In daily life, we often see some people's facial skin turn red, and a series of dilated capillaries can be seen by naked eyes, some of which are red or purple spots, spots, lines or stars. This is telangiectasia, commonly known as red silk. It is a kind of skin injury that occurs on the face or trunk, most of which are acquired, and some patients are congenital. Facial telangiectasia is the main reason affecting beauty, which is more common in women. The clinical manifestations are filiform, punctate, star-shaped or flaky erythema on the face. If you look closely, you can see that there are many red blood vessels on the skin, just like a small red line. Many women who love beauty are often troubled by their blushing, but many people may not know that red blood will not only affect your beauty, but also affect your health and seriously affect the absorption of nutrients by the skin. Over time, it will lead to skin malnutrition, rough, dry and premature aging symptoms. In the theory of traditional Chinese medicine, it is called "blushing", which is attributed to heat stagnation of heart meridian and poor blood circulation.

Blood vessels cover all organs of the body and are divided into arteries, veins and capillaries. Small arteries, veins and capillaries are distributed in skin and mucosa. Capillary dilatation refers to the filamentous, stellate or cobweb changes of these vessels on the surface of skin or mucosa. It is bright red, the color of the glass sheet does not fade after being pressed, and it is single or multiple, which develops slowly or does not increase obviously after it occurs. It can be limited to a certain part or a large range, it can be a local change, or it can be a special manifestation of some diseases. Most of them can't fade by themselves, and the benign process affects the appearance. Telangiectasia can be primary, such as vascular nevus and hereditary benign telangiectasia. It may also be secondary to diseases such as scleroderma and rosacea.

Common telangiectatic diseases.

Congenital malformation of capillaries means that the walls of capillaries are very fragile and cannot contract. The disease mostly occurs on the face, neck, pillow and scalp at birth or shortly after birth. It can be unilateral, sporadic, bilateral or multiple. At first, there were reddish or dark red or purplish red lesions on the skin or mucosa, ranging in size from the tip of the needle to a limb or a half trunk. After crying, the color deepened, the boundaries were clear, and the shape was different, not higher than the skin, but higher locally. Partial or total fading after compression, smooth surface. With the increase of age, if children or young adults may have symptoms or nodular lesions, which mostly occur in the lower legs and feet, they can be manifested as painful purple-blue nodules and plaques, and they can still fester.

Pathological telangiectasia in the upper and middle dermis increases with age and extends to the deep dermis and subcutaneous layer.

Second, spider-like telangiectasia mostly occurs in normal children, pregnant women and patients with liver disease. The etiology is unknown, which may be related to estrogen. The lesions were spider-shaped, and the radial capillaries were dilated with naked eyes, like spider feet. Slightly elevated, arterial pulsation can be seen after compression. Sizes vary from 1 to 1.5 cm in diameter. It usually occurs in the face, neck and hands, but also in the upper body. Most patients are single, often on one side, such as multiple patients, so liver disease should be ruled out. For example, spider-like telangiectasia of nasal mucosa and lips is difficult to distinguish from hereditary hemorrhagic telangiectasia. For example, in children, most of them persist and it is difficult to fade naturally. If it happens to pregnant women, it is expected to disappear about 6 months after delivery, and if it is pregnant again, it may recur in the same place. It is not uncommon for this disease to persist.

Hereditary hemorrhagic telangiectasia is an autosomal dominant disease, characterized by telangiectasia of skin, mucosa and organs and venules with bleeding. The cause of the disease is still unknown. Its basic pathological change is congenital capillary contraction defect, which is characterized by thin blood vessel wall. Some hairs are only composed of a layer of endothelial cells on the walls of blood vessels, arterioles and venules, and are only surrounded by a layer of muscle-free and inelastic connective tissue, which makes blood vessels unable to contract, makes blood vessels, arterioles and venules expand like hemangioma, and can cause arteriovenous fistula. Some patients have abnormal coagulation, and the fibrinogen activator components in the tissues around capillaries increase, which increases the fibrinolytic activity and leads to bleeding. Most of them start from childhood, and the incidence increases with age. Typical lesions are: punctate bright red or purplish red spots papules. Generally, the diameter is < 4~5mm, and it can also show linear or spider-like telangiectasia with clear boundaries, which is white after compression and can recover quickly after loosening. This skin lesion is persistent and cannot be solved by itself. Typical diagnostic skin lesions are cluster of the back of the hand, tiny telangiectasia and purplish red or bright red spots. Skin usually occurs on the face, ears, upper torso, nail bed, lips, tongue, nose and mucous membrane. It can also involve digestive tract, liver, spleen, lung, meninges, brain and other internal organs. Nosebleeds are the most prominent, especially in early childhood, and repeated nasal congestion can lead to severe anemia. The degree of bleeding varies. The focus is slightly smaller than 1~4mm, slightly prominent, and the bright red punctate or linear capillaries in the nose are actually small fistulas connecting tiny veins. Local bleeding occurred after rupture, followed by punctate telangiectasia of lip margin, soft palate, buccal mucosa, tongue base, tongue margin and tongue base. , may also occur or bleeding. If the internal organs are involved, they can cough up blood, vomit blood, urinate blood and stool blood, and subarachnoid hemorrhage. For example, lung 1 has symptoms such as dyspnea, purple mood, erythrocytosis and finger-like.

