Vitiligo- Depigmentation

  • Best Results9-24 months
  • Treatment Recovery8-14 days
  • Procedure TimeVariable
  • Skin SpecialistDermatologist
  • Duration of ResultsLong-term
  • AnaestheticNA
  • Back to WorkVariable
  • Cost$$

Vitiligo- Depigmentation

For extensive areas of vitiligo, depigmenting normal skin can give a uniform colour. Careful consideration is required as this is frequently irreversible. This form of vitiligo treatment is best conducted in a public hospital as side effects to chemicals & lasers are universally seen.

FactsFacts On Vitiligo Depigmentation

  • This is a last resort treatment for vitiligo
  • It is considered if vitiligo affects more than 60-80% of body surface area
  • MBEH topical creams are first line
  • Skin lightening with MEBH is always associated with skin irritation
  • Treatment can take up to 18 months to complete
  • Focal areas of pigment can be treated with lasers
  • Skin lightening & depigmentation is best conducted in a dermatology department

What is the aim of depigmentation?

This procedure aims to give the vitiligo patient a more uniform skin colour. In a nutshell it takes away pigment. This gives skin a white appearance. Think Michael Jackson white. The long-term implications must be considered as it is irreversible.

When to consider depigmentation as a treatment for vitiligo?

Careful patient selection is required. As a guide, dermatologists consider depigmentation if the total BSA or body surface area of vitiligo exceeds 60-80%. Patient factors including skin type, location, age & psychological impact are taken into consideration.

What is the most frequent ingredient for skin whitening?

MBEH or mono-benzyl ether of hydroquinone is the drug of choice in most countries. It destroys cells that produce pigment, in addition to blocking melanin synthesis. Concentrations range from 5% to 40%. It is performed under the guidance of an experienced dermatologist.

How is skin lightening performed?

Most specialists will start on a small area first, such as your forearm. This is called a test patch. If you do not have allergic contact dermatitis, they will then instruct you to apply MBEH on other areas. Different concentrations are used according to areas treated & your skin reaction. Examples- MBEH 15% face & neck, MBE 40% legs & torso.

Davin’s Viewpoint on Vitiligo Depigmentation

This is one area of vitiligo treatment that I have no experience with in private practice. The last patient I treated for skin lightening in the context of vitiligo was in 2005. The agent of choice is still an ester of hydroquinone.

Complete removal of pigmentation is an enormous step to take. It changes the social acceptance of some cultures, namely darker skin patients. Complete removal of pigment also increases the susceptibility to skin cancer, photoaging & sun burn. 

The process of skin lightening can take several years. Your dermatologist will guide you accordingly. The first few months is learning how to modulate your inflammatory response (skin irritation) due to MBEH. Residual pigmentation can be effectively treated with lasers. This is where my team & I come in.

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