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Vitiligo

Vitiligo is an autoimmune disorder. Basically, it causes white patches to appear on the skin. Certain reasons damage melanin-producing cells called melanocytes.

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Many treatments help restore skin color or even out skin tone. However, these results vary. Moreover, they are unpredictable. READ MORE

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In individuals with vitiligo, the skin may lose pigment rapidly in several areas. In fact, there may be cycles of pigment loss and stability.

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Vitiligo

Vitiligo is a non-contagious disease that is caused by an autoimmune disorder. In fact, this causes the immune system to become overactive and destroy melanocytes. Therefore, this results in white patches on the skin. It may also happen because of genetic causes, injuries, exposure to harmful chemicals or neural causes. White patches that appear on the hands, feet, arms, face, and lips are the main sign. These patches do not itch or pain.

Do & Don't for Getting Vitiligo

DO: Use fabrics that absorb moisture
DO: Make use of natural oils to keep your skin healthy
DO: Bathe with mild, non-acidic body wash, glycerin-based soaps.
DO: Apply moisturisers
DO: Use a broad-spectrum sunscreen.
DO: Take physical sun protection like scarves and umbrella.
DO: Join support groups.

DON’T: Don't wear clothes made of synthetic fibres
DON’T: Avoid exposure to direct sunlight
DON’T: Don't use hair dyes, lipsticks, perfumes
DON’T: Avoid things made out of rubber
DON’T: Don't eat unhealthy food
DON’T: Don’t get tattoos.
DON’T: Avoid sunbathing.
DON’T: Don’t isolate yourself.

Affected areas are

  • Armpits
  • Groin
  • Around the mouth
  • Elbows
  • Ankles
  • Knees
  • Lower back
  • Eyes
  • Nostrils
  • Navel
  • Genitals
  • Fingers and toe tips
  • Rectal areas
  • Back of the hands

The most common type of vitiligo is the non-segmental vitiligo and is found in up to 90 per cent of cases.

In the cases of non-segmental vitiligo, patches often appear equally on both sides of the body and are also symmetrical. In most of the cases, these spots appear on parts of the skin which is commonly exposed to the sun, such as the face, neck, and hands. However, patches can also appear in other areas.

Types of Vitiligo

  • Generalized:
    This type of vitiligo appears as multiple patches all over the body. Moreover, it may occur in mirror images on the left and right sides of the body.
  • Acrofacial:
    This type of vitiligo appears mostly on the face, especially around the nose and lips.
  • Mucosal:
    The mucosal vitiligo appears mostly around the mucous membranes and lips and genital mucosa.
  • Universal:
    This occurs in extremely rare cases. However, in such a scene depigmentation covers most of the body.
  • Focal:
    Scattered white patches may develop in a single, localised area. Moreover, this type of vitiligo occurs very young children.

Treatments of vitiligo 

Vitiligo is not curable. It is only treatable. Moreover, it is not even preventable. This is because it is an autoimmune condition. When you visit a skin specialist, you need to provide your entire medical history to your doctor. In fact, your doctor will assess your skin to first rule out any other skin ailment. 

The doctor may do the following things to assess whether you have Vitiligo or not: 

  1. Use a special lamp with ultraviolet light to determine whether you have vitiligo.
  2. Skin biopsy and blood draw

Finally, your doctor will determine if you have Vitiligo. Further, he will also determine how extreme or severe your condition. He will decide on a treatment plan accordingly. 

In fact, before choosing a treatment method, doctors generally take a blood test to assess the health of the thyroid gland. This is because people who have vitiligo often have thyroid diseases. If the patient has a thyroid disease, treatment can successfully control it.  The treatments will take multiple sessions.  In fact the results will be visible over a period of 6-12 months.

The treatment approach for Vitiligo can be either one of the below treatments alone, or in combination: 

  • Topical applications

These medicines aim to restore the skin tone. However, none of these medicines stop the process of vitilig or the loss of pigment cells (melanocytes). Dermatologists may prescribe either of the following creams: 

  1. Creams that control inflammation: These creams are usually corticosteroid creams. They help affected skin to return to its original color. This is especially true in the early in the disease. However, you may not see a change in your skin's color for several months.
    These cream are effective. In fact they are the easiest to use. However, these creams may cause side effects like skin thinning. 
  2. Ointments that affect the immune system: These ointments contain tacrolimus or pimecrolimus (calcineurin inhibitors. Moreover, they are effective for people with small areas of depigmentation on the face and neck.These creams  may have fewer side effects than corticosteroids. 

 

  • Therapies

  1. Psoralen and light therapy: This treatment is a step-step process. The first step is to take psoralen orally or apply it topically. Psoralen is a plant-derived substance. After you take the psoralen, you're exposed to ultraviolet (UVA) light, UVB light or excimer light. One may need to repeat this treatment as per the dermatologist’s advice. 
  2. Depigmentation: This therapy involves the removal of the remaining color. Dermatologists may recommend this option if the vitiligo is widespread or other treatments haven't worked. 

This treatment involves the application of a depigmenting agent to the unaffected areas of skin. This area gradually lightens. Eventually, it blends with the discolored areas. The therapy is usually done once or twice a day for at least nine months, sometimes longer.

This treatment may cause certain side effects.These may  include redness, swelling, itching and dry skin. 

