Hirudotherapy in ophthalmology (treatment of eye diseases with medicinal leeches)

The principle of action of leeches against wrinkles on the face

The glands of medicinal leeches secrete compounds that are ideal for use in cosmetology. They improve skin structure, microcirculation, local blood circulation, increase its elasticity and oxygenation (oxygen saturation). Hyaluronidase and collagenase elastase, components of leech saliva, act as agents that reduce tension and enhance the penetration of other compounds from the salivary glands into the skin tissue. A substance similar to histamine dilates blood vessels, increasing local blood circulation.

Medical leech (Hirudo medicinalis) is a type of annelid worm used in medicine and cosmetology.

Today, there are ointments and creams on the market with active extracts of leeches, but they cannot replace the natural enzyme hirudin, which penetrates into the blood only during a hirudotherapy session.

Along with anticoagulants, lipids and proteins also enter the skin as part of a powerful group of salivary compounds. The largest group is formed by phosphatidic acids and free fatty acids. Along with lipids, enzymes are released, such as phospholipases and lipases, which play an important role in the restoration of phospholipid membranes of skin cells and have a therapeutic and protective effect during the healing of wounds after leeching, which extends to surrounding tissues.

The therapeutic effect of a hirudotherapy session acts in 3 directions:

• reflex - medical leeches are placed on the skin of the face not randomly, but in the area of ​​​​biologically active points, or so-called points of youth, corresponding to the projections of internal organs responsible for blood supply and microcirculation;
• mechanical - when feeding, leeches act similar to the method of therapeutic bloodletting, unloading the blood flow and stimulating the production of new blood cells; as a “side effect”, blood pressure is normalized and the work of the heart muscle is facilitated;
• biological - it contains the main therapeutic and rejuvenating effect - the release of the unique secretion of hiruda, which contains a lot of natural biologically active substances.

Indications for the use of hirudotherapy in cosmetology

Treatment of cosmetic skin defects, including the first signs of aging, has no age restrictions. Anyone can enjoy the benefits of hirudotherapy for facial rejuvenation, regardless of gender. The use of leeches in cosmetology helps reduce or eliminate defects such as:

• unsatisfactory cosmetic condition of the skin (tired appearance and dull complexion, swelling, the first signs of age and photoaging);
• deformation of the oval face, double chin, drooping eyelids;
• early small wrinkles in the eye area, upper lip;
• spider veins (telangiectasia);
• hyperpigmentation.

Today, hirudotherapy is widely used in plastic surgery to improve blood circulation in a skin graft or other defects resulting from corrective surgery.

At the same time, the overall condition of the skin will significantly improve and defects such as:

• scars from acne, post-acne rash (post-acne);
• acne and pustular diseases;
• some dermatological diseases, including those of an autoimmune nature (atopic eczema/dermatitis syndrome, psoriasis).

What is a leech?

Leeches are a type of annelid and are blood-sucking ectoparasites (“ecto-” means “outside”). In total, about 400 species of leeches are known. However, in medical practice only the medical leech and its two subspecies are used: pharmaceutical (Hirudina officinalis) and medicinal (Hirudina medicinalis). The leech bites the skin to a depth of 1.5 mm and sucks blood in a volume of 5-15 ml. The same amount of blood flows from the bite site subsequently (over the next 3-24 hours). In one treatment session, usually from 5 to 7 individuals are assigned.

How does a hirudotherapy session work?

Before prescribing hirudotherapy, the doctor examines the face to make sure there are no open lesions (ulcers, wounds). It is recommended to review any medications you are taking that increase the risk of bleeding or decrease the immune response. Caffeine should be avoided during and until completion of therapy to reduce the risk of vasospasm. Smoking and the use of nicotine substitutes are contraindicated during therapy due to the vasoconstrictor effects of carbon monoxide and nicotine.

Carrying out the procedure

The recommended course of rejuvenating procedures is 6–10 sessions of hirudotherapy with breaks of 3–4 days. The patient's position during the session should be as comfortable as possible for a comfortable stay for an hour. The algorithm of actions of a hirudotherapist is approximately as follows:

1. Before applying the leech, the skin is washed with neutral soap and rinsed with sterilized water. Wipe dry.
2. The therapist wears medical gloves and uses a pair of long, non-toothed forceps to remove the leech from its container. This is easier to do immediately after removing the container from the refrigerator, when the leeches are relatively docile.
3. Then the leech is placed in a 5 cm plastic syringe (with the tip previously removed) and inverted over the treatment site.
4. When the leech has attached itself, the syringe can be removed. To prevent the leech from moving and to calm the patient, you can use a soaked cotton ball and place it under the leech's body.

