#microbioserum

Collagenase preparations have been used in the treatment of non-healing wounds in diabetic patients, particularly in the context of diabetic foot ulcers. Collagenase is an enzyme that breaks down collagen, which is a major component of the extracellular matrix in wounds. By degrading the collagen, collagenase can help remove devitalized tissue, promote wound bed preparation, and facilitate the healing process.

The effectiveness of collagenase preparations in diabetic wound care has been evaluated in various clinical studies and systematic reviews. Overall, the evidence suggests that collagenase can be beneficial in certain cases, although individual responses may vary.

One randomized controlled trial published in 2013 compared the use of collagenase with a placebo in patients with diabetic foot ulcers. The study found that collagenase treatment resulted in a higher proportion of wounds achieving complete closure compared to the placebo group. Additionally, collagenase was associated with a shorter time to complete wound closure.

Another systematic review and meta-analysis published in 2018 examined the use of collagenase in diabetic foot ulcers specifically. The analysis included several randomized controlled trials and concluded that collagenase was effective in promoting wound healing and reducing the time to healing. The review also noted that collagenase appeared to be safe and well-tolerated.

It's important to note that collagenase preparations are typically used in conjunction with standard wound care practices, such as regular wound cleansing, appropriate dressings, offloading pressure from the wound, and managing underlying factors like blood glucose control. The exact protocol and treatment duration may vary depending on the individual patient and wound characteristics.

Studies evaluating the wound healing rate when using collagenase preparations have shown positive results in various types of wounds. Here are some key findings from clinical studies:

Diabetic Foot Ulcers: A randomized controlled trial published in The New England Journal of Medicine in 2012 compared collagenase treatment with placebo in patients with diabetic foot ulcers. The study found that the collagenase group had a significantly higher incidence of complete wound closure compared to the placebo group (37% vs. 19%). The time to complete wound closure was also shorter in the collagenase group.

Venous Ulcers: In a randomized controlled trial published in JAMA Dermatology in 2013, collagenase treatment was compared with placebo in patients with venous leg ulcers. The study reported a higher rate of wound healing in the collagenase group compared to the placebo group (70% vs. 46%). The collagenase-treated ulcers showed faster healing, with a shorter median time to complete wound closure.

Pressure Ulcers: A study published in the Journal of Wound Care in 2019 evaluated collagenase treatment in patients with pressure ulcers. The results showed a significant reduction in wound size and a higher proportion of wounds achieving complete healing with collagenase treatment. The study concluded that collagenase was effective in facilitating wound healing in pressure ulcers.

Surgical Wounds: Collagenase preparations have also been studied for their effectiveness in surgical wound healing. A randomized controlled trial published in the Annals of Plastic Surgery in 2018 compared collagenase treatment with standard care in patients with surgical wounds. The study found that collagenase treatment resulted in faster wound healing, reduced wound surface area, and improved overall wound appearance.

It is difficult to give an exact answer "How often" - often. Not only Covid as a disease, but also drugs to treat Covid negatively affect hair, especially antibiotics and hormonal drugs. After Covid, hair begins to fall out in many people, especially the elderly. Why? This is largely due to the destruction (decrease in thickness) of the mucous membranes and, in particular, to the drying of the hair follicle. It is necessary to restore the mucous membranes of the body. One possible way is to use polyamines (spermidine) as a hair serum and/or orally.

1. Why does irritation and inflammation occur?

A mask that is attached to the face causes friction and squeezing in areas of tight contact - usually the bridge of the nose and under the eyes. If you wear the mask for a long time, red streaks, abrasions, irritation and even small wounds and abrasions may appear on these areas of the skin. If the mask has to be worn every day, then the skin does not have time to recover from damage and irritation progresses, occupying an ever larger surface and causing discomfort. In fact, these irritations can be compared to calluses on the feet - areas of hardened skin appear as a result of the same pressure from uncomfortable shoes.

2. Another problem is inflammation

Any friction and irritation causes damage to the skin, which facilitates the penetration of bacteria and dirt into the skin. This causes inflammation ("maskne"). Typically, these pimples are localized in the chin, nose and cheeks. Sweat and moisture, which are especially active under the mask, accumulate on the skin and clog the pores. Even our own breathing can lead to the appearance of a mask: with each exhalation, the moisture under the mask increases, creating a greenhouse effect. Increased humidity affects the pH of the skin, and this can lead to more active growth of bacteria and the appearance of inflammation.

3. How to avoid maskne?

To prevent inflammation, you need to change your daily skin care routine and carefully choose the mask you wear every day. If it is a reusable protective dressing, then a mask made of silk or with a silk lining is better. Firstly, this material is suitable for people with sensitive skin and has antimicrobial properties. Secondly, silk is highly hygroscopic - that is, it absorbs moisture well (for example, sweat and condensation formed when breathing under a mask). A cotton mask is better than a neoprene mask as it is less irritating to the skin. But dense material absorbs moisture worse, can create a greenhouse effect and chafe the skin. The most common thin neoprene models can increase perspiration and cause mechanical irritation by adhering tightly to the skin.

However, any reusable mask must be carefully processed after each use - both to protect against the virus and to prevent inflammation (oil and dirt accumulated on tissue can cause mask). The reusable mask does not last forever and after a certain number of uses it will have to be replaced with a new one.

Disposable masks can also cause irritation and inflammation, but are safer as they have to be changed more often and discarded after use. Respiratory masks (for example, model 95) are more reliable in protecting against coronavirus, but, in turn, squeeze the area of ​​the bridge of the nose and under the eyes, causing irritation.

