Vitiligo Treatment: Light Therapy & Surgery

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Vitiligo is a skin condition characterised by white milky uneven patches. These patches can be treated to even tone the skin. The choice of Vitiligo treatment depends on various factors such as patient’s age, percentage of widespread, the progression of the disease and how Vitiligo is affecting one’s life.

Light-based therapies are done to help restore the lost skin colour or to give a unified skin tone. Some people may also experience some side-effects and hence a skin specialist may recommend some self-tanning products before taking you through the treatment process.

Whatever the treatment process your skin specialist recommends, it will take a few weeks or even months to deliver the expected results. Also, be prepared to go for a combination of therapies where the doctor may prescribe more than one therapy to get the desired results through a best suitable treatment for your skin. Moreover, the doctor may prescribe some maintenance therapy to prevent relapse.

Light-based therapies

  • Phototherapy: Phototherapy performed with narrowband ultraviolet A (UVA) or ultraviolet B (UVB) has proven to stop or at least slow the disease progression. If used with corticosteroids inhibitors, the therapy works even more effectively. This therapy usually requires two-three sessions per week for two-three months to make a significant difference. Possible side effects of phototherapy include redness, itching or inflammation. However, these side effects usually go away within a few hours of the treatment.
  • Targeted Phototherapy: Also called as concentrated phototherapy, it is performed to delivers ultraviolet radiation on a targeted spot. This phototherapy is targeted on the skin lesion using special delivery mechanisms for treatment.
  • Depigmentation: This therapy is performed to remove the remaining pigment in Vitiligo affected person’s body. It is only recommended for patients with 50% or more widespread Vitiligo. To perform this therapy, the doctor will recommend applying depigmentation agent on the unaffected areas of the skin which will gradually lighten the skin tone to match with the Vitiligo affected areas. The therapy is usually given once or twice a week for a few months. It’s a permanent therapy and cannot be undone afterwards. This therapy does not cause any major side-effects. Minor side effects such as redness, itching, swelling or dryness may occur.

Surgical treatment for Vitiligo

Surgery is recommended when light therapy or other medications do not work to stabilise the condition. This treatment is also recommended for people with stable Vitiligo disease. Surgical techniques used to even out skin tone can be of different types.

  • Skin grafting: This procedure is performed by transferring very small segments of healthy, pigmented skin to the discoloured areas. This procedure is usually recommended for patients with small patches of Vitiligo.
  • Blister grafting: To perform this procedure, the doctor creates blister on the pigmented skin using suction and then transplants the blister tops on the discoloured patches.
  • Cellular suspension transplant: To perform this procedure, the doctor will take some tissue from the pigmented skin and will transfer them to a solution before transplanting them in the affected area. The results usually start showing up within four weeks from the procedure. These procedures may involve small risks of infection, scarring, spotty colour and failure to re-pigment the areas.

At Dr. Paul’s Skin Laser Centre, Vitiligo treatment is performed under the supervision of certified MD Dermatologists after an open discussion about the procedure, results, and possible effects of the treatment. Call today at 9803 029 029 to know more! 

Know Vitiligo: Symptoms & Treatment

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Vitiligo is a skin condition characterised by white patches on the skin. The patches can occur on any part of the body, even in the scalp and inner mouth. Our skin gets its colour from a naturally occurring pigment – melanin which is produced by melanocytes. Vitiligo or white patches occur when these melanocytes start dying due to unknown reasons. People of any skin type can get affected by this condition, but the patches are more noticeable on dark-skinned people. The first signs of Vitiligo usually appear before the 30s, but it can affect at any age.

Vitiligo is not a life-threatening condition, but it is stressful due to social stigma associated with it. Patients often struggle with low self esteem & confidence due to their uneven skin tone but treatment can help them gain their confidence back. Vitiligo treatment helps restore the skin colour of the affected area and unify the overall skin tone.

