Vitiligo- Genital areas

  • Best Results8-12 months
  • Treatment Recovery6-12 days
  • Procedure Time60-120 minutes
  • Skin SpecialistDr Davin Lim
  • Duration of ResultsLong-term
  • AnaestheticLocal
  • Back to Work6 days
  • Cost$$ Medicare

Vitiligo- Genital areas

Vitiligo frequently affects the genital areas, including the penis. It is NOT sexually transmittable, nor does it affect sexual function. Vitiligo in this area also affects the pubic hair turning it white. The mainstay of treatment is with the use of appropriate prescription creams & narrowband phototherapy. Surgical procedures including pigment transfer grafting is not recommended in this area.

FactsFacts on vitiligo in genital areas

  • Genital & pubic area involvement is seen in up to 20% of vitiligo cases
  • Most cases occur in young adult life
  • Mucosal vitiligo also affects the lips
  • Treatments are modified given the delicate areas involved
  • Prescription creams are designed to reduce inflammation & stimulate pigment production
  • Narrowband phototherapy is useful
  • Re-pigmentation often takes 6-12 months

Is genital vitiligo a venereal disease?

Vitiligo Genital Areas

No, genital vitiligo is not a venereal disease, so don’t stress out. You cannot ‘catch’ vitiligo, nor can you pass it on to others.

What is the best way to treat?

A combination of creams & phototherapy gives the best results. With this combination, you have up to 70% chance of getting some of your pigmentation back. It takes several weeks to notice changes.

Topical creams include anti-inflammatories & creams that assist in migration of melanocytes. Special formulations are used in the genital area due to thin skin.

What is phototherapy?

This procedure delivers filtered light in the 311 nm spectrum. Light reduces skin inflammation in vitiligo & stimulates pigmentation cells to migrate into the white areas & produce pigment.

Phototherapy sessions are bulk billed & take 1-4 minutes to perform. Patients undertake 2-4 sessions per week. Phototherapy is available at Clinic Cutis

Can lasers treat vitiligo?

Yes. Excimer lasers can be useful for treating smaller areas of vitiligo. I did use excimer 308 lasers in the past, however by definition it does not fulfill the Medicare criteria for narrowband phototherapy, hence it costs patients over 1500 dollars per month (with excimer) compared to no out of pocket charge for narrowband.

Davin’s Viewpoint on genital/penile vitiligo

This is a sensitive & potentially embarrassing type of vitiligo & is classed as flexural vitiligo or lip tip-mucosal vitiligo. Isolated patches on genital areas are not uncommon, however in most cases it is associated with white patches elsewhere on the body or mucous membranes.

Treatments can be challenging as the genital areas are sensitive to strong topicals. The current consensus is that rotational therapy with calcineurin inhibitors & moderate strength cs ointments are safe. Start off with either tacrolimus 0.03 to 0.1% or pimecrolimus, alternating with methylprednisolone ointment. In the absence of contraindications, one can add narrowband phototherapy. In Australia, we tend to avoid PUVA due to the carcinogenic nature of this treatment.

Unlike vitiligo on the face & upper limbs, surgical procedures are limited due to the higher incidence of scars. This includes micrografing & melanocyte repurposing treatments such as ReCell. An exception is with foreskin vitiligo whereby elective circumcision by a urologist can be helpful.

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