The leech is planted on a specific area of ​​the face using a plastic syringe

If problems arise with attachment, the doctor may make a small puncture of the skin. The released drop of blood will stimulate the attachment of the geruda. The medicinal leech has three jaws with tiny teeth, with which it pierces the human skin and injects its own saliva, which has a healing effect. After the leech has finally attached and the sucking process has begun, the patient may feel a slight local burning sensation similar to a nettle burn. But after a few minutes, the natural pain-relieving components of saliva begin to act and the discomfort stops.

The leech releases about 60–70% of its medicinal substances in the first 10–15 minutes of the session. But in order for the patient to receive the full dose of enzymes, the procedure should last about 45 minutes. During this time, one leech manages to suck up to 15 ml of blood, after which it independently detaches from the wound. In case of reluctant detachment of the leech, use a 5% solution of benzoylecgonine externally to paralyze. Forced removal of a creature with tongs is never used.

A persistent reluctance of a leech to attach or detach indicates dying tissue or insufficient tissue nutrition.

Bite wounds will bleed for up to 10 hours after completion of the session, which is normal after the administration of hirudin, which has a blood thinning effect. During this time, the skin should be regularly washed with a disinfectant solution or protected by applying an aseptic dressing. After a few days, the wounds gradually close and then disappear without a trace, leaving no marks or scars.

Leeches should never be used repeatedly, even on the same patient, to avoid the transmission of bloodborne infections. After one-time use, leeches are disposed of as biohazardous waste. They are destroyed by immersing them in a 7% ethanol solution for five minutes before euthanizing them with 70% ethanol alcohol.

What is hirudotherapy?

Hirudotherapy (from the Latin “hirudo” - leech) - treatment with leeches.
It was used a thousand years before the birth of Christ. Medical leeches were used by the Egyptian pharaohs; leeches are mentioned in both the Bible and the Koran. Later, the great doctors Hippocrates, Galen and Avicenna eased the suffering of their patients with the help of leeches. In medieval Europe, leeches were considered a proven and officially recognized treatment for many diseases. In 1665, a scientific treatise was even published entitled: “On the application of leeches to the internal parts of the uterus.” Apparently, it was from this moment that leeches began to be widely used in gynecology. Hirudotherapy began to be used especially widely towards the end of the 18th and first half of the 19th centuries. However, then doctors were so carried away by the healing properties of leeches that they overdid it: they prescribed them for all diseases and charged 200 of them per session. The uncontrolled use of leeches gradually discredited the very idea of ​​hirudotherapy, and by the beginning of the twentieth century, many doctors abandoned this method of treatment. Today, there is a new surge of interest in leech treatment all over the world. And this is not a tribute to fashion, but a sign of a person’s reasonable and careful attitude towards his health.

Possibilities of hirudotherapy in cosmetology

The complex therapeutic effect of using leeches on the face is externally noticeable after 1–2 sessions. Hirudotherapy helps smooth out wrinkles on the face, eliminate bags under the eyes and general swelling (pasty), reduce fat deposits in the form of a double chin, and get rid of unsightly age spots. The tone and elasticity of the facial skin increases, a healthy color and natural glow appear.

Hirudotherapy is a natural and safe way of facial rejuvenation

Using leeches at home

Experts, as a rule, recommend resorting to the services of professional hirudotherapists, who know many of the nuances and subtleties of the procedure. However, if you have certain knowledge and experience, for example, having undergone a course of hirudotherapy from a specialist in the past, you can try to conduct a rejuvenation session yourself at home. In this case, a preliminary consultation with the attending physician is required to exclude contraindications to the procedure. It is better to purchase leeches for home use in specialized pharmacies, which guarantees their safety.

It is first recommended to familiarize yourself with the classic options for applying them to the face for the purpose of a rejuvenating effect. However, it may turn out that using this therapeutic method on your own face is not very convenient. In addition, hirudotherapists categorically do not recommend installing leeches on the area around the eyes yourself. It is important to avoid areas where large arteries or veins anatomically pass. This procedure requires a reserve of patience and the development of the appropriate skill, which comes with experience. Therefore, it is recommended to start with 1–2 leeches, gradually increasing their number to a maximum of 5–7.

