Vitiligo (Leucoderma) is a condition where patches appear in different parts of the body. It is relatively higher among the Indian population. It is a matter of concern as misconceptions about the disorder are higher, and so is rejection in society.
What part of the body can be affected?
Any part of the body can be affected: hands, legs, head (scalp), soles, lips, and mouth (oral cavity) too. Any part of the skin and 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. A genetic predisposition is present. Children whose parents have the disease 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 often associated with hyperthyroidism or hypothyroidism.
What age groups get affected?
Any age group can develop vitiligo. This disorder affects all races and sexes equally. White-skinned people usually don’t bother much about it, as it doesn’t show as much as in darker-skinned individuals. 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 the rapid spread of the condition. Some patients’s complaints of itching during the 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, the better.
Myths about Vitiligo?
Vitiligo is not 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.
Vitiligo Treatment
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.
NonSurgical Methods
Cosmetic makeup Colors to match your skin are available, and these can help the patient regain their confidence. Self-tanners are also available and must be used regularly to retain the color.
Oral medications are available that stop the white patches from spreading, and oral psoralens also help with depigmentation. These medications should be prescribed by registered doctors.
A Topical application of cream helps with re-pigmentation. Topical psoralen solutions are also used to help re-pigment the skin.
There are a lot of constraints when using topical applications. Small parts are more effective, and usually the face helps more than limbs or body parts, which are less exposed to sunlight. Light therapy Light therapy is very effective. PUVA therapy has been used for many years and is now outdated. It has a few side effects and is very slow in re-pigmentation.
Narrow Band UltraViolet B (UVB) light is the latest in light therapy and has minimal 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.
Surgical Procedures
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 (the skin is very thin) is ideal for this technique, as the cosmetic results are very good.
Split Skin Graft It is very commonly done. The graft is taken from the normal skin with special knives and transferred to the white patches. Very large areas cannot be treated with this procedure.
Melanocyte transfer surgery
In this procedure, the advantage is that the 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 within a short time span of 3-6 months. There are laser treatments and some medications that are used very judiciously in resistant cases (patients not responding to any treatment). Vitiligo is one disorder that does not physically affect a person, but the mental trauma it causes is unfathomable! …
