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.

Life of Vitiligo Patients | 6 True Stories

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People with vitiligo are often mistreated, looked down or shunned from society. Very few people understand that it’s a skin condition which is not fatal or contagious. People with vitiligo have to struggle mentally and emotionally more than physically. The way society treats people with vitiligo, it only worsens their condition and makes them withdraw from society.

Apart from the physical stress they feel, society’s behaviour towards them leaves a deep scar on their mind and many of them get into depression. Life becomes an everyday struggle for them, and people tend to hide from others. But there are some strong people who shared their story of struggle with everyone to lighten up society and raise the voice against the social stigma. These stories open our eyes that how crucial society can be towards physical outlook and how people with vitiligo feels like. Vitiligo is a never-ending journey, but our affectionate behaviour can make someone’s life easier.

Patients Stories

Amit Singh: encouraging life every day

While the society tries best to corner him, he encourages himself and always tries to make people understand that it’s just a different skin tone than others. This brave-hearted man knows how to face society with courage and takes only positive vibes. Am amazing story of inspiration for all of us!

Keya Anand: why I have to paint myself?

She is fighting vitiligo since her 5th grade and ever since society never missed a chance to make her feel low. Even her own parents used to tell her to cover herself and hide the white patches. Medicinal creams were given to paint her patches to look normal. Even after been through such a rough phase, the brave girl dared to share her story with us.

Rahat Khan: I want to Live!

In his turn of sharing his story, he managed to write at times he wants to end his life but in reality, he wants to live a normal life. Instead of writing a long story of sufferings, he only wrote that he is speechless and have no words to share his sufferings.

Shreya Gupta: who cares if you are judgemental.

The brave-hearted girl accepted her white patches with open arms and understand that its only a skin condition that requires a bit more expert care. While she lost all her friends due to these white patches, she made friends with them. Although society never missed to being judgmental, she believes in leaving a happy life. Such an inspiration and answer to social stigma!

Uditi Menon: are we really in the 21st century?

Once she was proud to have the white patches as she used to think that she is different. Well, this feeling lasted only for a while and the society reminded her that a girl with vitiligo is not a desirable one in the matrimonial market. Since her age of eight years, she has been facing such question like who will marry her which not only remind her but also questions if we are actually living in 21st century.

Rayna D’Souza: is an outlook that important?

She was bullied since her school age and had even rough college days. All because of her different skin tone which makes her question if the whole world is so cruel or if it’s only in India.

Can you relate to their stories? Which of them connects to you more? Do these stories help you to a bit more affectionate towards people with Vitiligo?

Vitiligo can be treated and, in some cases, can be cured too. But all they need is some empathy and acceptance from us to fight through the journey.

Social Pressure on Vitiligo Patients | Fight it With Microskin

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Vitiligo is a common skin condition related to the discoloration of skin in patches which spreads on the outer skin of the body.  Vitiligo patients in India often face a cruel social pressure which they do not deserve for sure. In India, many people also call this disease a result of the wrongdoings in their past lives and patients are blamed for their lesions. This undue pressure causes psychological stress on the patients and with time many patients go under depression too. A harmless disease like Vitiligo becomes a serious cause of concern due to social stigma and the many cosmetic reasons & expectations attached to it. However, there are ways to conceal Vitiligo patches which can help avoid social pressure and make better first impressions.Social Pressure on Vitiligo Patients

Microskin To Conceal Vitiligo Patches

Microskin is the new revolutionary cosmetic skin correction formula that covers up vitiligo patches and corrects skin discoloration. This light semi-liquid foundation-like application is put on the outer skin to hide the depigmented circles. The main difference between Microskin and other cosmetic camouflage treatment is, it does not rub off easily on clothing and stays longer on the skin. It is also water-proof & smudge-proof. Unlike other cosmetic applications, it allows the skin to breathe and suits almost everyone.

The vitiligo surgeon custom prepares this cream to match an individual patient’s skin color, with maximum precision. Microskin can be applied through a stipple or airbrush, as suggested by the doctor. Depending on skin types and a particular part of the body, Microskin stays on the skin for several days and a slight touch up can give an even longer lasting result. This liquidized skin-color corrector does not give any makeup effect but makes the affected skin look more natural.

