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Although science has not yet discovered a cure for vitiligo, there are several treatment options that may restore the lost skin colour. Sometimes people may also consider removing the remaining colour of their skin—depigmentation, for example Michael Jackson.
Studies have shown that people with vitiligo can experience a significant increase in their overall well-being after achieving an even skin tone.
Here, you will find the most common Vitiligo treatments available to people currently and relevant information on how to manage the condition. Let’s find out some basics of the condition first to understand it better.
What is vitiligo?
Vitiligo is a skin condition affecting about 1% of the world population (70 million) in which a person develops white or discoloured patches (called macules) all over their body.
This condition can develop in any person irrespective of their gender or ethnicity, but these patches/macules are more visible in people with dark skin tones or a tan.
Where some people with vitiligo develop only a few spots, others might have most of their skin and/or hair (more than 80%) lose colour. It is important to note that it is a non-contagious condition.
Usually, vitiligo runs in families; people who have a family history of the disease are likely to develop the condition. Vitiligo is believed to be an autoimmune disease that causes a person’s immune system to attack healthy melanocytes (the cells that produce melanin—the colour pigment of the skin).
How is vitiligo diagnosed?
To correctly diagnose this condition, the doctor will perform a visual examination and enquire about the patient’s and their family’s medical history. Depending on the severity of the condition, the doctor might recommend a specialist—dermatologist.
The dermatologist will likely use a ‘Wood’s lamp’ with different lights to figure out if a person has vitiligo or not. In addition, some blood tests and a skin biopsy might be recommended to eliminate the possibility of other diseases.
Since vitiligo is a chronic condition, a healthcare provider will likely share some lifestyle changes to better manage the condition and reduce the likelihood of condition/white patches spreading further.
Things to know before starting vitiligo treatment
- There is no cure for vitiligo, but its symptoms can be treated. Thus, depending on a person’s choice, they can either get the white spots on skin treated and restore the lost colour or go for a complete depigmentation to even out the skin colour. Additionally, stopping the macules from getting bigger and new patches from emerging is an available alternative.
- Vitiligo treatments usually work slowly or not at all for different individuals. If the treatment works for a person, they can see the natural skin colour returning to the depigmented patches slowly.
- After seeing how the body responds to treatment, the dermatologist might start with the gentlest treatment options and add more procedures to the care plan.
Treatment options for vitiligo
Here are the some of the treatments for white patches on the skin recommended by dermatologists that work on restoring the lost skin colour.
Topical medication
- Corticosteroid cream
This is a prescription medication recommended to children/adults who recently developed vitiligo. Although it is effective, doctors only recommend it for a short while due to possible side effects. - Tacrolimus ointment and pimecrolimus cream
These are safer alternatives to corticosteroid cream and can be used for a longer duration. They work especially well with macules on the head and the neck. - Calcipotriene cream
Although famous for its use in treating psoriasis, calcipotriene cream is quite effective in treating vitiligo in combination with corticosteroid.
Light therapy
This therapy is recommended by the dermatologist to people who are looking for treating specific areas of their body. Laser therapy requires follow-up visits to the doctor’s clinic as it works slowly. People who have a large area of depigmented skin are recommended to consider phototherapy, a variation of light therapy.
In this procedure, the doctor exposes the affected skin with a certain type of ultraviolet (UV) light for a set amount of time in different sessions. This procedure works especially well for the face and neck, but the lips, fingertips, and toes are least responsive to this treatment. To speed up the treatment process, a doctor might recommend additional treatments with light therapy.
Vitiligo laser treatment is a new option for light therapy and has been found to be quite effective. Research shows it can result in the re-pigmentation of more than 75% of the white patches in about 15 days in majority of the patients two undergo this treatment. However, further research is required.
Vitiligo Surgery
As a last resort, a dermatologist might recommend the following options to treat vitiligo:
- Skin grafting
In this surgery, the dermatologist replaces the white patches on the skin with healthy pigmented skin from elsewhere on the body. - Cell transplant
This is a more advance version of the skin grafting method. In this procedure, the dermatologist takes healthy pigmented skin from the person’s body and places them into the affected areas. Usually, people who undergo this surgery can see visible results in about 6 months post-surgery, but it might take up to 12 months as well.