However, depigmentation is permanent. Although, you'll always sensitive to sunlight. As a result, you will have to take strict measures to protect yourself from the sun. 

Both these approaches tend to have better results than just medications. 

 

  • Surgery 

Dermatologists will recommend you surgery neither medications nor light therapies have worked for you. However, they may also suggest surgery in combination with other therapies. Surgery aims to even out your skin tone. It also aims to restore your skin colour.

  1. Skin grafting:  In this procedure, your doctor will remove or graft small sections of your pigmented skin. He will then attach those grafts to areas that have lost pigment. This procedure is effective for small patches of vitiligo.
    It is important to remember that this possible is risky. If not done by a well-trained dermatologist, it can result in infection, scarring, a cobblestone appearance, spotty colour or even failure of the area to recolour.
  2. Blister grafting: In this procedure, your doctor shall create blisters on your pigmented skin. Thereafter, he shall remove the top of the blisters to transplant them to the area of discoloured skin.
    There are some side effects of this surgery too. These could include scarring, a cobblestone appearance and failure of the area to recolour. Any skin damage due to the blister grafting can trigger another vitiligo patch.
  3. Tattooing (Micropigmentation): In this technique, the doctor uses a special surgical instrument to implant pigment into your skin. This procedure is most effective in and around the lips in people with darker complexions.
    However, it might get difficult to match skin color. If the procedure is not done properly, it can trigger another patch of vitiligo.

These treatments will be recommended by a dermatologist or a skin specialist. 

Lifestyle Changes

It is important to also make some lifestyle changes. 

    1. Sun protection: One must take complete protection from all kinds of UV light. Use a broad-spectrum, water-resistant sunscreen with an SPF 30. Apply sunscreen well. In fact, it is important to reapply it every three to four hours. 
    2. Make sure you take physical protection too. This includes wearing a scarf, stole, long-sleeved clothing, using umbrellas. 
    3. Don't sun-bathe. 
    4. Don't get a tattoo ever. 

Vitiligo isn’t a threatening disease. However, it affects one’s self-esteem. Many individuals feel ashamed or sad and distressed due to Vitiligo. It is even more frustrating because it recurs.

Moreover, if the condition is not letting you lead your life properly, it can become stressful. You need support to cope with it. 

    • Find a doctor who can truly help you deal with this condition. 
    • Learn and be aware about everything you need to know about the condition. Make sure you are aware about the myths and don’t believe them. 
    • Communicate your feelings with your doctor. 
    • Confide in others. Join support groups to talk to people who are going through the same issue as you. 
    • Reach out for support from your loved ones. 
    • Don’t isolate yourself ever.

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Clear Skin &HairMD team is pleased to offer ONLINE VIDEO COUNSELLING facility to to help patients with basic counselling for their skin and hair ailments, especially in the trying times when social distancing has become a necessity.

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About Doctors

Dr. Dhananjay Chavan

Clearskin is spearheaded by Dr. Chavan, a certified dermatologist with over 30 years of experience. He has successfully treated patients with different dermatological problems.
He is the Medical Director and the driving force behind ClearSkin.
He completed his Masters in Dermatology from the historic B. J. Medical College Sassoon Hospital, Pune. He is a visiting faculty at the Department of Dermatology, Krishna Institute of Medical Sciences, Karad.
He is very passionate about all types of cosmetological and dermatological procedures and is strongly recommends a holistic approach for all types of skin and cosmetological problems.

Dr. Chavan is one of the leading dermatologists in India, and is well known internationally as well.

Dr. Sachin Pawar

Dr. Sachin Pawar is a highly qualified hair transplant consultant and surgeon with more than 17 years of industry experience. He completed his post graduation from Krishna Institute of Medical Sciences KIMS, Karad. He has been associated with Dr. Dhananjay Chavan since the past 10 years. He has relevant experience in the fields of dermatology, hair transplant and surgery. He has an associate member of International Society of Hair Restoration Surgery (ISHRS).

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Timeline for Vitiligo

The doctor can diagnose vitiligo by examining the patient's skin. It is a lifelong condition. Once the skin loses the pigment, it is very rare that it will return. The vitiligo patches usually start to appear around 20 years of age. Once they appear, the size may remain stable for a while, however, with time they will get bigger and spread over the skin. It may be controlled with modern medical treatments but there is always the possibility of recurrence.

Do & Don't for Tattoo Removal

DO: Keep the affected area clean and dry.
DO: Apply antibiotic ointment 2-3 times a day.
DO: Keep it covered for the first 2-3 days.

DON’T: Take hot baths.
DON’T: Expose it to direct sunlight.
DON’T: Use any cosmetics, since they can irritate the skin.
DON’T: Scrub the treated area since it is sensitive.

Do & Don't for Getting Aging

DO: Consult your dermatologist before trying any product or treatment
DO: Use broad-spectrum sunscreen to prevent photodamage.
DO: Maintain a healthy skincare routine.
DO: Drink 2-3 litres of water daily.
DO: Eat a healthy & balanced diet

DON’T: Use sulphate and petroleum jelly based skin care products.
DON’T: Use skincare products that don’t suit your skin type.
DON’T: Leave the house without sun protection.
DON’T: Smoke and drink.
DON’T: Overuse anti-ageing products.



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