Microskin is the best solution for the social pressure that vitiligo patients face every day. Be it a party or interview or any social gathering, Microskin helps in creating a normal-like first impression for them. Once applied, Microskin stays on the skin for several days and does not wash off. It’s a layer of cream that sticks to the skin allowing it to breathe and fade away gradually with time. This is what makes it different from normal foundation cream. Its easy self-application makes it preferable for daily wear or for such events as patients can apply the cream by themselves.

Dr. Munish Paul, Dermatologist & Vitiligo Surgeon, recommends Microskin due to its safe and easy application. The vitiligo surgeons/Dermatologists prepare the right shade matching the real skin tone for individual patients. Patients can bring home the application and apply by themselves on the depigmented area to cover the white patches. The application can be done through a spray or sponge rub. Microskin not only hides white patches but also helps patients to stand confidently in society with an even tone skin.

Melanocyte Cell Transplantation or MCT as Vitiligo Treatment

This surgical approach is now being considered as “may be a cure”. Unfortunately, science is still not able to find a permanent cure for this condition but there are many cases where Melanocyte Cell Transplantation (MCT) Melanocyte Keratinocyte Transplant Procedure (MKTP) as Vitiligo Treatment has made wonders.

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The new approach to treat vitiligo is cellular grafting. This surgical approach is now being considered as “may be a cure”. Unfortunately, science is still not able to find a permanent cure for this condition but there are many cases where Melanocyte Cell Transplantation (MCT) Melanocyte Keratinocyte Transplant Procedure (MKTP) as Vitiligo Treatment has made wonders. The idea of MCT is to remove the top layer of pigmented skin and replace it with healthy pigment cells (melanocytes) taken from another part of the body. Within a few months, the transplanted melanocytes start making pigment and deposit it to the surrounding areas. The success of this treatment wipes away the white spots and, in many cases, it has worked like magic. Patients with successful results don’t need any standard vitiligo treatments after that. However, not everyone is the right candidate for this Treatment of Vitiligo.

A Deep Insight into Melanocyte Cell Transplantation:

Vitiligo or white spots start appearing on the skin when immune cells sneak into the skin to find melanocytes and kill them. Melanocytes are the cells that produce pigment in our skin. So killing melanocytes stops the pigment production process and skin starts to lose its color.

In this Melanocyte Cell Transplantation (MCT) treatment, new melanocytes are transferred to the affected area. But, the immune cells active in that area kill the new melanocytes too which drives failure of this Vitiligo Treatment. This treatment shows higher success rate only if the disease is stable where the immune cells are quiet and no longer destroying the melanocytes. In such condition, the new melanocytes start working and bring the original skin color back. Now, the problem is, it is very difficult to know when the disease is stable. In common practice, the Dermatologist carries out this treatment only if the patient has no lesions from last 1-2 years.

This Vitiligo Treatment appears to be excellent for, segmental vitiligo patients. As in the segmental vitiligo, the disease is limited to one portion of the body, chances of success rates appear to be higher. 80-90% of such cases have seen success and may never require further vitiligo treatment. That’s the reason why this treatment is addressed as “may be a cure” which is normally never used for any other vitiligo treatment.

In Cellular grafting or Melanocyte Cell Transplantation (MCT), the top layer of the affected area’s skin is removed and melanocytes & other skin cells from normal skin is transplanted into that area. Among all other Vitiligo Treatment procedures, cellular grafting has appeared to be the most successful one until now. In medical terms, this process is also called as Melanocyte-Keratinocyte Transplant Procedure or MKTP.

But, I know only a few centers around the world that offer this treatment. This was the biggest reason I have started offering this treatment into my own SKIN LASER CENTRE. Here, we not only offer treatment but also provide post-treatment care to ensure the complete success of this process. This procedure requires special equipment and professional training. At our center, we have experienced excellent success rate for MKTP so far. As per my opinion and experience, it is the best Vitiligo Treatment for right patients, whom we decide after a careful series of examination. This procedure is a bit costly than others and thus I suggest the treatment only to the patients who fulfill the prerequisite health conditions.

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