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Vitiligo (White Patches)

What is Vitiligo?

Vitiligo is a disease in which the skin loses pigment due to the destruction of melanocytes or pigment cells. Areas of the skin become white. Vitiligo is common; in fact 1 to 2% of the general population has it.

What causes Vitiligo ?

Some researchers think the body may develop an allergy to its pigment cells; others think that the cells may destroy themselves during the process of pigment production. Research on the cause is continuing. Vitiligo could be associated with Diabetes, Thyroid problems, pernicious anemia, alopecia in a few patients.

Will it Spread?

Vitiligo may spread to other areas, but there is no way of predicting whether or where it will spread. In many cases, initial pigment loss will occur; then after several months, the number and size of the light areas become stable and may remain so for a long time. Episodes of pigment loss may appear again later on. Many vitiligo patients report that initial or later episodes of pigment loss followed by periods of physical or emotional stress, which seem to trigger depigmentation in those who are predisposed. Sometimes, depigmented areas may spontaneously repigment.

Can Vitiligo be Treated?

Several modes of treatment are available for Vitiligo.

Topical treatments may include steroids, tacrolimus, psoralens, placental extracts.

What is PUVA ?

PUVA therapy-  The treatment name comes from "Psoralen + UVA," the two factors involved. Patients are given a drug called Psoralen (applied to the skin or taken orally), then are exposed to a carefully measured amount of a special form of ultraviolet A (UVA) light. The treatment is given 2-3 times per week, each lasting 5-10 minutes. It takes approximately 25-30 treatments, over a two- or three-month period, before improvement is seen. Because Psoralen remains in the lens of the eye, patients must wear UVA blocking eyeglasses when exposed to sunlight from the time of exposure to Psoralen until sunset that day. Narrow Band UVB treatment is a new development, which is more effective than UVA, more safer and can also be used in children. 

The psoralen treatment is not always successful, but many patients find that it is helpful in restoring significant degree of pigmentation to areas of the skin with Vitiligo.

What are the other modes of treatment for Vitiligo ?

Camouflage make-up may be used to blend the white patches into the surrounding normal skin color and has to be used on a daily basis.

Oral medications in the form of steroids, Levamisole may be necessary to control the spread of vitiligo.

Surgeries like punch grafting, suction blister gafting, Split thickness grafting, Melanocyte transplantation, dermabrasion could be done for treatment of difficult areas. One of the important prerequisites for surgery is that the vtiligo should be stable for atleast 6 months.

In some cases, physicians use a different kind of medication to totally depigment the skin so the patient is an even color. Total depigmentation is tried, however, only in very severe cases of Vitiligo.

Treatment for Vitiligo is given by dermatologists. You can discuss these treatment options further with your physician.

Is it Contagious?

Vitiligo is absolutely not a contagious disease.

Will My Children Inherit it?

There seems to be a hereditary component to Vitiligo. In about 30% of cases, there is a family history of Vitiligo. Your children have a somewhat higher probability of developing Vitiligo than do children from families with no history of the disease.

Should children and adults change their diets?

There are no known factors in foods that cause individuals to get vitiligo. We don't recommend any routine changes in the diet.

Does skin that is injured or stressed have a greater tendency to develop vitiligo?

The normal appearing skin of a person is in truth not really normal. With special microscopes investigators have shown that all skin in a person with vitiligo is altered. So any injury -- an abrasion, a cat scratch, a surgical procedure -- can cause whitening of skin at that site. Hence, all sorts of injuries must be avoided in these patients.


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