Vitiligo – Ensuring Freedom from White Patches on your Skin
Introduction
Vitiligo is a condition where the skin loses its natural colour and white patches appear in its place. Vitiligo can affect any part of the body including eyes, hair and the inside the mouth. These white patches may spread to different areas of the body and there is no way to properly estimate the rate at which they spread around.
This is not a contagious or serious disease but the perception of common people towards those who have Vitiligo may seriously affect their mental health. Many people with Vitiligo struggle to maintain their self-esteem and could even lead them to depression.
What Causes Vitiligo?
Melanin is responsible for the colour of our skin, hair and eyes. Vitiligo occurs when melanin stops producing in particular areas of the body. Scientists have yet to point out a specific reason for the sudden halt in the production of melanin. Some of the common causes of Vitiligo generally relate to:
• Disorder in the autoimmune system where the immune system, instead of attacking the germs, turn against its own cells in the body
• Hereditary factors
• Any exposure to harsh industrial chemicals, acute sun exposure, etc.
What Are The Signs of Vitiligo?
You can identify Vitiligo when you notice white patches developing on the skin. Vitiligo symptoms can be observed in different instances.
• The discolouration of skin in the areas exposed to the sun – hands, feet, face and neck.
• Discolouration around the folded areas in the body like the armpits or in near body parts with openings like lips.
• Premature greying of hair on head, eyelashes, eyebrows or beard.
• Loss of colour or changes in the colour of the retina.
Vitiligo starts at a young age, generally before the age of 20. It can occur in anyone irrespective of any physical conditions but the white patches are prominently observed in dark-skinned people.
Depending on the condition, the white patches may stop soon or it could spread rapidly to different areas of the body. It is important to visit a doctor as soon as you can the first signs of Vitiligo.
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How Is Vitiligo Diagnosed?
The doctor will first consult your medical history and will look into your family history for hereditary factors. The doctor will perform a physical examination of the affected area and may ask you to go for a blood test to check for any autoimmune diseases. Some may also perform a skin biopsy to look for the presence of melanin in the white patches.
From the results of the tests, the doctor can conclude if it is a condition of Vitiligo.
There are two main types of Vitiligo.
Segmental Vitiligo: This occurs only in one segment of the body like legs, hands, etc. Segmental Vitiligo is generally observed in young people and this can stop in a year after the occurrence of white patches on a particular body part.
Non-Segmental Vitiligo: This is a common kind of Vitiligo where the patients will observe white patches on either side of the body. The loss of colour may occur in a particular part of the body, stop for some time and may resume in different areas of the body. This may continue for the entire lifetime of the patient. The first signs of non-segmental Vitiligo are generally observed in the fingertips, feet or around the mouth and eyes.
Depending on your condition, the doctor may offer you options for treatment to bring Vitiligo under control.
In the meantime, it can be hard for many patients to be out in the public with this problem. During such times, it is important to talk about your feelings with your friends and family. You can also attend support groups for Vitiligo to cope with your issues of self-confidence.
What Are The Treatment Options for Vitiligo?
There are Vitiligo treatment options depending on the current condition. Some have good results on certain patients while others may have side effects. It is important to discuss with a dermatologist about your expectations and the safest options. There is no one proper Vitiligo cure and you may probably need to try out different methods to see which suits you the best.
If you have less white patches on the skin, the doctor may advise you to go for makeup or tanning options to hide the discolourations. In case if you want to go for a more permanent solution, the doctor may start with suggestions for some medications. Keep in mind that not all treatment works for everyone and there is no proven treatment to cure Vitiligo permanently.
The Vitiligo treatment cost varies widely based on the type of treatment you opt for. It may start from around Rs. 20,000 and may go up to one lakh depending on the duration of the treatment.
Medications
Some medications as prescribed by the physicians could help get away with Vitiligo.
For Minimal White Patches: If you have early symptoms of Vitiligo, the doctor may recommend corticosteroid cream to return the original skin colour. This can work for some patients who have fewer instances of white patches on the skin. It may take a while to see the effects of the cream and even if you can observe the changes, it still comes with some side effects like the appearance of lines on the skin or thinning of the skin.
You can also go for creams that could influence the immune system when you have a little occurrence of Vitiligo. This has lesser side effects than using the corticosteroid cream although in some recent research, it is linked to skin cancer.
For Extensive White Patches: Depigmentation is one of the rare options to go for. If most of the entire body is covered with white patches, then some patients may go for depigmentation medication to even out the entire skin tone. There are ointments for depigmentation that need continuous application for more than a year as advised by the dermatologist. This strips the skin of all natural colour pigments and makes the skin look white entirely.
