Vitiligo clinic
What Is Vitiligo?

Vitiligo or skin fading is also know as leukoderma. It is an auto immune disorder where ones own body cells starts reacting towards it. It is a long term skin condition which is characterised by milky white patchy skin that can be seen on the different parts of the body and is usually sharp on margins. Hair also becomes white in that area. This is due to the cells that make pigment in the skin are destroyed. Vitiligo can be seen on people with darker skin also, although it can be seen in all skin types, and patches starts appearing when the skin is exposed to the sun. This condition is non-contagious but can affect life style of the people.

What are the causes of vitiligo?

The exact cause of vitiligo is not known but few reasons can contribute to this auto immune disorder, like:

  • Disorder occurring in the immune system that could destroy the healthy melanocytes in the skin.
  • Stress, over-exposure to sun or to chemicals can also contribute to vitiligo.
  • In some patients family history of vitiligo can also be seen although there is no strong association found.
Which age group is usually affected?

Age is not specified, although it can start at any age group, but one can see it between the age of 20 or 30 yrs. The white patches can be seen on the face, neck, armpits, elbow, genitalia, hand, knees or even in the mouth and nose, and even on the whole body.

Things to Know

Vitiligo can be seen in both male and female. But it depends upon the family history, and the area involved.
Lifestyle plays a very important role in any problem that can affect the life of people. Staying happy, avoiding stress is also very important. One should eat a well balanced diet, exercise daily, avoid direct sun exposure and using sunscreen at least twice daily and avoid using chemicals. Staying positive in life can solve a lot of issues and help the person heal from within.
Vitiligo is very common in people where one has a family history of this condition. Environmental factors are also responsible for this condition.
Vitiligo responds to medicines but those case which have black hair present in the lesion respond faster to the treatment than, white hair/no hair in that lesion. The areas that are non-hairy especially lip respond slow for the treatment. Vitiligo usually does not respond to oral medicines and sometime skin grafting is required. It should be done if the disease is stable for at least one year.

1. Oral medications- Prescriptive oral medications can help in suppressing the body’s immune system and allows the pigment of the body to return back in leucoderma. Psoralen with a combination of phototherapy can be helpful in restoration of pigmentation. The drug renders the skin light sensitive and turns pink triggering a healing process and the skin returns its normal colour.

2. Suction blister grafting- A normally pigmented donor site is subjected to negative pressure to promote the formation of blisters. Blisters can be raised with the help of a syringe, suction cups or suction pumps. The syringe sizes are usually 10 ml to 20 ml and takes around 2 hours for the development of the blisters.

3. Mini-punch grafting- Small sized and full thickness grafts are harvested and placed in the affected area of leucoderma along with PUVA. It is a very simple and efficient technique and commonly preferred. 2mm bits of skin are punched from the donor site and placed on the recipient areas where also punches would have been created.

4. Split thickness grafting- Layers of skin are shaved off from the donor site to be placed on the recipient site. Large areas of skin can be covered with split thickness grafting. This technique produces uniform pigmentation in leucoderma.

5. PRP Therapy- Platelet rich plasma therapy can be very effective in the treatment of vitiligo, if there is a small patch of affected area. Centrifuged and concentrated blood plasma is administered to the skin to induce effective pigmentation. Blood is drawn from the patient’s own body and does not have any side effects.

6. Phototherapy- Considered as the gold standard in the treatment of vitiligo, phototherapy or narrow band UVB light, is one of the most common treatments for vitiligo. It uses UVB spectrum from 311-112 nm. PUVA light therapy uses UVA light.

This treatment is quite safe but medicines that are used in treating vitiligo can cause some side effects. So one must follow all the instructions for this treatment and it should be done only by an experienced dermatologist and one must know all the pros and cons of the treatment. Phototherapy can cause redness, discomfort, dry & itchy skin. Sunlight induced rash called polymorphic light eruption which is due to ultraviolet light or radiation.
Medicines can have side effects like topical steroids can cause atrophy of the skin and should be used judicially and sometimes people give oral steroids for this which can cause weight gain and a lot of other problems.
Vitiligo being an auto immune disease can sometimes come back at the same site or at other site also. But the chances of vitiligo coming back is less or very minimal especially in stable cases.
According to Dr Shail Gupta, MD (renowned dermatologist) with almost 2 decades of experience in the field of dermatology says vitiligo is a condition which has a lot of social stigma associated with it. People go into depression and just want to hide it so it is not a disease, it is just depigmentation of the parts of the skin. One should not worry too much about it and there are effective treatment available for vitiligo. A person has to keep the social factor out, because it builds unnecessary pressure on the mind and the body does not respond well to this.
A prior consultation is required with the dermatologist to understand the need of the treatment. Medicines work hand in hand with the procedural treatments. Selection of the right treatment according to your needs is very much necessary. Knowing the downtime of the individual treatment and its outcome is equally important. After a thorough consultation , patient can opt for the treatment and can get it done after taking a prior appointment as per his/her availability.

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