Symptoms

Signs & symptoms of Vitiligo include:

  • Loss of skin colour in patches. These patches usually first appear on the sun-exposed areas such as face, hands, shoulders & lips.
  • Loss of skin color in the lining tissues of inner mouth and nose.
  • Premature whitening or greying of the hair, eyelashes, eyebrows, beard and body hairs.

However, the signs of VVitiligo also depend on the type of Vitiligo one has such as:

  • Universal Vitiligo: Wwhen the loss of pigments occurs on nearly everywhere on the body.
  • Generalized Vitiligo: When patches occur in many parts of your body. It is the most common type of Vitiligo.
  • Segmental Vitiligo: When patches occur on only one side or part of the body. This type of Vitiligo usually occurs in children which progress for 1-2 years and then stops.
  • Localized (focal) Vitiligo: When patches occur on one or only a few areas of the body.
  • Acrofacial Vitiligo: When the patches appear only on face and hands, eyes, nose, ears and around body openings.

Predicting the progress of Vitiligo is difficult as sometimes the condition spreads widely or sometimes it stops spreading even without any treatment.

Treatment:

Cosmetic camouflage: This is performed with colouring creams to cover-up the white patches. Usually, a semi-liquid foundation-like application is applied to the skin to hide the depigmented white circles. When correctly applied as per doctor’s instructions, camouflage creams can stay up to 96 hours on the skin. Although the duration may decrease in the case of the face and other exposed areas.

Microskin is a new revolutionary camouflage technique that stays on skin for several days. It’s smudge-proof and waterproof which also allow the skin to breathe. It comes in over 100 shades and gives a natural skin tone,

Phototherapy: Light therapy or phototherapy given with narrowband ultraviolet A (UVA) or ultraviolet B (UVB) has shown to stop the growth of Vitiligo. This treatment is often given with corticosteroids or calcineurin inhibitors for effective results. The treatment is given two to three times a week for several months. Effective changes can be seen within 2-3 months of the therapy.

Excimer (Targeted Phototherapy): It is one of the most effective Vitiligo treatments where ultraviolet radiations are directly focused on the white spots. As the name suggests, this treatment only targets the white spots leaving the rest of the skin unexposed. Usually, this treatment is often recommended for localized Vitiligo patients.

Depigmentation: This treatment is recommended for patients with more than 50% widespread Vitiligo. It is applied to the unaffected skin area to reduce melanin percentage and make a unified skin tone. This is achieved by using strong medicated topical lotion or creams that reduce melanin percentage on the skin. It is a permanent treatment and the entire procedure may take up to 12 to 14 months.

Melanocyte Cell Transfer: under this treatment, the top layer of white spots are removed and replaced with healthy melanocytes(pigment cells) taken from other parts of the body. Within a few months of the transplantation, the melanocytes start working to produce melanin which results in the disappearance of the white spots.

Skin Grafting: under this procedure, a small section of healthy pigmented skin is transferred to replace the depigmented skin areas. This treatment is recommended for Vitiligo patients with limited Vitiligo spots. Due to the complexity involved in this procedure, doctors only recommend it when all other treatment fails to restore the lost skin colour.

At Dr. Paul’s Skin Laser Centre, Vitiligo treatment is performed under the supervision of certified MD Dermatologists after an open discussion about the procedure, results, and possible effects of the treatment. Call today at 9803 029 029 to know more! 

Depigmentation Therapy for Vitiligo

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Vitiligo or leukoderma is an autoimmune skin condition that results in partial loss of skin pigmentation cells. Pigmentation cells called ‘melanin’ are responsible for our skin colour and absence of them results in white milky patches over the skin surface. The condition can affect any part of the body and cause white patches. However, commonly the condition starts appearing in the sun-exposed areas of the body such as face, lips, hands, feet, neck etc. Depending on the severity of the condition, doctors for white marks on the skin suggest various treatment. Depigmentation treatment is one of such treatment processes.

