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Vitiligo

Treatments that aim to hide the white patches - Skin Camouflage
Skin camouflage uses special coloured cover creams that are put on the white patches of vitiligo. Skin camouflage does not alter the disease but improves the skin's appearance. The aim is to find a colour to match the colour of your skin. Some special cover creams can be prescribed which are available over the counter and some are prescription items. The cream can disguise vitiligo very well which may greatly increase self confidence.

Treatments that aim to reverse the changes in the skin:
There is no once and for all 'cure' for vitiligo. However, some treatments have been shown to slow down the progression of the condition, and some treatments cause affected skin to regain pigment and colour in some cases. No single treatment for vitiligo works well in all cases. The response to the various treatments is variable. The following just gives a brief overview of current treatment options.

  • Steroid cream :
    This is sometimes prescribed when a patch of vitiligo first develops. It may prevent a smaller patch from getting bigger. Occasionally, skin colour may return over a treated area. However, steroid cream is usually only advised for a limited time as long-term use can cause side-effects.

  • Tacrolimus/pimecrolimus cream or ointment :
    This is a relatively new treatment. It has been used to treat eczema for a few years, but has also been shown to restore skin colour to some people with vitiligo. It seems to be most effective for vitiligo on the face. It works by suppressing cells of the immune system in the skin (which probably attack the melanocytes).

  • PUVA treatment :
    PUVA stands for Psoralen and Ultra Violet A light. It involves taking a special medicine (a psoralen) which makes the skin very sensitive to light. The skin is then treated with ultra violet A light (UVA) from a special machine in hospital. This treatment works well in some people .Treatment is needed twice a week for 6-12 months or more.

  • Narrowband UVB phototherapy :
    This is another 'light' treatment that has recently been developed. It uses ultaviolet B light (UVB). As with PUVA, treatment is twice or thrice weekly but you do not need to take a medicine to sensitise the skin. It is reported to have better results. It can be safely used in children and even pregnant women.

Surgical Management :

  • Micropigmentation
  • Punch skin grafting
  • Split skin grafting
  • Bullous roof grafting
  • Autologous Cultured Melanocytes Transplant
  • Non Cultured Autologous Melanocyte Transplant
  • Hair transplant for Leukotrichia in vitiligo

Treatment to completely de-pigment the skin
In some people with extensive vitiligo a treatment may be considered to make the remaining normal areas of skin to go white. This makes all the skin an even white colour. This is done only after a full discussion with a specialist. The removal of all the skin pigment is permanent and it takes about a year to complete.

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