Some patients, after depigmenting their entire skin, may notice several spots after being out in the sun. They can remove these spots with the depigmentation cream. Depigmentation is permanent and therefore, it is important to try other forms to treatment to restore the natural skin colour before opting for it.
Light Therapy
Light therapy is one of the effective therapies to treat Vitiligo. Although, it is not sure how long they last. There are two main types of light therapy
Using Laser: For this treatment, the patient will need to sit in a box to receive the laser treatments. You will have to go for this treatment regularly for several weeks to see the results. Though there may be a colour mismatch between the treated skin and the normal skin initially, this will soon get normalized after a few months. This is not a permanent treatment as a majority of patients will lose the colour on the treated skin within a few years after stopping the treatment.
Using UVA Light: In this treatment, the doctor will apply a substance called on the affected areas or taken internally. Right after this, the patient will be exposed to UVA light to restore the natural skin colour. You will need to go for this treatment weekly twice for over a year to see good results. This is one of the popular treatments for Vitiligo although there are chances of the eyes getting affected by psoralen.
Surgery
When none of the above treatment works, the doctor will recommend you to a plastic surgeon for undergoing surgery. Surgeries are effective on more than 90% of the patients. Various surgical options can restore the skin colour, which will be chosen by the surgeon based on your condition. Sometimes, the surgery will be performed in combination with one of the light therapies for maximum benefits.
It is not recommended for children with Vitiligo to go for surgery. Children can try for other safer treatments options and opt for surgery only when they have reached an admissible age.
How Is The Surgery for Vitiligo Performed?
There are different methods of Vitiligo surgeries and your plastic surgeon will recommend the best procedure based on your condition.
Micropigmentation
In this procedure, the surgeon will add pigments to your skin with a special surgical instrument. This method is best suited for those having dark complexions, as there can be chances of mismatches in the skin tone with the pigmentation.
Skin Grafting
This procedure is performed for those who have fewer signs of Vitiligo on their body. Through skin grafting, the surgeon will take small sections of the normal, unaffected skin from your body and graft it on the areas of the white patches. This will help in making your affected skin look normal.
Blister Grafting
This procedure involves creating blisters on the normal, pigmented skin on your body. The surgeon will induce these blisters, which will then be taken and transplanted to the areas of the affected skin.
After the completion of the surgery, the patient will be kept under observation for a few hours and discharged. The surgeon may ask the patient certain preventive measures to preserve the results of the procedure, like avoiding sun for a few days and using certain skin products. It is important to follow the instructions of the surgeon to prevent Vitiligo from showing up again.
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What Are The Risks Associated with Vitiligo Surgeries?
• There can be chances of infection due to the grafting techniques.
• The surgery may leave permanent scarring on the skin.
• Blister grafting surgery may sometimes result in triggering the chances of Vitiligo on another section of the body.
• Some patients may experience itchy skin.
• The appearance of the skin may be streaked, spotted or have prominent lines in different colour.
• There are some chances that the results of the treatment may not be permanent.
How Can You Care for Your Skin after Vitiligo Treatment?
No matter what kind of treatment you go for, to preserve the effects of the treatment for a long time, it is essential to take some day-to-day precautions.
• Wear Sunscreen: It is best to avoid going out in direct sunlight as much as possible. Wear a high SPF sunscreen even if you stay indoors and especially before you step out in the sun. Consult a dermatologist to opt for a good sunscreen that does not have any chemical reactions with your treatment.
• Protect The Skin: Cover your skin with clothes as much as possible under sunlight and avoid wearing dark colours when going out in the sun. Covering your skin will also protect it from other dirt and dust from the environment.
In case if you find the signs of Vitiligo after the treatment, you can consult the doctor for further steps. In the meantime, you can use any of the makeup products available in the market to cover the affected skin and make it look normal.
The information is being provided by PlasticSurgery.in and have no intention to replace the medical advice of your doctor. Please consult your doctor directly for advice about a specific medical condition. This document was last reviewed by Dr. Tejinder Bhatti, Plastic Surgeon on: 20-JUN-2020
“Dr. Tejinder Bhatti is a cosmetic plastic surgeon by training but now completely dedicated to the art and science of minimally invasive hair restoration surgery. He also runs a hospital, the Five Rivers Hospital in Mohali, Chandigarh where junior plastic surgeons perform esthetic plastic surgery under the overall supervision of Dr. Kulwant S Bhangoo who is the Chairman of the Program. Dr. Bhangoo is certified by the American Board of Plastic Surgeons. He is an internationally renowned top cosmetic surgeon and chief of Plastic Surgery in Buffalo NY, USA.”
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