Vitiligo is an acquired skin pigmentation disorder, characterized by milky-white or discolored patches, single or multiple on any part of the body. The reason behind this pigmentation is due to the progressive destruction of color-producing cells of the skin called melanocytes.
Although, vitiligo is a harmless condition, due to social stigma the patient feels embarrassed and develops low self-esteem and very low confidence. Most of the patients due to social pressure adopt treatment.
There are various modalities of treatment. The choice of treatment depends on your age, how much skin is involved; the disease is progressing and affecting your life.
Many treatments for vitiligo are available – medication, phototherapy, surgical treatments, etc. In the past, the treatment options were few, with the intensive research we can clear vitiligo from 20% to 100% depending upon the disease stability and early treatment invention. The treatment available helps to restore skin color and in some, it ends up making the skin color look more even. As the treatments can have various untoward side effects, they need expert monitoring.
Medical treatment helps to achieve the repigmentation of skin color and arrest the spread of the depigmentation process. In the majority of cases phototherapy is helpful to restore the pigment; and in limited stable vitiligo, not responding to conventional treatment, repigmentation can be achieved by 308 excimer and or with surgery.
Herewith we at Clear Skin Centre, before suggesting you with treatment, we will undertake you through a whole counseling process as to what your actual problem is, why are we suggesting this treatment and how is it feasible for you, etc., and regarding the best possible treatment to restore our color.
1. Medical or Conventional treatment includes topical and systemic medication.
Topical medication: such as topical corticosteroid and most recently used topical calcineurin inhibitors (tacrolimus, pimecrolimus) are most commonly used to achieve repigmentation.
Systemic Medication: to be added if topical therapy fails to respond or in whom the condition is progressing rapidly. Immunosuppressive drugs such as oral corticosteroid or methotrexate or azathioprine or psoralens and sunlight exposure may be useful.
If Conservative treatment fails, we may need interventional treatment such as phototherapy or surgery to restore the color.
2. Phototherapy: are further divided depending upon the area of exposure and the band of light used.
In this phototherapy process, we expose the patient to the whole body or specific areas such as hand & foot to artificial Ultraviolet A & Ultraviolet B rays. This treatment process may take about 4 to 6 months.
Targeted phototherapy: Targeted phototherapy is an exciting new technology that seeks to overcome some of the disadvantages with conventional phototherapy. This modality involves the application of light energy directly focused on or targeted at the lesion through special delivery mechanisms. The main advantages are safety, ease of administration, and suitability for difficult to treat areas and in children.
The two most used commonly in the field of dermatology across the globe are:
Daavlin Lumera & 308 Excimer system.
The world’s most advanced treatment with specific ultraviolet wavelength targeting the only affected skin without involving surrounding skin. It is most effective, quick, and needs only a few treatment sessions once in four or seven days.
3. Surgery Treatment:
If phototherapy and medications haven’t worked, some patients with the stable and limited disease may be best suitable for surgery. The following techniques used are: Skin grafting: In this procedure, very small sections of your healthy pigmented skin, transfers to areas that have lost pigment. Possible risks include infection, scarring, a cobblestone appearance, spotty color, and failure of the area to recolor. There are different techniques of skin grafting mentioned below such as:
Miniature Punch Grafting (MPG):
Taking of thin, miniature split thickness of sizes 1.5, 2, or 2.5 mm with a specialized skin punch from normal/pigmented skin usually external part of thighs or gluteus area grafting them in the appropriately punch out chambers at recipient vitiligo site. Basically, this is a kind of skin implant.
Suction Blister Grafting (SBG):
In this procedure, the blisters are created on a donor or pigmented skin; usually with suction, and then the roof of the blisters is carefully removed and placed or transplant on the dermabraded or laser-ablated vitiligeneous site. The pigmented cells from the implant begin to move into the vitiligo area within a week. This re-pigmentation may take about two to three months to complete.
Ultrathin split-thickness skin graft containing the epidermis and the uppermost part of the dermis, grafting them to the dermabraded or laser-ablated recipient vitiligeneous site.
Non-cultured melanocyte transplant or Cellular suspension transplant: This is a simple, outpatient procedure, in which some tissue from pigmented skin is taken, put into a solution to separate the cells, to get a rich yield of melanocyte, and then transplanted to the affected area. The repigmentation start showing up within four weeks of the procedure.
Micropigmentation: Micropigmentation is a technique in which rapid instantaneous insertion of minute, metabolically inert pigment granules are implanted below the epidermis for cosmetic and/or corrective enhancement. The process can be performed in vitiligo involving lips, areola, in less than two hours.
All of these procedures are usually completed in one sitting, though large areas may take several sittings. These are outpatient procedures and there is no sort of hospitalization required.
As the latest equipment or technology and advanced treatment are the demands of the present time. We at Clear Skin Centre bring to you these all at one place, the most advanced, up-to-the-date world’s best technology, and enabling to treat the vitiligo problem under one roof. In fact, if you go on comparing, you will find that we have some of the most popular equipment that is widely used in most of the well-advanced countries.