Treatment for Vitiligo

Vitiligo is incurable but there are a number of treatments, including natural vitiligo treatments, that can help slow down the spread of the condition and help patients feel better about their vitiligo. Some treatments focus on evening out skin tone by using cover-up make-up on the white skin patches, tattooing to repigment the white spots of skin, or through depigmentation of the remaining skin areas. Where extensive vitiligo has caused almost complete loss of melanocytes and there are just a few patches of pigmented skin remaining some patients do choose to deliberately destroy those remaining melanocytes for an even skin colour.

Many patients with vitiligo simply choose to ignore the condition or just use extra sunscreen and cosmetics to protect and camouflage the white skin spots. Homemade skin stains using food colouring and rubbing alcohol may also be used although the alcohol can severely dry out the skin and lead to other skin conditions aside from the vitiligo. More conventional vitiligo treatment usually involves the use of topical steroid creams, topical immunomodulators, and/or narrrow-band UVB in an attempt to slow down the progressive depigmentation. As the cause of vitiligo is largely unknown it is difficult to apply effective treatments for all patients although the general approach is based on the concept of vitiligo being an autoimmune condition where the body is triggered to destroy its own pigment-producing cells. Using those medications mentioned can be extremely effective for vitiligo in children as they respond much faster to such intervention than adult vitiligo patients do.

Topical Corticosteroid Therapy for Vitiligo

When corticosteroid treatment is used for children with vitiligo it can sometimes help in returning colour to the skin. This is less likely to happen in adults or older children unfortunately, but for those under ten years of age a mild topical corticosteroid applied to the white patches of skin is the simplest of vitiligo treatments and often effective. There are however possible side-effects including streaking of the skin and skin-thinning. Corticosteroid treatment must, therefore, be closely monitored and children should not be left to apply the vitiligo treatment themselves, nor should anyone other than the patient for whom it is prescribed use the steroid cream. Corticosteroid creams for vitliligo are often used alongside a topical vitamin D derivative.

Topical Psoralen Plus Ultraviolet A (topical PUVA) Treatment for Vitiligo

One of the most effective vitiligo treatments is the combination of topical psoralen plus ultraviolet A (known as topical PUVA). A thin layer of psoralen on the white patches of skin, left for thirty minutes to soak in and then exposed to UVA light can help restore pigment to the white skin spots. The skin will usually turn pink initially and then normal skin colour may be restored as the pinkish hue fades. This type of treatment occurs over a number of weeks with sessions once or twice weekly. The results of treatment vary between individuals with potential side-effects of topical PUVA therapy including severe sunburn, blistering of the skin, and hyperpigmentation where the treated skin and/or surrounding areas of skin become darker than normal skin.

Oral Psoralen Photochemotherapy (oral PUVA)

Oral psoralen photochemotherapy (oral PUVA) is another possible vitiligo treatment that may be used for patients with extensive depigmentation affecting more than a fifth of their skin. Patients who tried topical PUVA with little success may be advised to attempt oral PUVA instead. This vitiligo treatment involves the ingestion of prescribed psoralen two hours prior to exposure to UVA light or sunlight. The treatment is given two or three times a week but not on consecutive days so as to allow the skin time to heal and avoid blistering or sunburn as far as possible. Patients may experience side-effects such as itching of the skin (pruritis), nausea, vomiting, sunburn, and hyperpigmentation. Changes in hair-growth may also occur and the oral PUVA treatment increases the patients’ risk of skin cancer and damage to the eyes. As such, it is important to use sunglasses with protective UVA filters to protect the eyes as well as sunscreen on the skin during the next day or two after treatment. Patients are advised to avoid direct sunlight as much as possible for the 24-48 hours after vitiligo therapy to minimise skin damage.

Narrow-Band Ultraviolet B Therapy

Another light-based vitilgo treatment uses UVB rather than UVA without the need for psoralen, either orally or topically. This makes treatment simpler to administer and, arguably, safer than PUVA therapies. Patients may have treatment three times a week and this is often the preferred vitiligo therapy for those with white patches covering more than 20% of their body.

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