Cellulitis

Cellulitis is changes in the skin and subcutaneous fat as a result of disorder of microcirculation and lymphatic edema. The intensity of cellulitis can vary from the insignificant aesthetic changes of the skin to a serious dysfunction of the extremity and the pain syndrome. It should be especially mentioned the acute indurated cellulitis with the fascio-compression syndrome that can result in the loss of the extremity without an adequate treatment.

The so-called cellulitis is the first step to appearance of great problems in the structure of body tissues. Due to mass media cellulitis is associated with aesthetic problems requiring mainly ointments and creams. But it is not so, cellulitis is the initial form of lymphostasis.

Skin - outer covering of the body that protects the body from the many external influences.

The skin consists of epidermis, derma and subcutaneous fat (hypoderm). It is the external integuments of the organism protecting the body from a wide spectrum of external influences.

The skin participates in breathing, thermoregulation, metabolism, different types of surface sensitivity (pain, pressure, temperature) and many other processes. Elastic, collagenous and smooth muscle fibres give a high strength and elasticity to the skin.

Subcutaneous fat consists of bunches of the connective tissue and fat cells (adipocytes) pierced by blood vessels and nervous fibres.

For normal skin the presence of a great amount of fat cells (adipocytes) of a small size is characteristic, they are forming groups in the "fatty lobules" surrounded by collagenous and reticular tissues. Fat cells are surrounded by arterial, venous and lymphatic microcapillaries, through which lipids enter the blood and feed tissues of the organism. There are also nervous receptors and nervous conductors, their functions are regulated with the help of them.

A few stages of cellulitis development are distinguished:

• The first stage is edema - congestion of liquid between the cells. It is a relatively "soft cellulitis".
• The second stage is hardening of fibres of the connective tissue. The inflow and outflow of blood and lymph gets worse at the capillary level (the skin loses its elasticity). The skin changes its colour.
• The third stage is liposclerosis. It is very often accompanied by dermosclerosis. Skin integuments are dense. Pigmentation appears. The blood circulation in the skin and subcutaneous fat are considerably disturbed. This stage is often characterized as "hard" cellulitis.
• On the fourth stage nodulation is greater, nodules combine into conglomerates and are the source of pain when touching and pressuring. Ulcers can appear. Often infection is also possible.

The classification given is very conditional. Simultaneously there can be different processes in the neighbouring areas of the skin and subcutaneous fat. The closer to the foot, the worse arterial, venous and lymphatic capillaries are. The worse the blood supply of tissues is. The more rapidly trophic changes of tissues develop.

TREATMENT

The main condition of success is normalization of the blood circulation in tissues. Increasing the arterial blood inflow and improving the outflow of the venous blood and lymph we provide renewal of metabolic processes. At the same time correction of hormonal, water, fatty, electrolyte exchange, etc. is necessary.

With the help of special methods (apparatus and medications) we increase the bloodstream in tissues up to 1000 %. The result is the improvement of quality of the skin and subcutaneous fat, decrease in volumes of extremities and thighs, restoration of the blood circulation in tissues, normalization of the skin's natural colour, disappearance of pains, discomfort, wonderful aesthetic appearance.

PAY ATTENTION! Every rough, hard manipulations with the skin and subcutaneous fat result in the rather bad consequences. For example, when performing massage with cups, vacuum, etc., incorrectly, the strain of weak fibres of the connective tissue and the damage of the capillary bed (appearance and worsening of reticular varicosity, worsening of lymphostasis) occur.

Treatment and prevention:

One of the most important terms is healthy lifestyle. Nutrition of full value (it is that what is spoken about everywhere and many times; both overnutrition and undernutrition affect the organism, including the skin. Starvation and becoming thin are both not good.). Giving up harmful habits (smoking, alcohol). Adequate physical loadings (swimming is the most beneficial).

Apparatus treatment: The most and the best effect in cellulitis and lymphostasis is achieved by lymph drainage. Manual lymph drainage is a myth, it is simply a massage. But massage is also good. Simply it is necessary to call everything by own names. Now there are a lot of apparatuses for pneumomassage at the market.

We use world-recognised apparatuses and they are practically in all clinics of the world. They are Lympha Press® and Phlebo Press®. The apparatuses are both for work in clinics and for home application.

Medicines used in cellulitis: Unfortunately, efficiency without complex treatment is very low. When a patient thinks that if he applies a cream and takes a tablet, his skin and subcutaneous fat will become ideal, then he is mistaken. Only the course of treatment under the supervision of a specialist can give an effective result.

Medicines for cellulitis and lymphostasis (they are only of auxiliary importance):

Phlebotrophic medicines. In complex therapy of lymphedema different medicines of this combined group are widely used:

Vasoket; Detralex (Dyosmine + Hesperidine); Dyovenor; Dyosmine; Flebodia, Daflon, etc.

Troxerutin and (Troxevasin), Paroven, Venorutone, etc.;

Escine, Venastat, Escusane, Aecine, etc.

Combined medicines are Cyclo 3 forte, Gyncor forte, etc.

Anticoagulants (medicines decreasing blood coagulability). Hirudotherapy (treatment by leeches) should be referred to this group as well. It can be stated that there are no reliable data about the effect this group of medicines in cellulitis and lymphostasis. But these medicines may be often harmful as the blood coagulation system should be under control when prescribing them. I do not speak about those cases when indeed it is necessary to correct the coagulation system (thrombosis, thrombophlebitis).

Diuretics. They have a rapid effect when treating peripheral edemas. Medicines of this group are used by strict indications and under the supervision of your doctor.

In the case of infection the antibacterial therapy is conducted when infection of soft tissues of the diseased extremity develops. Medicines that are tropic to the most frequent pathogens of these infections - gram-positive cocci - are usually prescribed intravenously in severe inflammation of subcutaneous fat (erysipelas), lymphangitis and bacteriemia.

Medicines of the most different groups and mechanisms of action such as pentoxiphyllin, vitamin Е, proteolytic enzymes, etc. may be prescribed in cellulitis and lymphatic edema; however, their indication is stipulated by theoretical preconditions and is not proven to be correct in practice.

Various gels and ointments. The most effective is a gel with heparin - Lioton 1000 gel. In my opinion, Lioton 1000 gel is the most effective medicine with the transdermal action, which improves microcirculation in the skin and subcutaneous fat.

Gels with horse-chestnut extract (aescine) possess the venomotor action.

Pay attention that any gel, cream, ointment, paste, etc., except the base (gel, ointment, etc.) and active substance, has a number of additional concomitant components. Allergy can develop to any of the components. Any gel (cream, ointment) should be applied on a clean, undamaged skin. Any medicine is prescribed by a doctor taking into account the peculiarities of your organism and the stage of the disease. The medicine that has helped your relative (your neighbour, friend) can do harm to you.

Conclusion: The treatment of cellulitis and the treatment of lymphostasis (at initial stages) do not differ at all. The complex treatment (apparatus and medicinal) directed to normalization of lymphatic outflow from the skin and subcutaneous fat, normalization of the metabolic processes in them leads to renewal of the skin structure, decrease of the body shape. Elasticity of the skin improves. Flabbiness of the skin disappears.