Best Treatment For Vitiligo

What  is Vitiligo? Vitiligo is a disorder in which patches of white skin appear on various parts of the body. Vitiligo is a skin disease in which pigment cells of skins damaged in some body parts, resulting into some white areas (patches) on skin at any location. This disease can effect in some special area or whole body. The skin is white because the cells responsible for producing brown pigment have disappeared from the affected areas.

Skin Specialist defines it as a loss of colour or loss of pigment (depigmentation). This disease can occur on any parts of body. For example:

• Hair (beard, scalp, eyebrow and eyelash,).

• Inside the mouth.

• Skin

• Genitals (sex parts).

People affected with this disease lose colour on their skin. The affected parts become completely white or lighten their colour. This disease does not show any other symptoms except depigmentation of their skin, they remain healthy.

This disease spread with the passage of time and some people feel itching and pain as well on the affected portions.

A large number of people in all over the world are suffering with this disease. Especially people less than 21 year of age have this but some people may have affected after 21 years. Male or female both can be affected with this disease. The chance of receiving vitiligo increases if a patient has:

• A close blood relative (like husband and wife) who is suffering with vitiligo.

• A person having autoimmune disease like Hashimoto disease or alopecia areata.

Vitiligo is often brushed aside as being “just a cosmetic defect” with the inference that it does not require any treatment. This is incorrect because every patient requires some treatment. The treatment should be tailored individually to the needs of the patients, the extent and location of the vitiligo, and the likely response to the given treatment. If your skin specialist suspects that you have vitiligo, he will:

• Evaluate medical history, and will ask precise questions such as whether anyone in family member is suffering from vitiligo.

• Carryout a physical exam, looking carefully at the affected skin.

•  Also test thyroid is functioning properly or not.

• Use cosmetic options including makeup, self- tanner and skin dye etc.

•  Several different topical (applied to the skin) medicines can repigment the skin.

• Prescribed for small areas.

• The most commonly prescribed medicine is a potent or super-potent topical corticosteroid. About half, 45 percent, of patients regain at least some skin color after 4 to 6 months.

• Use light to repigment the skin.

• Patient may sit in a light box or receive laser treatments.

• Light box used to treat large area vitiligo, whereas laser used to treat small area.

• Shows best results on the face and less on hands and feet.

• Effective for many patients; about 70 percent see results with laser.

• Results can disappear. About half, 44 percent, see results disappear within 1 year of stopping treatment. After 4 years, about 86 percent lose some color restored by treatment.

• Uses UVA light and a medicine called psoralen to restore skin color.

• Psoralen may be applied to the skin or taken as a pill.

• Some vitamins, minerals, amino acids and enzymes have been reported to restore skin color in people who have vitiligo.

• This treatment removes the remaining pigment from the skin.

• Very few patients opt for this treatment.

This is the minimum treatment that must be used by any patient with vitiligo on exposed areas of the body.
The reason is simple: the skin in a patch of vitiligo has lost most of its protection against the damaging effects of ultraviolet light in sunlight. If left unprotected, premature aging of the skin and ultimately skin cancer are inevitable consequences. A patient with vitiligo should avoid exposing the white areas to sunlight. If exposure is inevitable, as for example with vitiligo on the face and hands, daily application of a sun- screen SPF 15 or higher is essential from March to November.

Treatment with ultraviolet light therapy is the main means of restoring pigment to the white areas of vitiligo. Two types of light therapy are effective in vitiligo. PUVA therapy and narrow-band UVB (311) phototherapy. PUVA therapy consists of taking a medication called psoralens and then being exposed to ultraviolet A light. Psoralens are distributed to the skin and there interact with the UVA light to stimulate formation of new pigment cells in the skin. Narrow-band phototherapy does not involve taking a medication and has a similar but probably less powerful effect on pigment cells.

PUVA therapy has been used in India and the Middle-east for several thousand years for treatment of vitiligo and it has been used in America since 1952. Sunlight was used as the source of UVA light, but recently, more effective indoor sources of light have been developed. These improvements to the treatment have resulted in much better response rates and also have allowed definition of what the likely response will be in an individual patient. Narrow-band phototherapy was introduced in the 1990s.

The most recent light treatment for vitiligo involves use of an excimer laser.

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