Vitiligo

Vitiligo is a skin condition in which smooth white patches called appear on a person’s skin. It generally starts on the hands, forearms, feet and face. Globally, one percent of the population could be suffering from vitiligo 

best treatment clinic for vitiligo in Hyderabad

What is vitiligo ?

It is a skin disorder that causes the skin to lose its color. Smooth white areas (called macules if less than 5mm or patches if 5mm or larger) appear on a person’s skin. If you have vitiligo in a place that has hair, the hair on your body may also turn white. The condition occurs when melanocytes the cells responsible for lending colour or pigmentation are destroyed by the body’s immune system.

How does it spread ?

Vitiligo usually begins with a few small white patches that may gradually spread over the body over the course of several months. Vitiligo typically begins on the hands, forearms, feet, and face but can develop on any part of the body, including the mucous membranes (moist lining of the mouth, nose, genital, and rectal areas), the eyes, and inner ears.
vitiligo treatment before/after images in Hyderabad
Vitiligo treatment before/after images
Sometimes the larger patches continue to widen and spread, but usually they stay in the same place for years. The location of smaller macules shifts and changes over time, as certain areas of skin lose and regain their pigments. Vitiligo varies in the amount of skin affected, with some patients experiencing few depigmented areas and others with widespread loss of skin color.

1. What are the types of vitiligo?

Vitiligo can be:

• Generalized, which is the most common type, when macules appear in various places on the body.

• Segmental, which is restricted to one side of the body or one area, such as the hands or face or the body

• Mucosal, which affects mucous membranes of the mouth and/or the genitals.

• Focal, which is a rare type in which the macules are in a small area and do not spread in a certain pattern within one to two years.

• Universal, another type of vitiligo, and one in which more than 80% of the skin of the body lacks pigment.

2. What causes vitiligo?

The causes of vitiligo aren’t completely understood.however there are a number of different theories:

• Autoimmune disorder: The affected person’s immune system may develop antibodies that destroy melanocytes.

• Genetic factors: Certain factors that may increase the chance of getting vitiligo can be inherited. About 30% -35% of vitiligo runs in families

• Neurogenic factors: A substance that is toxic to melanocytes may be released at nerve endings in the skin.

• Self-destruction: A defect in the melanocytes causes them to destroy themselves.

• Vitiligo may be triggered by certain events, such as physical or emotional stress.

How is Vitiligo treated?

Camouflage therapy:

• Using sunscreen with an SPF of 30 or higher. Also, the sunscreen should shield ultraviolet B light and ultraviolet A light (UVB and UVA). Use of sunscreens minimizes tanning, thereby limiting the contrast between affected and normal skin. • Makeups help camouflage depigmented areas. • Hair dyes if vitiligo affects the hair. • Depigmentation therapy with the drug monobenzone can be used if the disease is extensive. This medication is applied to pigmented patches of skin and will turn them white to match the areas of vitiligo.

Repigmentation therapy:

• Corticosteroids can be taken orally (as a pill) or topically (as a cream put on the skin). Results may take up to 3 months. Your treating physician will monitor you for any side effects, which can include skin thinning or striae (stretch marks) if used for a prolonged period. • Topical vitamin D analogs. • Topical immunomodulators such as calcineurin inhibitors.

Light therapy:

• Narrow band ultraviolet B (NB-UVB) requires two to three treatment sessions per week for several months. • Excimer lasers emits a wavelength of ultraviolet light close to that of narrow band UVB. This is better for patients who do not have widespread or large lesions since it is delivered to small, targeted areas. • Combining oral psoralen and UVA (PUVA) is used to treat large areas of skin with vitiligo. This treatment is said to be very effective for people with vitiligo in the areas of the head, neck, trunk, upper arms and legs.

Alternative medicine:

In India it's a widely trusted modality especially unani and some forms of Ayurveda help in control the condition and prevent further spread.many patients receiving these treatments have been reported to even have gained pigmentation in the affected areas.in those patients having an unstable condition ,we strongly recommend that patients receive these treatments before attempting any type of corrective surgical procedures.

Surgery:

Surgery is attempted in those patients seeking cosmetic improvement provided the lesions are stable for the last one and a half years . If light therapy and medications haven't worked, some people with stable disease may be candidates for surgery. The following techniques are intended to even out skin tone by restoring colour : • Skin grafting. In this procedure, your team of surgeons will transfer very small sections of your healthy, pigmented skin to areas that have lost pigment. This procedure is sometimes used if you have small patches of vitiligo.
Possible risks include infection, scarring, a cobblestone appearance, spotty color and failure of the area to recolor. • Blister grafting. In this procedure, your surgeons create blisters on your pigmented skin, usually with suction, and then transplants the tops of the blisters to discolored skin.
Possible risks include scarring, a cobblestone appearance and failure of the area to recolor. And the skin damage caused by suctioning may trigger another patch of vitiligo. • Cellular suspension transplant(micrografting or Melanocyte transplantation)In this procedure, your surgeons take some tissue on your pigmented skin, put the cells into a solution and then transplants them onto the prepared affected area. The results of this repigmentation procedure start showing up within four weeks.the advantages of cell suspension procedures are that the results are more even toned and that larger and more extensive areas can be treated in one single session as compared to skin grafting or suction blister grafting .

Post Operative Care for Vitiligo

Immediately after the surgery
  • You will be given a dressing which needs to be changed once in 3-5 days.
  • After the surgical site is dry ,the part may be exposed to air .
Full recovery timeline
It is recommended that one exposes the part to sunlight for atleast 30 mins to enhance pigmentation creams enhancing pigmentation may also be prescribed for a period of 4-6 weeks till you start noticing pigmentation in the operated area moisturisers may be prescribed to reduce itching.