Understanding vitiligo: main treatment options available

close up photo of woman s shoulder

Premature whitening of the hair, depigmentation on various areas of the body including face, hands and feet, change in color of the retina all represent signs of vitiligo, a skin disorder that certainly does not discriminate, taking into account that it can affect all individuals across the globe, regardless of the age, language, religion, culture or gender. Everyone can recognize a person suffering from vitiligo due to the visible white patches on the skin, but most people do not actually know the causes leading to such an unforgiving skin disorder. These include heredity, meaning that sometimes it runs in the family, a virus, exposure to certain toxic chemicals, sunburn, which people can avoid easily, a stressful life event or an autoimmune disorder that forces the immune system, the body‘s natural defense, to destroy the melanocytes, skin cells that produce melanin, a skin-darkening pigment. Even though some people might have the tendency to stay away from those affected by vitiligo because it changes their physical appearance, the medical condition is harmless meaning that it is not contagious.

Experts recognize two main types, namely segmental and non-segmental. The first type is non-symmetrical and even though it spreads very quickly, it is not as erratic as non-segmental vitiligo, which results in skin patches on areas bearing too much sun exposure, such as mouth, nose, eyes, arms, knees and elbows. Those individuals who view it as a cosmetic issue are terribly mistaken because vitiligo represents a disease that requires medical treatment. Unfortunately, vitiligo does not have a cure, but specialists work towards decreasing its visibility. Thus, the most common vitiligo treatment options refer to phototherapy, whether with UVA light or UVB light, depigmenting and skin grafts, among others. Those who suffer from this medical condition choose make-up or tattooing as a solution to hide the skin blotches. The good news is that we can already start thinking about potential treatments developed in the future, such as a drug that sends stimuli forcing melanocytes to produce color, a drug that prevents vitiligo from spreading or a drug that reverses the change in or loss of color.

Until then however, those affected by the disease can explore the options available today, which involve medications, therapies and surgery. In what concerns medications, which have the purpose to restore skin tone as much as possible, we recognize creams, particularly corticosteroid cream, which is ideal in the early stage of the disease because they control inflammation and medications – calcineurin inhibitors –  that might provide satisfactory results for people with small white patches, which affects the immune system and have certain side-effects because researchers have identified a link between these medications and lymphoma. When it comes to therapies, doctors use a combination of psoralen and light therapy or photochemotherapy, which might prove to be more effective than the ones mentioned above, especially for widespread vitiligo. As for surgery, the methods available include blister or skin grafting and micropigmentation, which refers to implanting pigment into the patient’s skin. Grafting is a procedure that consists in applying small section of normal skin to areas without pigment.

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