Vitiligo- ReCell

  • Best Results6-12 months
  • Treatment Recovery6-12 days
  • Procedure Time90-120 minutes
  • Skin SpecialistDr Davin Lim
  • Duration of ResultsLong-term
  • AnaestheticLocal
  • Back to Work4-10 days
  • Cost$$$

Vitiligo- ReCell

ReCell is an Australian invention. It was used initially to repopulate open burn wounds. This is a form of autologous non-cultured cellular grafting. This treatment is novel; however it has been used to treat vitiligo for over 15 years. The theory behind ReCell is sound, however in my hands I get much better results with free hand cellular grafting. Read this page to find out more on ReCell.

FactsFacts on ReCell treatment for Vitiligo

  • This is a technique of transferring pigment from skin to areas that has vitiligo
  • The cell type is known as a melanocyte. This produces pigment known as melanin
  • ReCell than process skin to repigment up to 80 times the area of the donor site
  • Your normal pigmented skin acts as a donor for these pigment producing cells
  • ReCell involves breaking down the donor site with enzymes
  • The cell suspension is then placed on the prepared bed of vitiligo
  • Pigmentation takes 6-12 months before maximal results are achieved

What is ReCell?

ReCell is a patented kit for transferring cells from one area (known as the donor site) to another called the recipient site. In the context of vitiligo, the recipient site is the vitiligo involved area. The donor site is an area of skin that has pigment, most commonly the front of the leg.

How is ReCell performed?

Read below to understand the terms donor and recipient sites for more detail. Donor skin is broken down using an enzyme called trypsin. This helps separate the epidermis (where pigment cells reside) from the underlying dermal layer. This kit uses a compound called sodium lactate. This facilitates the appropriate dilutions for the cell suspension that is then transferred to the areas of vitiligo.

The entire procedure takes between 90 to 120 minutes to perform. It is done under local anaesthesia in an operating room. I have a team of nurses & technicians to assist in processing the cellular grafts. My role is to harvest the donor sites & prepare the vitiligo skin for the melanocyte suspension.

How is this different from other cellular grafts?

The major difference between the ReCell technique and conventional cellular transplantation techniques is the use of a patented sodium lactate as cell delivery system and for dilution of the cell suspension, which gives a donor ⁄ recipient ratio of about 1:80. It is thought that this medium plays an important role in both survival & multiplication of pigment cells.

What is the donor site & how do I harvest the melanocytes?

My usual donor site is the front of the thigh, or the inner upper arm. I harvest the skin using either a free blade or a dermatome.

For vitiligo, I am only interested in the upper layer of skin, namely the epidermis. Hence the thickness of harvested skin is only 0.15 to 0.2 mm. I remove between one to three square centimetres; about the size of 1-2 postage stamps. 

Davin’s Viewpoint on ReCell for Vitiligo

Invented by Australian innovation, ReCell has been a novel treatment over the past two decades. I have personally employed ReCell to treat hypopigmented scars, burns, dermal scarring, as well as cases of vitiligo. I suspect that this treatment is best used to increase the number of keratinocytes, as compared to the number of melanocytes.

In the context of vitiligo & hypopigmented skin conditions, my success rate is less than 30 percent. Let us compare the logic and efficacy of three different methods of regenerating or transposition melanocytes. This page has discussed ReCell, namely enzymatic separation of dermis & epidermis, followed by a cell suspension in sodium lactate solution. The advantage of ReCell is that it requires very little in the way of clinical skills, that is why a dermatologist who has a paucity of skill sets can be a key opinion leader in this field. Harvesting skin is easier than filleting a fish. One to two postage stamps. Thickness is not that important as trypsin breaks down the layers. Preparation of the bed is easy; it is less complex than sanding a floor board. Press a button on a laser, stop when you get pinpoint bleeding. Place solution on the area, cook for 7 days.

The new competitor in this field of ‘skin kits’ is of course Regenera. This device is even easier. Take 3 punch biopsies with a 3 mm device, this takes approximately 4 seconds to harvest (no kidding). Place in a blender device that breaks up pieces of skin to 5/100 of a millimetre, add some dilution to the solution, then inject under the skin. The advantage of Regenera is that the skill required to harvest & to deliver is even less- to a point that it can even be performed by someone who has zero knowledge of skin surgery. The success of Regenera depends on the ability of stem cells to differentiate into melanocytes, & the ability to repopulate the epidermis at a density whereby re-pigmentation is clinically relevant. Many variables determine success- the rate limiting is your immune system.

I find that manual micrografting gives the most predictable results for treating stable vitiligo & hypopigmented scars. This is technique dependent. Everything from donor thickness to transfer & dressings is super important. The upside of micrografting is the much higher density of melanocytes in the transposed skin. My usual ratio is 1:3 to 12. This technique is not only better, but also about one third the price of ReCell, & is significantly cheaper than Regenera. If you really want me to use ReCell, I would be more than happy to do so.

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