Vitiligo (Leucoderma) is a condition where patches appear at different parts of the body. It is relatively higher amongst the Indian population. It is a matter of concern as misconceptions about the disorder are higher and so is rejection society.
- What part of the body can be affected?
Any part of the body can be affected hands, legs, head (scalp), soles, Lips & mouth (Oral cavity) too. Any part of the skin & mucosa can be affected.
- What causes these white patches?
The disease is autoimmune. One’s own immune system destroys the melanocytes (pigment cells) in the skin. Genetic predisposition is present. Children whose parents have the diseases are more likely to develop it. At times deep injuries or burns where the deeper layers of the skin are affected, can cause a flare of the condition or trigger the disease process. It is associated may time with hyperthyroidism or hypothyroidism.
- What age groups get affected?
Any age group can develop vitiligo. This disorder affects all races and sex equally. White skin people usually don’t bother much about it as it doesn’t show as much as in darker skin individual. In India the prevalence rate is high (2%).
- How to assess if it will spread all over the body?
There is no way to predict the course of the disorder. For some patients, the patches just remain stable. Few experience rapid spread of the condition. Some patient’s complaint of itching during spread. Physical and emotional stress the condition can aggravate. There are many ways the spread of the disorder can be controlled. So the earlier the patient approaches the doctor better.
- Myths about Vitiligo?
Vitiligo is not a contagious and does not spread through touch. This is not a life threatening disorder and does not affect any other system in one’s body.
Treatment modalities for vitiligo are many. The goal of the treatment is usually to stop the spread of the disorder and restore lost skin color.
Cosmetic makeup Color to match your skin is available and these can help the patient get back their confidence. Self-tanners are also available and must be used regularly to retain the color.
Oral medications are available which stop the white patches from spreading and oral psoralens also help re-pigmentation. These medications should be prescribed by registered doctors.
A Topical application of cream helps re-pigmentation. Topical psoralen solutions are also used to help re-pigment the skin.
There are a lot of constraints in using topical applications. Small parts are more effective & usually, face helps more than limbs or body parts which are less exposed to sunlight.
Light therapy is very effective. PUVA therapy has been used for many years and outdated now. It has a few side effects and very slow in repigmentation.
Narrow Band UltraViolet B (UVB) is the latest in Light therapy and has minimum side effects. Re-Pigmentation is faster and it also helps control the spread of the disorder.
High power Narrow Band UVB is the most effective in re-pigmentation but is limited to smaller areas.
Suction Blister Technique– Blisters are made with special equipment on the normal skin and the top layers of these blisters are used as skin grafts, which are fixed on the white patches. The skin around the lips and eyelids (skin is very thin) are ideal for this technique as cosmetic results are very good.
Split Skin Graft
Very commonly done the procedure. The graft is taken from the normal skin with special knives and transferred to the white patches. Very large areas cannot be treated in this procedure.
Melanocyte transfer surgery
In this procedure, the advantage is larger area can be treated with small grafts. White patches up to 100 sq.cm can be treated in one session. The procedure needs only a short time and re-pigmentation in within a short time span of 3-6 months.
There are laser treatment and some medications which are used very judiciously in resistant cases (patients not responding to any treatment).
Vitiligo is one disorder which does not physically affect a person physically but the mental trauma caused is unfathomable!…
Dr. Hema Sathish