Depigmentation therapy:

Depigmentation therapy can be best described as a medical procedure to remove skin pigmentation cells. It is mostly used for patients with widespread vitiligo but has few patches of original skin colour left.  In simple words, people who have incomplete vitiligo on faces or other body parts can go under this treatment. It improves their appearance by giving an even skin tone.

This depigmentation therapy for vitiligo is done by using many methods such as Monobenzyl ether of Hydroquinone (MBEH), Topical Diphencyprone (DPCP), Imiquimod, Phenol, Cryotherapy and Lasers. Among them, Monobenzyl ether of hydroquinone and lasers are most commonly used and tend to deliver the best results. Doctors for white marks on the skin often use combination therapy as well for faster & better results.

This depigmentation therapy is considered for people with more than 50% widespread vitiligo and has patches over the body parts that are exposed or sensitive to cosmetics. It is necessary for the patients to understand some facts about the depigmentation therapy prior to taking it. These factors must be discussed with the patient to let them understand the process & side effects. These factors may include:

  • Nature of the treatment
  • Care and protection needed for the long run. For example, people undergone depigmentation therapy need to wear medicated sun protection to maintain the benefits of this therapy and reduce the risks of sun damage, cancer or other skin conditions.
  • Longer downtime and requires ‘touch–up’ sessions.
  • May have side effects depending on various individual factors.
  • Repigmentation can be patchy for a while.

Patients should be given the opportunity to discuss treatment options with their family and friends.

Monobenzyl ether of hydroquinone

Doctors for white marks on the skin commonly uses MBEH or monobenzone as the depigmenting agent to treat vitiligo patches. It is the only medically approved depigmentation therapy agent for treating vitiligo. It is a derivative of hydroquinone which causes irreversible depigmentation by killing the pigmentation cells. Depending on the individual, doctors may suggest different concentrations. The concentration also depends on the area to be treated for.

Side-effects also may cause after MBEH application, but they are mostly mild ones. If MBEH application causes transient irritation or burning sensation to the patient’s skin, then the doctor may stop the treatment for a while. In the case of blistering, scaling or dry skin, the doctor may suggest some topical corticosteroids cream to apply and stop the process for a while. If any of these side-effects happen, the doctor may reduce the strength of MBEH for next sessions. Very few cases of contact allergic dermatitis are found as a side-effect of this treatment which resulted in the permanent stop of this treatment. Few cases of exogenous ochronosis or ashy brown pigmentation have been seen after prolonged use of MBEH treatment. However, all these side-effects occur very rarely and only a few cases have been found around the world.

Application of monobenzyl ether of hydroquinone

Before starting the treatment, best clinics for white patches on the body always carry a tolerance test for MBEH. Under the tolerance test, the patient is given MBEH cream to apply daily for a week or two to apply in a small area such as inner upper arm or elbow. If no side effects experienced in this period, then patients are advised to proceed.

The MBEH creams are usually instructed to apply once daily for two weeks and then increase the daily application frequency. The creams should be applied around the pigmented area to lighten them. Such creams should not be applied on the eyelids or mucosal surfaces. Also, while under this treatment, the patients are advised to avoid sun exposure as that can cause repigmentation in the patches.

Usually, the treatment takes 1-4months to achieve desired results, but there are instances when vitiligo patients have to continue it for a longer period. However, the duration varies from patients to patients depending on various factors and their vitiligo patches.

It is always advised that if desired outcomes are not achieved within 4 months of use than this treatment should be discontinued. Once the cream has delivered the desired results, the patients need to use them intermittently as a maintenance routine. Usually, post-treatment applications are advised to do for twice a week, but it may vary for individual. Also, post-treatment, the patients need to apply SPF50+ broad-spectrum sunscreen daily to avoid repigmentation and sunburn.

Why professional services matters?

Taking depigmentation therapy services from random clinic never deliver the desired results and also could cause serious side effects. In the best clinics for white patches on the body, professional dermatologists do the proper skin test before proceeding with the treatment which minimizes the chances of side-effects and assures the best outcome.

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