Vitiligo treatment emedicine
An estimated 1 to 2 million Americans have vitiligo. It affects any gender and all races, but is often more noticeable and more disfiguring in people with darker skin. Vitiligo usually starts as small areas of pigment loss that spread and become larger with time. These changes in your skin can result in stress and worries about your appearance.
Indication:
The main sign of vitiligo is pigment loss that produces milky-white patches (depigmentation) on your skin. Other less common signs may include:
- Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard
- Loss of color in the tissues that line the inside of your mouth
- Loss or change in color of the inner layer of your eye (retina)
Although any part of your body may be affected by vitiligo, depigmentation usually develops first on sun-exposed areas of your skin, such as your hands, feet, arms, face and lips.
General vitiligo patterns:
- Focal: Depigmentation is limited to one or a few areas of your body.
- Segmental: Loss of skin color occurs on only one side of your body
- Generalized: Pigment loss is widespread across many parts your body
General Treatment
In some cases, medical treatment for vitiligo may not be necessary. Self-care steps, such as using sunscreen and applying cosmetic camouflage cream, may improve the appearance of your skin
Depending on the type of therapy, vitiligo treatment may take from 3 to 6 months. Medical treatment choices are based on the number of white patches you have and how widespread they are. Each person responds differently to treatment, and a particular therapy may not work for you.
Medical treatment
- Topical psoralen plus ultraviolet: Topical PUVA may be a treatment option if you have a small number of depigmented patches (affecting less than 18 percent of your body).
- Oral psoralen: Oral PUVA therapy may be used if you have extensive vitiligo (affecting more than 18 percent of your body) or if you haven't responded to topical PUVA therapy
- Narrow-band ultraviolet therapy: In recent years, narrow-band UVB, a special form of UVB light, has been used as an alternative to PUVA. This type of therapy can be administered like PUVA and given up to three times a week. However, no pre-application of psoralen is required, thus simplifying the treatment process. Narrow-band UVB may be a safer long-term alternative to PUVA.
Depigmentation: Depigmentation involves fading the rest of the skin on your body to match the already-white areas. If you have vitiligo on more than 50 percent of your body, depigmentation may be the best treatment option. In this procedure, the drug monobenzone is applied twice a day to the pigmented areas of your skin until they match the already-depigmented areas.
Laser Therapy: Another innovation is therapy with an excimer laser. This new treatment is an efficacious, safe, and well-tolerated treatment for vitiligo when limited to less than 30% of the body surface.
Surgical Therapies
Five basic methods for repigmentation surgery have been described, as follows:
- Non-cultured epidermal suspensions
- Thin dermoepidermal grafts
- Suction epidermal grafting
- Punch mini grafting
- Cultured epidermis with melanocytes or cultured melanocyte suspensions
Micropigmentation is another option
Tattooing can be used to repigment depigmented skin in dark-skinned individuals. Color matching is difficult, and the color tends to fade.
But keep in mind no single therapy for vitiligo produces predictably good results in all patients; the response to therapy is highly variable. Treatment must be individualized, and patients should be made aware of the risks associated with therapy.
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