Where do they get leeches?

Of course, no one catches medicinal leeches with a net in a pond, like Duremar in the fairy tale about Pinocchio. If only because in the wild they swim dirty, lazy and well-fed. Medicinal leeches are bred in special medical laboratories and then sold in pharmacies.

During a hirudotherapy session, hungry leeches are placed on the area of ​​the organ that needs to be cured: on the area of ​​the heart, liver, along the affected vessels, etc. The placement of leeches should be carried out under the supervision of a doctor, since only he can correctly determine the point of influence and the number of leeches.

Contraindications and possible consequences of leech bites

Like any therapeutic procedure, hirudotherapy has its limitations. Contraindications to the use of the method include:

• blood clotting disorders (thrombocytopenia, hemophilia);
• postoperative period, when the risk of bleeding is increased;
• tumor process of a malignant nature (any localization);
• anemia with a hemoglobin level below 110 g/l;
• hypersensitivity reaction to one of the components of leech secretion;
• abnormally low blood pressure;
• acute inflammatory process in the body;
• chronic fatigue and physical exhaustion;
• pregnancy;
• toxicosis.

The bacterium Aerophonas hydrophilia lives in the intestines of the medicinal leech, which can pose an infectious threat to patients with weakened immune systems.

The leech's intestines contain the bacterium Aerophonas hydrophilia, which plays an important role in the digestion of the annelid. The presence of these bacteria may cause or complicate local or systemic infections, which should be considered before initiating therapy. A fifth of patients may develop infectious complications if they do not receive prophylactic antibiotics. Aeromonas hydrophilia is usually sensitive to second and third generation cephalosporins, Chloramphenicol, aminoglycosides, fluoroquinolones and Trimethoprim. Penicillins and first-generation cephalosporins are ineffective against this microorganism.

Dispelling myths

It must be said that the advisability of using hirudotherapy in cosmetology is perceived ambiguously by women. Let's look at the features of the procedure and dispel common myths about hirudotherapy.

• It's unhygienic! It should be noted right away that salons use only sterile medicinal leeches, since natural inhabitants can indeed be carriers of infections. After the session is completed, the used leeches are disposed of; in many salons, disposal is carried out in front of the client, so that there is no doubt that disposable material is used. But all of the above applies only to salons that value their reputation. Doing the procedure at home with an unverified specialist is strictly not recommended.

• It's disgusting! Indeed, many women cannot overcome their disgust towards leeches. But the procedure will last at least half an hour, during all this time you will have to endure “these vile creatures” on your face. Therefore, it is worth weighing in advance what is more valuable to you – beauty or the absence of discomfort from contact with leeches. And then make an informed decision.
• It hurts! In fact, the leech bite is practically not felt, because when the skin is pierced, it injects its secretion containing anesthetic substances. During the procedure, you may feel a slight burning and tingling sensation, but you will not experience any pain.
• After the procedure, noticeable marks remain on the skin! Indeed, at the sites of bites, wounds remain, around which the skin may turn red and slightly swollen. But the swelling will go away within the first three days. And after a week, not the slightest trace of the procedure will remain on the skin. However, it should be borne in mind that skin reactions are individual, so before the first session it is recommended to leave one leech in some inconspicuous place (for example, behind the ear) to see how strong the swelling will be and how long the wound will heal.

Advantages and disadvantages of hirudotherapy over other types of rejuvenation

One of the main advantages of the method is the absence of significant side effects on the body, as from the use of any chemical or medicinal anti-aging procedures. A bonus to natural rejuvenation are anti-inflammatory and immunostimulating effects, normalization of fat metabolism in problem areas of the face and neck.

The disadvantages include:

• increased risk of bleeding as a result of administration of the blood-thinning enzyme hirudin;
• the possibility of infectious infection, which is important in the case of using not pharmaceutical artificially grown leeches, but worms from the wild.

Provided that basic safety measures are observed, taking into account individual contraindications, a hirudotherapy session is an absolutely reliable procedure.

How do leeches help with glaucoma?

The ability of leeches to restore microcirculation is extremely important for glaucoma. Bradykinins and histamine-like substances dilate blood vessels. Hirudin, destabilase and a number of other enzymes thin the blood and dissolve blood clots.

Hyaluronidase ensures better penetration of leech secretions into tissues. Apyrase cleanses blood vessels of cholesterol deposits. Eglins relieve inflammation. Kininase reduces pain.

