What Treatment Options Are Available For Vitiligo?
The main goal of treatment is to reduce the contrast in color between affected and unaffected skin.
The choice of therapy depends on the number of white patches; their location, sizes, and how widespread they are; and what you prefer in terms of treatment.
Each patient responds differently to therapy, and a particular treatment may not work for everyone.
Current treatment options for vitiligo include medication, surgery, and adjunctive therapies (used along with surgical or medical treatments).
A number of medical therapies, most of which are applied topically, can reduce the appearance of vitiligo. These are some of the most commonly used:
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Topical therapy. Creams, including corticosteroids, may be helpful in repigmenting (returning the color to) white patches, particularly if they are applied in the initial stages of the disease.
Corticosteroids are a group of drugs similar to hormones such as cortisone, which are produced by the adrenal glands.
Yet, as with any medication, these creams can cause side effects. For this reason, the doctor will monitor you closely for skin shrinkage and skin striae (streaks or lines on the skin).
Light treatment. Light therapy or excimer laser treatments are also used to treat vitiligo, although results may not be permanent.
Psoralen photochemotherapy. Also known as psoralen and ultraviolet A (PUVA) therapy, this is an effective treatment for many patients.
The goal of PUVA therapy is to repigment the white patches. However, it is time consuming, and care must be taken to avoid side effects, which can sometimes be severe.
Psoralen is a drug that contains chemicals that react with ultraviolet light to cause darkening of the skin.
The treatment involves taking psoralen by mouth (orally) or applying it to the skin (topically).
This is followed by carefully timed exposure to sunlight or to ultraviolet A (UVA) light that comes from a special lamp. You must minimize exposure to sunlight at other times.
Known side effects of oral psoralen include sunburn, nausea and vomiting, itching, abnormal hair growth, and hyperpigmentation.
Oral psoralen photochemotherapy may also increase the risk of skin cancer, although the risk is minimal at doses used for vitiligo.
If you are undergoing oral PUVA therapy, you will be advised to apply sunscreen, avoid direct sunlight, and wear protective UVA sunglasses for a period of time after each treatment.
Depigmentation. This treatment involves fading the rest of the skin on the body to match the areas that are already white.
For people who have vitiligo on more than 50 percent of their bodies, depigmentation may be recommended.
Patients apply the drug monobenzyl ether of hydroquinone (monobenzone) twice a day to pigmented areas until they match the already depigmented areas.
You will be advised to avoid direct skin-to-skin contact with other people for at least 2 hours after applying the drug, as transfer of the drug may cause depigmentation of the other person’s skin.
The major side effect of depigmentation therapy is inflammation (redness and swelling) of the skin.
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You may also experience itching or dry skin. Depigmentation tends to be permanent and is not easily reversed. In addition, a person who undergoes depigmentation will always be unusually sensitive to sunlight.
Surgical techniques may be an option when topical creams and light therapy do not work. These include:
Autologous skin grafts. The doctor removes skin from one area of your body and attaches it to another area.
This type of skin grafting is sometimes used for patients with small patches of vitiligo. The doctor removes sections of the normal, pigmented skin (donor sites) and places them on the depigmented areas (recipient sites).
There are several possible complications of autologous skin grafting. Infections may occur at the donor or recipient sites.
The recipient and donor sites may develop scarring, a cobblestone appearance, or a spotty pigmentation, or may fail to repigment at all. Many people find skin grafting neither acceptable nor affordable.
Skin grafts using blisters. In this procedure, the doctor creates blisters on your pigmented skin by using heat, suction, or freezing cold.
The tops of the blisters are then cut out and transplanted to a depigmented skin area.
The risks of blister grafting include scarring and lack of re-pigmentation. However, there is less risk of scarring with this procedure than with other types of grafting.
Micropigmentation (tattooing). This procedure involves implanting pigment into the skin with a special surgical instrument.
It works best for the lip area, particularly in people with dark skin. However, it is difficult for the doctor to match perfectly the color of the skin of the surrounding area.
The tattooed area will not change in color when exposed to sun, although the surrounding normal skin will.
So even if the tattooed area matches the surrounding skin perfectly at first, it may not later on.