Pathologically, large and irregular thin-walled blood vessels can be seen in the telangiectasia area of the skin. Laboratory examination showed that anemia could be aggravated by repeated bleeding, and the coagulation test was normal. There is pulmonary arteriovenous fistula, peripheral blood picture shows that erythrocytosis, coagulation time and platelets are normal, and coagulation factor V can be slightly reduced. Repeated nosebleeds in childhood gradually develop into telangiectasia on the skin mucosa and even visceral bleeding. Experiment: No special abnormality, obvious family history, generally not difficult to diagnose.

☆ Classification and etiology of telangiectasia

Telangiectasia is generally divided into two categories: primary and secondary.

Primitive, mostly genetic, parents blush.

The causes of secondary telangiectasia are very complicated, mainly as follows:

(1) climatic and environmental factors, living in a harsh living environment for a long time, such as thin air at high altitude and lack of oxygen in the skin, lead to an increase in the number of red blood cells and compensatory dilation of blood vessels. Over time, vasoconstriction dysfunction will lead to permanent telangiectasia. Or sailors, chefs, farmers and athletes who have been exposed to the wind, sun, cold and heat for a long time.

(2) Hormone-dependent telangiectasia is often the sequela of improper treatment, such as the abuse of topical facial drugs (such as Fusong, Piyanping and Pikang Cream).

(3) Stimulation of physical factors, such as temperature change, makes the tolerance of capillaries exceed the normal range, causing capillary dilation and rupture. Excessive sunlight, chronic actinic dermatitis, dry skin, etc.

(4) Abuse of cosmetics or long-term "monthly skin care" and improper skin change cause sequelae. The acidic components of skin substitute products destroy the protective effect of the stratum corneum and the elasticity of capillaries, leading to the expansion or rupture of capillaries.

(5) Complications of some local or systemic diseases, and certain skin diseases (such as rosacea). There are also some people whose reasons are unclear. With this kind of skin disease, it is easy for the face to turn red. For example, when you are hot, emotional, strenuous exercise, or drinking alcohol, not only the color will deepen, but also the whole face will flush (that is, red face and Guan Gong face), which is difficult to fade away and affects the appearance. The face of patients with telangiectasia looks redder than normal skin color, and some of them are only red on both sides of the zygomatic region, and the boundary is round, so they are nicknamed "red two groups". This kind of skin is thin and sensitive, and it will turn red when it is too cold, too hot and emotional. It mainly affects appearance, and some people become psychological problems because others often misunderstand that they are too shy.

For people with dilated or ruptured capillaries, special attention should be paid to daily maintenance. When choosing cosmetics, try to choose anti-allergy series and don't change cosmetics easily. For severe telangiectasia, you can go to the hospital for professional "red-dispelling" treatment, or you can take some drugs orally, such as Xiaoyao Pill and Buzhong Yiqi Pill. Usually drink less, eat less blood-activating drugs and food, and drink more chrysanthemum tea.

☆ Past treatments and shortcomings

Telangiectasia has long been a difficult problem in dermatology. Before the invention of new laser, cryotherapy, high frequency electrotome therapy and isotope radiotherapy were commonly used. Although some of these methods can achieve a certain curative effect, they are easy to cause serious complications, such as ulcers, scars, radiation necrosis and so on. , can not achieve the ideal cosmetic effect, beauty lovers can not accept.

High-tech laser treatment of telangiectasia.

Recently, there has been a leap in the treatment of telangiectasia, which is treated with a laser therapy machine with a wavelength of 585nm. The principle of laser treatment of vascular skin injury is mainly to use oxygenated hemoglobin to selectively absorb a certain wavelength of laser, resulting in highly selective destruction of vascular tissue. In addition, the intense pulsed photon rejuvenation instrument can obviously improve the telangiectasia, which is proved to be a safe and simple treatment method in practice. After treatment, the skin is intact, which brings good news to the patients.

☆ Possible problems and solutions after treatment with new laser instruments or strong light instruments.

(Because the skin lesions are superficial, the treatment is simple and quick, and there are generally no complications after operation. A few patients may have the following complications):

1, soft tissue edema: it often occurs in eyelids and face and usually subsides within a few days.

2. Pigmentation: A few patients have mild pigmentation reaction after laser treatment, and generally do not need treatment. When necessary, 0.025% to 0.05% tretinoin ointment and hydroquinone cream can be used to accelerate pigmentation.

3. Disease recurrence: Re-opening of blood vessels within 2-4 weeks after treatment leads to disease recurrence. Recurrent patients can be treated for the second time, and the second irradiation range should be slightly wider and deeper than the first one.

This kind of skin disease, conventional treatment is usually ineffective, and drugs have little effect. Because the lesions are usually deep in the skin, conventional treatment (such as freezing and electrolysis) is difficult to remove. If the treatment is too shallow to remove the focus, if you want to reach the ideal depth of treatment, you will definitely leave scars. Due to the lack of medical knowledge, some beauty salons in the society use masks for monthly care, hoping to get rid of the expansion of capillaries. This is impossible, but it will get heavier and heavier.