Freelance Writing Jobs | Today's Articles | Sign In

Articles
Writers

Vitiligo Treatment: Frequently Asked Questions

Is the Loss of Skin Color Reversible?

Jul 8, 2009 Hanish Babu

Though not curable, vitiligo is potentially treatable, especially the localized types; and, it is possible to reverse the loss of skin color in a good number of patients.

There are a number of effective medical and surgical or cosmetic treatments for vitiligo, though the treatment outcome is not always predictable. The presence of pigmented hair in the vitiligo patches is a good indication that the white skin in vitiligo may respond favorably to medical treatment.

Which is the Best Treatment for Vitiligo?

The most effective treatment for vitiligo is PUVA or photochemotherapy. This involves oral or topical psoralens to sensitize the skin to ultraviolet rays followed by exposure to UVA, UVB or sunrays. Improved efficacy of PUVA in combination with topical Calcipotriol and minoxidil has been reported.

The management of vitiligo with oral Khellin (instead of psoralens) and UVA was found to be as effective as PUVA therapy with fewer internal side effects and less photo toxicity. Phenyl alanine with UVA also gives good results, though not as effective as PUVA. Treatment of vitiligo with narrow band UVB, broad band UVB, UVB with topical application of pseudocatalase and calcium and salt water baths (as in dead sea) with UVA or UVB exposure are additional effective therapeutic interventions for vitiligo reported by various authors.

What are the Other Medical Treatments Available for Vitiligo?

  • Topical corticosteroids, mild to moderate strength topical steroids are effective in vitiligo, especially in children. High potent steroids like clobetasole dipropionate, betamethasone dipropionate should not be used in children and, in adults, near eyes or body folds. Clobetasone ointment (note the spelling difference-clobetasole is super potent and clobetasone is mild in potency and side effects) is particularly useful and harmless in children and adults if used properly. Before starting this treatment, it is advisable to learn how to avoid side effects of topical steroids.
  • Topical Calcineurin Inhibitors like tacrolimus or pimecrolimus and other immune modulating medications may be used as an alternative to topical steroids. These are less effective, but with fewer side effects. These medications are not to be used in children below the age of 2 years.
  • Vitamin D3 Analogue, Calcipotriol cream / ointment / lotion, was found useful in repigmenting the skin in vitiligo in some studies. Use of topical calcipotriol in combination with PUVA photochemotherapy has been proven more beneficial than PUVA used alone in vitiligo.

What are the Indications for Surgical Treatment in Vitiligo?

  • Surgical or cosmetic intervention is called for in vitiligo if there is no response to treatment over the years.
  • When the color loss in vitiligo is limited to small areas.
  • If the vitiligo has remained stable (without any change) for a period of 2 years (absolute requirement) or more. Surgical techniques are not useful in progressive vitiligo patches.

What are the Surgical or Cosmetic Treatments Available for Vitiligo?

There are a number of surgical or cosmetic treatments available for vitiligo. The most commonly practiced techniques are:

  • Punch Grafting in Vitiligo.Small round areas are punched out to dermal depth in the vitiligo patches and pigmented skin is grafted after taking skin punches from normal skin, usually from the buttocks or thighs of the patient. If done properly by a trained cosmetic dermatologist or plastic surgeon, this gives excellent results, even on lips affected by vitiligo. The disadvantage of this method is cobble-stoning of the recipient area, where the grafted skin is raised over the surface.
  • Epidermal grafting in Vitiligo.The epidermal layer from normal pigmented skin on the body is taken with a suction pump (other methods are also used), the vitiligo patch skin surface is abraded, and the epidermis grafted with a compressive dressing for a few days.
  • Melanocyte Culture and Grafting to Treat Vitiligo.New techniques to culture melanocytes from patients’ own melanocyte containing normal skin and grafting onto the abraded vitiligo patch are quite effective in treating stable vitiligo.

Is Laser Treatment Useful in Vitiligo?

Excimer lasers have been found to produce repigmentation in some patients, though the results are not as satisfactory as the surgical cosmetic treatments of vitiligo.

What is Cosmetic Camouflage in Vitiligo?

Using brown or dark brown temporary dyes to cover up the white patches of vitiligo is known as cosmetic camouflage. This is usually used on exposed parts like the face, neck, chest and hands. Michael Jackson regularly used cosmetic camouflage for many years while his vitiligo patches were progressing and his whole face and body were turning white, spotted with normal dark skin here and there.

Micropigmentationor tattooing with brown or brownish black pigment is an effective method of permanent camouflage for vitiligo affected lips in dark skinned individuals.

Related Article

References

Disclaimer

The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.

The copyright of the article Vitiligo Treatment: Frequently Asked Questions in General Medicine is owned by Hanish Babu. Permission to republish Vitiligo Treatment: Frequently Asked Questions in print or online must be granted by the author in writing.
Vitiligo Treatment: Repigmentation After 1 Month., Dr.Hanish Babu, MD Vitiligo Treatment: Repigmentation After 1 Month.
Vitiligo Treatment: 40% Color Restored at 2 Months, Dr.Hanish Babu, MD Vitiligo Treatment: 40% Color Restored at 2 Months
 
What do you think about this article?
NOTE: Because you are not a Suite101 member, your comment will be moderated before it is viewable.
post your comment
What is 4+3?

Comments

Jul 9, 2009 9:32 AM
Guest :
Makes pretty good sense to me dude!

RT
www.real-anonymity.pro.tc
1 Comment:
Related Articles


Related Topics
 

Reference


;