Vitiligo

Vitiligo At A Glance

  • Best Results2-8 Months
  • Treatment RecoveryNA
  • Procedure Time1-3 min
  • Skin SpecialistDavin Lim
  • Duration of ResultsMonths to years
  • AnaestheticNil Required
  • Back to WorkImmediately
  • Cost$

Vitiligo

Vitiligo is a common condition affecting 2% of people. This condition causes a loss of melanin, the pigment that determines the colour of your skin. Vitiligo is more common in skin of colour & usually affects the skin around the eyes, mouth, elbows, knees, armpits & genital areas. The 20 week vitiligo challenge program uses anti-inflammatory creams & narrowband phototherapy to halt the immune attack on pigment cells and stimulates pigment cells to reproduce- this results in re-pigmenation of white patches.

FactsFacts on vitiligo

  • Vitiligo presents as white patches on the skin
  • The most frequently affected areas are around the eyes, mouth & face
  • Vitiligo affects all ethnic races, but predominantly affects people with darker skin types
  • Treatment of vitiligo is with phototherapy, & anti-inflammatory creams
  • Our success rate is up to 90% re-colouring
  • Vitiligo on the face responds best to treatment
  • Vitiligo on the hands & feet respond poorly to treatment
  • All phototherapy sessions are bulk billed, so this treatment has no out of pocket expense

What is vitiligo?

Vitiligo is an immune condition where your body attacks the pigment producing cells in your skin. These pigment cells are called melanocytes. Once under attack, these melanocytes hide in your hair follicles.

Vitiligo can be associated with other immune conditions such as vitamin deficiencies, diabetes & thyroid disease.

Vitiligo occurs when the pigment producing cells called melanocytes disappear.

What treatments are available for vitiligo?

The internet is full of promised ‘vitligo cures’, ranging from tablets, thru to creams and hand held light devices. From a Specialist point of view, where vitligo is scientifically managed & skin repigmentation measured, there are only a few proven combinations that actually work-

Anti-inflammatory creams: These include Vitamin D creams, Calcineurin inhibitors and anti-inflammatory corticosteroid creams. They all work by stopping the attack of your immune cells on pigment producing cells called melanocytes. A combination of creams works best.

 Narrowband phototherapy: This is medically prescribed phototherapy using light at 311 nm. Phototherapy has to be conducted at least twice a week to stimulate melanin in vitiligo patches. (Ideally 3-4 times per week gives optimal results)

Vitamin D supplementation: A recent article published in 2014 suggests the use of Vitamin D tablets for supplementation in patients with vitiligo.

 Prostagladin Inhibitors: Emerging research has shown that this group of anti-inflammatory creams can help re-pigment patches of vitligo. Creams should be combined with narrowband phototherapy.

 Ginkgo biloba extract: One non- controlled study in India conducted in the early 2000s showed ginkgo supplements can help with skin repigmentation.

How do dermatologists treat vitiligo & what is the success rate?

Vitiligo is treated with a combination of creams, & narrowband phototherapy– this gives the highest success rate of re-colouring your skin.

Creams are used on a nightly basis, and phototherapy should be performed 2-4 times per week.

The success rate of re-colouring patches of vitiligo is mostly dependent on the areas involved, as a guide-

  • Facial vitiligo – 90% chance of re-pigmentation
  • Vitiligo on chest and body- 50-75% chance of re-pigmentation
  • Acral vitiligo (hands and feet)- 10-20% chance of re-pigmentation

Another important clue as to whether your vitiligo will respond to phototherapy and creams is the presence of hair follicles that are pigmented. The more pigment in your hair follicles, the higher the success rate.

This represents my average success rate for treating vitiligo.

Why is it essential to have BOTH phototherapy & anti-inflammatory creams when treating vitiligo?

Both treatments are essential for optimal success because the aim of the program is to stop your immune cells from attacking your pigment cells, and to stimulate any remaining pigment cells to re-colour the white patches of vitligo.

Anti-inflammatory creams such as Tacrolimus, Vitamin D & pulsed corticosteroids halt the immune attack.

Narrowband phototherapy stimulates the pigment cells hiding in your hair follicle to re-populate vitiligo affected skin, leading to re-pigmentation. If you have creams without phototherapy, the success rate of treating vitligo is low.

Davin’s viewpoint on vitiligo

Vitligo is a very common condition, and I have at least 150 patients under my care every year. The chances of re-pigmenting white patches depends on 3 important factors, the area of vitiligo– patches on the face, chest and upper back respond best, whilst vitiligo on the hands and feet/ fingers and toes have a poor response rate. Secondly, the presence of pigment within the hair follicles of vitiligo patches- repigmentation occurs from both the surrounding skin and within the hair follicle. Lastly – the commitment from the patient to undertake both phototherapy and use creams on a nightly basis. This combination treatment is the basis of the 20 week- vitiligo challenge program.

Re-colouring can be seen in over 90% of cases, especially for facial vitiligo.

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