The complex action of 200 biologically active substances stimulates a powerful drainage effect and outflow of intraocular fluid. Lymph microcirculation is restored, swelling subsides, and intraocular pressure is normalized.

Myths and reality of hirudotherapy

Most people tend to go to extremes: they either overestimate the expected effect of hirudotherapy, or, on the contrary, deny possible positive changes in facial appearance from the effects of leeches. Below are some of the most popular myths regarding the procedure:

1. Any defect or age-related changes in the skin can be eliminated with the help of a course (or several) of hirudotherapy. Such reasoning is incorrect. Many processes and diseases occurring in the body are genetically programmed or caused by a deficiency of certain microelements or other nutrients in the blood. In this case, the action of hirudotherapy alone is simply not enough, and leeches can only be considered as an addition to more radical solutions, for example, plastic surgery.
2. Too frequent sessions of hirudotherapy with a large number of leeches can lead to death from blood loss. In fact, it is difficult to accurately determine the maximum number of leeches that could become critical for a patient. Modern hirudotherapists say that you should not use more than 40 leeches in one session if we are talking about large areas on the body. In cosmetology, up to 10 pieces are most often used simultaneously. This amount is completely safe and does not threaten any serious blood loss. As for the optimal number of leeches in one session, expert opinions differ diametrically. Some consider it permissible to use no more than 5-7 leeches at a time, others believe that it is permissible to install up to several dozen worms at the same time. Of course, the second approach is allowed only in specialized hirudotherapy clinics. At home, it is allowed to install no more than 5–7 leeches.

   Experts recommend using no more than 5–7 leeches, provided that you independently conduct a hirudotherapy session at home

3. Medical leeches can be placed on any part of the face and body. According to biologists, the leech itself finds reflex points, which are the energy “points of youth.” But professional hirudotherapists refute this, claiming that a leech can attach itself to absolutely any warm place on the skin, provided there is no thick hair. They do not recommend allowing the leech to choose the location of its bite on its own. Instead, you should limit the suction radius with a syringe or glass flask, with the help of which the creature is placed on a particular area of ​​the face or body.
4. Leeches are slippery and disgusting creatures and it is very unpleasant to carry out any procedures on yourself with their help. It is difficult to argue with the fact that a leech is not as beautiful in appearance as a butterfly. It is difficult to get aesthetic pleasure from it. But you should also not expect that before the bite, the leech will crawl back and forth across your face, choosing the ideal place for “lunch.” Doctors apply leeches to certain points, preventing them from moving at all. And after the procedure, living “healers” are disposed of for safety reasons. Therefore, it is worth focusing on treatment and getting a positive result, instead of imagining unpleasant worms.
5. The hirudotherapy procedure is painful. A leech bite is comparable in pain intensity to a mosquito bite. For most people this is quite tolerable. Natural anesthetics, which are also present in leech saliva, soon begin to act and the patient ceases to feel even slight discomfort.
6. Any leech is suitable for use in therapy. In fact, only one type of leech is used to treat people - the medicinal leeches (Hirudina medicinalis). But even among representatives of the “right” species, finding the right specimen will not be easy. The leech should be smooth, with a flat body and a pointed head. It is desirable that it be greenish in color and always have orange stripes and black dots on the back. Any other leeches are not suitable for use in hirudotherapy.

Carrying out the procedure

The hirudotherapy procedure must be carried out in specialized clinics, in a fully equipped and sterile office, equipped with chambers for storing leeches, and the patient has the right to ask the doctor to demonstrate a diploma of medical education and a certificate for biomaterial.

After the first session of hirudotherapy, you may feel drowsy, so it is better to book an appointment in the evening.

Sensitive people need not worry: the intensity of pain during hirudotherapy can be compared to an ant bite or a subcutaneous injection. The pain does not last long while the leech is busy cutting the skin. This will take about ten seconds. In addition, leech salivary secretions contain substances that have anesthetic properties.

A rejuvenation session consists of several stages:

1. Before the “execution” begins, the patient must take a comfortable position and relax, because it is not known how long the session will last, 15 minutes or an hour - it all depends on the appetite of the hungry leech.
   

   A rich appetite, developed muscles and physical activity are sure signs of a “correct” leech.