Tattooing tends to fade over time. In addition, tattooing of the lips may lead to episodes of blister outbreaks caused by the herpes simplex virus.
Autologous melanocyte transplants. In this procedure, the doctor takes a sample of your normal pigmented skin and places it in a laboratory dish containing a special cell culture solution to grow melanocytes.
When the melanocytes in the culture solution have multiplied, the doctor transplants them to your depigmented skin patches.
This procedure is currently experimental and is impractical for the routine care of people with vitiligo. It is also very expensive, and its side effects are not known.
In addition to medical and surgical therapies, there are many things you can do on your own to protect your skin, minimize the appearance of white patches, and cope with the emotional aspects of vitiligo:
Sunscreens. People with the condition, particularly those with fair skin, should minimize sun exposure and use a sunscreen that provides protection from both UVA and ultraviolet B light.
Tanning makes the contrast between normal and depigmented skin more noticeable. Sunscreen helps protect the skin from sunburn and long-term damage.
Cosmetics. Some patients with vitiligo cover depigmented patches with stains, makeup, or self-tanning lotions.
Many cosmetic companies offer makeup or dyes that you may find helpful for covering up depigmented patches.
Self-tanning lotions have an advantage over makeup in that the color will last for several days and will not come off with washing.
Counseling and support groups. Many people with vitiligo find it helpful to get counseling from a mental health professional.
People often find they can talk to their counselor about issues that are difficult to discuss with anyone else.
A mental health counselor can also offer support and help in coping with vitiligo. In addition, it may be helpful to attend a support group.
Oral psoralen therapy
Oral psoralen therapy is formulated for people with more extensive condition, (greater then 20%), which is applied through psoralea corylifolia seeds.
The treatment is more effectual to get recovery or cure from the disease by use of UVA or UVB bands (light rays).
This therapy is not suggested for children as it causes many skin problems including skin cancer, further it also increase the risk of eyes damages.
For oral psoralen therapy, the doctor recommends patient to take a prescribed dose of psoralen drug before the treatment.
As it works to increase the skin-sensitivity of patient so that he can easily face the light rays.
Photochemotherapy or PUVA is an acronym where "P" stands for "Psoralen" and "UVA" stands for long wavelength UV light, also known as a type of ultraviolet radiation treatment.
Before the treatment, psoralen drug is given to patient. Different psoralen medicines include methoxsalen (8-methoxypsoralen), 5-methoxypsoralen and trisoralen.
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Psoralen is a compound, taken from the psoralea corylifolia seeds, to increase the skin sensitivity.
Many people has been found in this skin disorder, due to the deficit of nutritional factors like calcium, phosphorous, vitamins, protein, or other cuprous minerals.
The Ayurvedic treatment that is used for centuries, recommends taking a proper balanced diet, according to the vitiligo requirement along with medicines.
Many physicians in this treatment suggested to patient to take Babchi oil for massage.
As it is produced from natural sources so it can helps to re-produce pigment cells in skin.
Further there are many tablets or injections of calcium or vitamins are available in market in order to reduce or fulfill the nutritional requirement of body. Patient should use them but with the counsel of physician.
UVB and Psoralen Treatment
In Photochemotherapy or light therapy Psoralen drug along with UVB shorter wave length (315-280nm) is used, in order to re-produce pigmentary cells in skin.
UVB rays consider very important or widely recommend now a day. The major side effect of these rays is that it can be a cause of skin cancer.
Autologous skin grafts
In this treatment physician takes pigment producing cells from any part of body with the help of surgical tools, transfer it to de-pigmentary parts of body.
Homeopathic treatment is conducted through natural sources. Anti-vitiligo oil is a homeopathic product that is produced from natural herbs, free from chemicals, helps in the reproduction of pigment containing cells, effective for every type of skin, and gives 100% best results to its users.
The natural ingredients of anti vitiligo oil include Babchi oil or psoralea corylifolia, barberry root, coconut oil and black cumin.
Topical applications are includes creams, sun-creams, lotions. Many vitiligo topical applications are easily obtainable in market that can help a patient to treat vitiligo.