Our skin gets its color from melanin, a pigment produced by skin cells known as melanocytes when the skin is exposed to sunlight. For reasons not yet fully understood by medical professionals, some individuals lack such pigmentation in certain areas of their skin, and these colorless patches may evolve and spread over time. This non-contagious, non-life-threatening condition is known as vitiligo, and it affects between 0.5. and 1% of the population worldwide.
While vitiligo is primarily a cosmetic concern, severe cases can have detrimental physical and mental health effects. For these reasons, those suffering from vitiligo will likely want to seek treatment for their condition. There is currently no cure for vitiligo, but dermatologists can treat it in a number of ways based on the patient’s unique needs and the type and severity of their vitiligo. The goal of each of these treatments is to restore color to the areas of skin lacking pigmentation. Let’s discuss the various vitiligo treatment options available and go over which procedures might be best in a given situation.
Camouflage creams and procedures might be recommended for those with minor to moderate vitiligo. As its name suggests, the purpose of cosmetic camouflage is to conceal the colorless patches by making them blend in with the rest of one’s skin tone. This can be achieved via temporary waterproof creams that can offer up to 4 days of cover before requiring re-application. For a more permanent solution, patients might consider undergoing a micro-pigmentation procedure, which is akin to receiving strategically-placed tattoos that match one’s dominant skin color.
Those with widespread vitiligo (i.e. depigmentation that affects more than half the body) might have an easier time removing the color from their skin rather than restoring color to the patches that lack pigment. To achieve this, a “bleaching” lotion (hydroquinone) is applied to the pigmented skin to gradually lighten it. This treatment must be continuously applied to prevent the skin from regaining its natural color. This depigmentation process often yields permanent results and also strips the skin of its natural defense against ultraviolet radiation (sunlight), so additional precautions must be taken during and after this vitiligo procedure.
Topical steroids can potentially prevent the further spread of blank patches and sometimes bring back some of the skin’s natural color, though results vary from person to person. This treatment option is often best for those with non-segmental vitiligo that covers less than 10% of the body and/or those who desire a stronger treatment than camouflage creams alone. Pregnant individuals should not take topical steroids, and it’s worth noting that this treatment can cause thinning of the skin.
Heat and light can also be used to treat vitiligo. This more recent procedure is known as phototherapy, and it may be recommended for those with widespread vitiligo who have not responded well to topical treatments. Phototherapy involves exposing the affected areas of skin to UVA or UVB light emitted from a controlled source. Just before this procedure, individuals may also take psoralen, a drug that increases the skin’s sensitivity to light. When combined with other treatments, phototherapy can help stimulate skin pigmentation in a regulated manner. That said, undergoing light therapy for vitiligo does increase one’s risk of skin cancer and other UV-related skin problems.
Lastly, those with relatively static and stable vitiligo might consider replacing their blank patches of skin with pigmented skin taken from other areas of the body. This process is known as skin grafting. These procedures, while sometimes quite effective, are time-consuming and may lead to scarring. For these reasons, it’s important to discuss this option with a vitiligo specialist who can explain the risks and potential benefits of skin grafting in detail.
Whether or not you seek treatment for your vitiligo, it’s important to understand that this condition makes your skin more susceptible to sun damage. To keep your skin safe, be sure to apply sunscreen (30+ SPF) and wear protective clothing whenever going outdoors. Additionally, do your best to take in enough Vitamin D -- sunlight is a major provider of this key nutrient, so if you’re blocking off your skin from the sun’s rays, you’re at greater risk of Vitamin D deficiency. You can find Vitamin D in foods such as oily fish, egg yolks, and cheese, and you can also take supplements in lieu of these foods.
Though there’s currently no cure for vitiligo, new treatments are currently being developed to alleviate and reverse vitiligo symptoms, and the current treatment options are improving all the time. Talk to your dermatologist about which vitiligo treatment(s) might be best for your skin. In the meantime, the experts at Premier Dermatology Partners can give you more advice and details regarding vitiligo and how to take care of your skin.
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