2. First, the doctor will disinfect the manipulation area with alcohol, and then rinse with hot water to eliminate the odor.
3. They place leeches on certain biological points, but leave them the freedom to choose the most attractive place with the thinnest skin within a radius of two centimeters.
   

   If for some reason the leeches are in no hurry to begin fulfilling their direct duties, the site of the intended impact can be warmed up and massaged for blood flow, or careless “healers” can be seduced with a glucose solution applied to the surface of the skin - they cannot resist sweets.

4. The bloodsuckers feast to their heart's content, disappearing on their own. There is no need to tear them off and, moreover, it is dangerous. Such unceremonious actions in the midst of a bloody feast can cause stress in the leech, followed by an eruption of carefully sucked out “bad blood.” This is fraught for the patient with the occurrence of inflammation (all harmful substances will return to the blood) or the subsequent formation of a scar. To make the leech fall off ahead of time, the doctor can lubricate the surface of the skin with alcohol or iodine.

   The leech has two suckers, three jaws and 270 chitinous teeth with which it greedily bites into human flesh to a depth of 2 mm - it is not so easy to tear it off the skin

5. After finishing the meal, the doctor applies a sterile napkin for 15 minutes, and then changes it to a tampon, which is secured with a bandage to stop the bleeding.

Attention! Hirudotherapy uses medicinal leeches grown in laboratory conditions - their relatives caught in the nearest pond are not suitable for rejuvenating and healing procedures because they can cause blood poisoning. For the same reason, “used” leeches are disposed of, because they are unsuitable for reuse.

Video: stages of the procedure

Impact points

When fighting wrinkles, a lifting effect can be achieved by placing the blood-sucking ones pointwise, symmetrically on both sides of the face:

• along the hairline;
• behind the ears;
• at the outer corners of the eyes;
• in the cheek area (in the area of ​​the 5th–6th tooth of the upper jaw);
• on the inner edge of the eyebrow;
• in the submandibular zone;
• on the collar area.

Leeches are attached to the same points as during acupuncture

Attaching leeches to certain acupuncture points causes pleasant side effects in the form of indirect stimulation of other organs; at the same time, to activate renewal processes in the skin, some doctors use biologically active points in the area of ​​the liver and coccyx.

Due to the danger of bleeding, you cannot place leeches in areas with nearby (at a depth of less than 1 cm) superficial vessels; in addition, even knowing the points of influence, it is strictly forbidden to attach leeches yourself - this can lead to unpredictable consequences.

Course duration

The course of rejuvenation is usually about 10–14 procedures, but if there are no obvious signs of aging, then you can limit yourself to five visits to the hirudotherapist’s office. Sessions are carried out every other day to give the body time to recover from the effects of foreign substances. The rejuvenation course can be repeated after three months.

After each appointment, the patient’s condition is carefully monitored by the doctor. Any hemodynamic deviations from the norm serve as a reason to discontinue the course of treatment.

The effect of the rejuvenation procedure

The hirudotherapy procedure has a positive effect on the quality of the skin, stimulating the body's natural regenerative processes. As a result:

• the skin regains lost firmness and elasticity;
• facial muscles are tightened;
• improves complexion;
• skin texture is evened out;
• fine wrinkles and nasolabial folds are smoothed out;
• the oval of the face and the upper eyelid are tightened;
• the corners of the lips rise.

A properly performed procedure can have an effect comparable to a circular facelift, and as a pleasant bonus, the patient will receive skin free from age spots, scars, cicatrices, swelling, rosacea (spider veins) and inflammation

It is widely believed that hirudotherapy puts the nervous system in order, increases performance, normalizes sleep and the emotional sphere, and improves mood. Ladies who have experienced all the delights of hirudotherapy will be able to see this for themselves when they see their own rejuvenated reflection in the mirror.

Efficiency

Already after the first sessions of hirudotherapy, positive dynamics are observed. However, a lasting anti-aging effect can be achieved only after a few weeks or months, and its duration, depending on the age and skin type, reaches from six months to a year.

To consolidate the result, you can use face creams with leech extract, which, when used regularly, provide a cumulative effect. Hirudotherapy can be supported by salon procedures - biorevitalization, mesotherapy, peelings, professional facial cleansing.

Price issue

The cost of the procedure may vary, but on average, a therapeutic placement of one leech costs from 200 to 500 rubles, and a trial, including a consultation with a hirudotherapist, costs about 1 thousand rubles. The total price of a course of treatment depends on its duration and the number of individuals.