Depigmentation Therapy for Vitiligo

Share

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.

Benefits of Pixel Laser Facial

Share

Pixel laser facial or Pixel CO2 system is the proven way to get rid of age spots, wrinkles, acne scars and skin blemishes. It not only helps in rejuvenating the skin but also tightens the skin layers. Pixel laser facial uses the thermal energy pulses that create small micro-perforations in the skin. The perforations are done into target small area while keeping the surrounding area untouched. The laser source used in this treatment is of fractional ablative laser category. Although CO2 lasers are not very different from other fractional laser sources, yet the technology of use and its benefits makes it a lot different than others.

So, what are those benefits?

Delivers Immediate Results

The primary benefit of taking pixel laser facial is an immediate improvement in skin texture which can be visible instantly. In this treatment, the skins collagen production system is utilised which delivers immediate lasts for a longer time. Post the treatment, a bit of redness may appear but in the following days, the result will be clearly evident.

Improves Skin Texture and Tone

Pixel laser facial can improve multiple areas of the skin which makes it more favourable among other treatments. The micro-perforations created with this treatment method helps to signal the skin’s natural repair process to start and thus improves the overall texture of the skin. This treatment also helps to shrink the pore sizes as well. Even the untreated area around the micro-perforations acts as a reservoir and promote natural tissue healing giving the skin an improved even tone.

Improves Heavily Damaged Skin

Most of the non-invasive procedure skin rejuvenating are not very effective against heavily damaged skin. But pixel laser facial is the exception to mention as it is non-invasive yet offers very impressive results. It not only helps to remove skin spots & ageing spots but also eliminate extensive scars from surgeries or accidents. Reviews show that this is the best process to rectify the heavily photodamaged skin. Pixel laser facial not only removes scars & spots but also improves skin tone and texture within a few days.

Stimulates Collagen Production

Lack of collagen production is the primary reason behind many skin issues. Collagen is the most abundant protein in the human body that structures the skin. Hence, stimulating collagen production done in this treatment helps improve the skin immediately. Improving collagen production for a longer time helps the skin to have the best results for a longer time.

No Downtime Required

Being a non-invasive treatment, this requires very small downtime. It not only offers immediate results but also let you go back to your day after the session itself.

No one wants to look aged or have spots/marks on their skin. Yet, many times women can not go for various treatment due to busy schedule. Pixel laser facial requires less downtime and allows women to go back to work immediately which makes it more approachable over other skin resurfacing treatments.

THE MYSTERY OF THE DISAPPEARING WHITE SPOTS

Share

A 27 years old young healthy male reported to the skin OPD with complaints of white patches over his arms and thighs since 8 months. On examination the spots were flat white spots & were numerous and distributed over the arms and legs most of them measuring less than a cm in diameter. the spots were quite subtle almost playing hide and seek looking prominent at sometime and then not so obvious at other times It didn’t fit in clinically with the most common skin issues of similar look ie fungus, allergy, sun sensitivity etc. Routine blood tests Complete blood counts , liver , kidney function tests, thyroid , blood sugars were within normal limits and gave no further insight whatsoever The patient had visited couple of doctors who just like us couldn’t really come to a final diagnosis and he was treated as a case of fungus, allergy white patches with no improvement at all; the case was turning to be most eluding yet teasing,it was like the spots were taunting us having a secret laugh at our ignorance. With nothing more to offer to the patient we admitted to the patient yes even though we are supposed to be specialists we had no clue as to what we were dealing with and we thought let us sleep over this and rake our brains at a later date

Skin Laser Centre
image 1

Thankfully the patient was patient and persistent, and he had more trust in our abilities to help him than what we had frankly and were all about to throw our hands in the air when we noticed that his arms appeared slightly red kinda flushed. So we had a new clue and we started to prod deeper into that and the patient revealed that the redness is very much there on and off but it doesn’t bother him like pain or itch so he choose not to discuss that We then started a cross reference transient redness, flushing we dug into our books and online research ( Dr Google ) threw up a picture akin to our patients condition and we had the diagnosis it was BIER spots, a rare entity but nevertheless reported and published.

So this is how it goes when the patient raises his hands as shown in image 1 they disappear and when the patient puts his arms down the blood gushes down, the flush increase and the white spots reappear magically shining like stars in a dark moonless night (image 2).

In the image 3 we can see both the arms the right is red and beefy and left pale as it had been just raised for a few seconds a moment ago which had emptied the veins ; the contrast is startling and was staring in our face  Like a kid who has been give a free access to a video game parlor we were grinning and asking the patient to raise one arm and then the other and get them down and so on, even he was mesmerized to see the changes in his body happening with a bit of help from gravity The white patches would crop up the moment his arms were hanging

Skin Laser Centre
image 2 & 3

down in the dependent position and disappear in a jiffy the moment he raised them and even though I’m considered a specialist in treating vitiligo ( White Patches ) I swear I have never seen any white patch getting cured at this speed. Medical literature dispels the mystery behind this phenomenon as abnormal Vascular response to venous hypertension and tissue hypoxia so if u see that’s what was happening But the thrill of making this rare diagnosis was a eureka moment for me and my colleague Dr Nupur, the sweet pleasure of arriving at a diagnosis was just divine . We literally patted each other on the back Good job and after a long slog in the OPD we raised a toast ( with tea In thermacol glasses) and exclaimed Elementary Dr Watson Elementary I know some of u must be wondering why I’m so excited to sit down and write a article about this simple condition but it’s something u really go to experience yourself , and in the end it’s the small pleasures that really count in this beautiful journey of life, for these are the drops that become the ocean, and is it not that the entire ocean is in the drop……

― Dr Paul

Make an Enquiry

Click To Review
Whatsapp Chat
Call Us