Dr Sunaina Hameed's
Family Dermatalogy, Asthetic Lasers, Anti-Ageing Medicine & Plastic Surgery.

VITILIGO

Vitiligo is a condition where white patches develop on the skin. It is due to loss of pigment from areas of the skin. There are usually no other symptoms but the appearance of the skin can cause distress, not only to the sufferer, but to their loved ones as well. It is common, and affects about 1% of the world's population. Several diseases can cause loss of skin pigment, but Vitiligo is particularly distressing because of the striking milk-white color of the patches.

The exact cause of Vitiligo is not fully understood, but many dermatologists agree that it is a disease where the body produces antibodies against its own melanocytes, and in doing so destroys them. It affects men and women equally, and is more common among darker races like Asians and Hispanics. About a third of people with vitiligo, know someone in their family who also has it. However, the exact pattern of inheritance is not clear, hence if you have vitiligo, it does not follow that your offspring are sure to get it too. It is NOT contagious.

Vitiligo can start at any age, but about half of those who get it, do so before they are 20. The spread and severity of vitiligo varies from person to person, and cannot be predicted by your dermatologist. The white patches are more prone to sunburns as they lack the protective melanin. Hence, patients must always use generous amounts of sunscreens 2-3 times a day.

How can Vitiligo be treated?

In treating Vitiligo, your dermatologist's approach is two fold. One is to correct the misbehaviour of the WBCs, and the other is to stimulate the melanin in the normal skin around the patch or the dark hairs within the patch to generate fresh melanin pigment.

This is achieved through medicated creams and solutions like steroid creams, tacrolimus, growth factors or natural compounds like Psoralen, Placentrex etc.

Phototherapy with PUVA (Psoralen + UVA light) or narrow band UVB light is the most standardized, well-established, reproducible, predictable, well-studied and documented treatment for vitiligo. This treatment has been in vogue from the 1970s. The treatment involves exposing the skin to sunlight or a bank of ultraviolet rays, with or without oral medication. Generally, 2 or 3 treatments are administered in a week and it takes 100 to 300 treatments for satisfactory repigmentation. Our facility also offers Targeted Phototherapy, where the ultraviolet rays are only targeted to the patch, in order to avoid unnecessary whole body exposure to UV rays.

The outlook for regaining color in children is quite good; up to 25% of children with Vitiligo regain color without treatment.

In adults, areas like lips, genitals, fingers, toes, palms and soles are the hardest to treat. Patches which show white hair also respond poorly to treatment.

For patches which are unresponsive to medical treatment, and which have remained stationary in size, surgery is a viable option. This surgery includes mini punch grafting of normal skin from the thighs or buttocks, to the patch. Other methods include suction blister grafting. The patch can also be tattooed with color-matched pigments, as a 'quick-fix' for emergency situations like an impending wedding. It gives skin color for a period of 2-4 weeks and does not wash off. Stem-cell therapy or Gene therapy are revolutionary treatment options for Vitiligo, and these options are now available in India. Discuss these options with your dermatologist for more details.

For those who are unwilling or unsuitable for surgery, the use of cover-up or camouflage make-up is a good option. These are thick pastes/foundations that are spread into the affected areas and match the color of the surrounding skin and prevent undue attention being drawn to the patches. These cover-ups are available in all skin colors, are non-toxic, stay on for 15-16 hours and do not wash off with water or sweat. They are removed using cleansers. They also provide an immediate solution to your problem, while you continue your medical treatment. Good examples would be USA's Vichy Dermablend, Kryolan's DermaColor and CM-Beauty Covermark. These products are rub-resistant, water-resistant and last for 16 hours.

One must remember that not all white patches are Vitiligo. Your dermatologist is the best person to correctly identify your disease, and to guide and advice you regarding the ideal treatment option for you.

You can read more about Vitiligo at www.vitiligofoundation.org or www.vitiligosupport.com.

You can learn more about camouflage make-up at dermacolor-camouflage.com

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