4. How to treat maskne?

If inflammation and irritation have already begun, you should add cleansers with anti-inflammatory and soothing ingredients (for example, benzoyl peroxide, tea tree oil, chamomile extract) to your daily skin care.

Use mild exfoliants (exfoliators) several times a week to remove dead skin cells and prevent new inflammation. The inflammations themselves can be treated with anti-inflammatory drugs. It is important not to overdry the skin.

Monitor skin hydration carefully. You can choose a moisturizer with anti-inflammatory ingredients (for example, chitosan, hyaluronic acid, sodium alginate). For example, with niacinamide - it rebuilds the skin barrier by promoting the production of ceramides - proteins that hold water in the skin.

5. Microbioserum preparations for the prevention and treatment of MASKNE:

T1 anti-inflammatory tonic

Keratinase B - cleansing mask (antibacterial)

Propolis-PP - anti-inflammatory serum

Microbiome-S - revitalizing serum

Scar Treatment enzyme complex - acne correction serum

 And of course, change your mask regularly. If the mask is disposable, do it every two hours, it is better to change the reusable one during the day (and wash at home).

1. Collagen pathway of skin aging Collagen polypeptide chains have an increased number of cross-links in old age. During aging, the accumulation of the number of covalent crosslinks in human collagen transforms the protein into an insoluble form. As a result, it accumulates in tissues to the detriment of cells, causing disruption in the functioning of organs and the whole organism. With aging, the amount of soluble collagen in the skin decreases, while the amount of insoluble collagen increases. A study of the tail skin extract of rats aged from 1.5 to 24 months was carried out. As a result, it was found that the number of single collagen α-chains decreased rapidly with age, the number of collagen α-chain trimers increased, and the number of collagen dimers remained constant in all age groups. At the same time, the amount of insoluble collagen increased (see Fig. 1)

2. Equilibrium process of synthesis and destruction of collagen Collagen with elastin and reticulin is a support-structural protein located in the dermis. Collagen is the main component of the dermis (up to 70%) and is the main structural component of connective tissue. This protein, specific in amino acid composition and structure, does not dissolve in water under normal conditions (it only swells). Proteolytic enzymes (pepsin, trypsin, papain) break down only soluble fragments of collagen filaments. Collagenase is an enzyme that is capable of modifying a collagen filament (fibril) into a soluble state due to partial hydrolysis (see Fig. 2). Thus, the aging process of the body is accompanied by the accumulation of insoluble forms of collagen that do not react with collagenase. That is, a certain amount of collagen is removed from the equilibrium process of synthesis and destruction of collagen filaments, and the lifetime (τ) of these molecules increases to infinity. As a result, the number of cross-links in the molecules of collagen that is not reactive with respect to collagenase continues to increase, the collagen matrix of the skin becomes more rigid and, as a result, the elasticity of the skin decreases and the appearance (fixation) of wrinkles. Hard collagen accumulates in the skin and inevitably contributes to its aging. Unchanged collagen fragments continue to participate in the cyclic equilibrium process, synthesizing new unmodified ("young") collagen structures. The total amount of collagen per unit volume of the skin is constant throughout life. Given this, the need for the use and effectiveness of cosmetic preparations with collagen is highly questionable. Let's say we are using a collagen cream composition. It is natural to believe that the molecules of such collagen have practically no intra- and intermolecular cross-links and therefore are quite elastic. The obvious result of applying such a cream to the skin will be a momentary increase in elasticity. However, the effect will disappear immediately after the cream removal procedure (taking into account the skin's permeability limit). High-molecular collagen structures cannot penetrate deep into the skin and will remain on the skin surface. A completely different situation arises when using collagen structures with molecular weights below 100 kDa. Such structures have the ability to cross the transepidermal barrier. On the one hand, they more effectively increase the elasticity of the skin, affecting not only its surface, but also affecting deeper layers. On the other hand, collagen fragments are able to distract the enzyme from interacting with the skin's own collagen matrix and, as a result, the rate of the main reaction decreases - a state known in biochemistry sets in - competitive inhibition of the main process. Such inhibition increases the lifetime of its own collagen structures and, accordingly, the likelihood of the formation of intra- and intermolecular cross-links. All this inevitably leads to the acceleration of skin aging. Thus, the use of preparations with collagen (M.m. less than 100 kDa) can have negative consequences and accelerate the aging process of the skin.

3. Collagenase enzyme as an ingredient in cosmetic preparations If the intrinsic (endogenous) collagenase in the skin matrix begins to "pass" collagen crosslinks with age, then an additional amount of the enzyme must be introduced into the skin. In this case, it is necessary to fulfill the following conditions: - the molecular weight of the enzyme should provide real access to the internal structures of the skin; - injected collagenase should have a lower specificity of action compared to endogenous collagenase of human skin or interact with a wider range of substrates; - interaction with cellular systems should be sufficiently gentle. Such a drug prevents or inhibits the mechanism of skin aging associated with the accumulation of crosslinks in collagen. The molecular weight of the enzyme allows you to reach the area of ​​localization of collagen filaments (papillary dermis). Collagenase cosmetics act on collagen threads together with endogenous collagenase and accelerate the rate of their degradation. The preparation will help to reduce the lifetime of collagen crosslinks and, accordingly, reduce the likelihood of accumulation of crosslinks (wrinkles).