Vitiligo mostly presents as de-pigmentation of visible areas of the face, neck, arms, legs and torso causing the appearance of milky white patches of pale skin which can badly contrast with the appearance of the normal skin areas for those with dark complexions. While this is not a deadly or contagious illness, it can cause immense personal and psychological distress for the sufferer. Vitiligo treatment has proved to be difficult and often lengthy and there is no evidence yet of a long term solution. It develops in most patients during puberty and can cause severe social and psychological damage that also irritate the condition. So where do you turn for vitiligo treatment?
Vitiligo affects people from all over the world but the vast majority of sufferers in the west turn first for traditional medical advice. Occurrences of the disease are estimated at around one percent in Europe and the United States and most patients develop symptoms in childhood or during puberty. Western medicine has invested much research in vitiligo treatment and recent reports of success in the use of two types of topical corticoid therapy: tacrolimus and clobetastol.
Regulated trials for each of the two topical ointments proved better than the placebo results in vitiligo treatment over a two month period for a cross section of fifty girls and boys with Vitiligo symptoms. According to one author, tracolimus was more effective than clobetasol propionate in restoring skin colour in lesion of Vitiligo because it does not produce atrophy (thinning of the skin) or other adverse effects. The conclusions were that for young patients of for sensitive areas of skin, such as the eyelids. A doctor can prescribe mild topical cortiscosteroid cream for children younger than ten and a stronger form for adults. This type of vitiligo treatment may take up to three months to take effect. While this type of vitiligo treatment remains expensive, it is simple and safe and you doctor will monitor any side effects.
Another topical vitiligo treatment is PUVA (psoralen plus ultraviolet) performed using ultraviolet light a couple of times each week through your local surgery. A thin coating of psoralen is applied to the white patches of skin half and hour prior to exposure to the ultraviolet light. The result turns the affected skin pink. Again this is a lengthy solution and a doctor may slowly increase the dose of ultraviolet over many weeks. Oral psoralen photochemtherapy may be used where the vitiligo stretches over more than twenty percent of the body or where there is no response to the topical PUVA therapy. The dose is taken a few hours before vitiligo treatment with side effects reported that include sunburn, nausea, vomiting, itching and abnormal hair growth. UVB therapy is now thought to be a better alternative to PUVA and can be given as often as three times a week. There is no need to apply psoralen before this type of vitiligo treatment and because administration of this treatment is simple it is gaining wide acceptance.
Also considered by patients and therapists is a treatment for depigmentation of all the skin, usually where the sufferer already has extensive patches of white covering more than fifty percent of the body. Benoquin is applied twice daily to the colored areas of the skin until these areas match the existing areas that have lost colour. Sunlight must be avoided during treatment and patients will always then be very sensitive to sunlight.
Further vitiligo treatment includes skin grafting where small patches of skin are grafted from one area to another as well as blister grafting and tattooing. Further studies are being conducted to introduce laboratory induced regeneration of melanocytes into the white patches but this procedure is associated now with on a few research institutions.
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