided into the groups of barrier recovery cream(A,skin barrier recovery essence),the blank control group(without any use of topical cream,B)and the dimethicone cream group(C)respectively.All the patients were treated with minocycline(50mg twice daily)and ornidazole(0.5g twice daily)for 4 weeks.The basic facial skin care was to wash the face with clean water twice daily.Transepidermal water loss(TEWL),stratum corneum hydration,sebum level,pH and erythema index were measured at 0,2nd,and 4th week respectively.Meanwhile the lesions images were recorded by the VISIA skin tester.On every visit,the scores of the objective signs and subjective symptoms were evaluated,and the adverse reactions were recorded.Results:1.In the first part,eighty-one patients with rosacea were enrolled in case group along with twenty-eight healthy volunteers as controls.Compared with the control group,the patients with rosacea had a significant lower value of stratum corneum hydration and a significant higher level of erythema index on forehead,nasal tip,submaxilla and both cheeks(P<0.05).There was no significant difference in sebum level between case group and control group(P<0.05).The pH of both cheeks was higher than that of the other parts in case group(P<0.05).2.A total of thirty-two patients with rosacea were enrolled in the experimental study,of which two were lost to follow up and thirty were completed.There were no significant differences in age,sex ratio and baseline clinical scores among the three groups(P>0.05).(1)TEWL of group A and C decreased gradually without statistical difference(P>0.05).TEWL of group B increased gradually,and the difference between group B and A,as well as group B and C was statistically significant(P<0.05).(2)Stratum corneum hydration in group A and group C inceased gradually,while the difference was not statistically significant(P>0.05).Stratum corneum hydration in group B decreased gradually.The difference between group A and B,as well as group C and B was statistically significant(P<0.05)(3)There was no significant difference in the change of sebum level among three groups during treatment(P>0.05).(4)The pH of each group increased firstly and then decreased,and there was no significant difference in pH among three groups(P>0.05).(5)Erythema index of each group decreased,while there was no significant difference among three groups(P>0.05).(6)The clinical scores of the three groups were all decreased,and the decline in group A was the most obvious.The difference between group A and B was statistically significant(P<0.05).(7)The total effective rates of group A,B and C were 20%,0 and 10%respectively after 2 weeks of treatment,and there was a significant difference between group A and B(P<0.05).After 4 weeks of treatment,the total effective rates in group A,B and C were 90%,60%and 80%respectively,and there was no significant difference among three groups(P>0.05).During the treatment,three patients in group C had mild irritant symptoms,which did not affect the course of treatment.Conclusion:(1)Skin barrier function of the patients with rosacea was impared,with the decrease of stratum corneum hydration and the increase of erythema index.There was no statistical difference in sebum level compared with control group.(2)Skin barrier recovery essence used in our study could significantly increase stratum corneum hydration and decrease TEWL in patients with rosacea,while there was no statistical difference compared with dimethicone cream.(3)There was no significant difference in sebum level and pH of patients with rosacea before and after treatment.(4)After 4 weeks of treatment,skin barrier recovery essence was superior to dimethicone cream in improving the clinical score of rosacea patients.(5)It was effective to treat rosacea with oral minocycline and omidazole,and the efficacy of combining with skin barrier recovery essence was better than that of the oral medication only,as well as dimethicone cream group during the treatmemt.Supplemented with suitable moisturizing products could relieve pruritus,tightness and other clinical symptoms effectively. |
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