Oral medication
Besides the treatment options mentioned above, oral medications are used to slow down the spread of vitiligo. Although vitiligo usually spreads slowly, it might progress quickly in some people. For these people, the dermatologist will likely recommend oral medicines, such as prednisone. This is a potent medicine and usually recommended only for a week or two.
Depigmentation
Additionally, the dermatologist might recommend depigmentation therapy for people who have lost most of their natural skin colour and wish to remove the rest as well. This is done to achieve an even skin tone by applying a cream that gradually removes the remaining colour. It might take anywhere from one to four years to get rid of all the remaining pigment. It is better to take second opinions from a dermatology specialist before moving forward with this procedure to consider the pros and cons as depigmentation is permanent.
Vitiligo treatment for children
The treatment options mentioned here can be considered for children as well, expect for surgeries. Additionally, phototherapy with UV-A (PUVA) is not recommended for children below the age of 12 years. Since the medications (topical creams and oral medicine) have side effects, the dosage might be adjusted according to the child’s age and other medical condition they might be on. Having vitiligo at an early age might become a cause of child with this condition being bullied in the school and affect the child’s confidence and quality of life; parents are recommended to pay close attention to their children in such a case and consider counselling for them.
Alternative treatments for vitiligo—Ayurveda and homeopathy
Many people, especially in India, might not be comfortable taking allopathic treatments for vitiligo due to the possible side effects and costs involved. In such cases, people with vitiligo may resort to Ayurveda or homeopathy to find a cure for their condition, even if there is limited research on them.
Bakuchi is one of the most prominent Ayurvedic drug used for the regeneration of melanocytes (responsible for producing melanin/skin pigment). As per research, many people have experienced promising—about 80%—improvements in their condition without any side effects in comparison with oral psoralens and PUVA.
Homeopathy is also an extremely beneficial treatment choice for early-stage vitiligo cases. Although homeopathy takes slightly more time than its counterpart disciplines, it curates personalised treatment based on plant, animal, or mineral compounds that in most cases do not lead to any side effects.
Managing vitiligo
Apart from the mainstream treatment, people with vitiligo can benefit from the following tips to manage their condition as the treatment might take some time to show results.
- Makeup and other cosmetic products
If you are conscious about your appearance, you can rely on temporary methods to have even skin tone. This might include make-up products such as high coverage foundation and concealers. Self-tanners or skin dyes are also considerable options as they do not need to be reapplied every day, but it is important to consult with a doctor first before using them to avoid aggravating the condition.
Using these products will take time and practice to achieve the natural look, but they might help boost your confidence. People who do not wish to treat their condition might also indulge in such products to achieve even skin tone.
- Diet and supplements
The average diet of a person might not be able to provide adequate levels of nutrition required daily. Although there is not enough research that supports diet and supplements can help in vitiligo treatment, maintaining overall good health is generally good for you. Consuming a proper diet and nutrition might also help in fast recovery if you opt for in any treatment. - Lifestyle changes
You might notice that the affected white patches on your skin burn or itch after spending some time under the sun. Thus, it is important to protect your skin from direct sun rays and artificial UV light as they can irritate your skin. Your doctor will recommend you to use a broad-spectrum sunscreen—SPF 50 PA++ or more in summers and SPF 30 PA++ or more in winters. Apart from applying sunscreen, you can choose to cover the white patches on your body to protect your skin from the sun and wear shades and hats while going out.
Which treatment option is best for you?
The dermatologist will suggest all the treatment options available for your vitiligo after considering factors such as your age, severity of the condition, how quickly the condition is progressing, and your lifestyle and requirements. However, it is important to consider all the benefits, related side effects, and the cost of the treatments before picking the most suitable one for you.
Final word
Although vitiligo is a rare condition that affects only 1% people in the world, we often see people with the condition in our community due to the large population of India.
People often start their treatment journey by visiting and consulting a doctor. This might work for some people, but others choose to explore options in more traditional approaches—Ayurveda—or more conservative treatments without much side effects—homeopathy.
It is important to remember that irrespective of the treatment method you choose, the results will appear slowly and steadily if the treatment works. You are recommended to stay positive and consistently follow your therapy plan with patience to get the best results.
