While there is no cure for vitiligo, yet, we do have many options to make living with vitiligo a lot easier.
Treatments are focused on two main issues: combating the origin of the vitiligo, and stimulating the melanocytes to repopulate the vitiligo lesions. Here are the 5 Treatment Groups:
Treatment to reduce the color difference between vitiligo and pigmented skin.
Concealing the white patches is the only way that I have found to give me the immediate satisfaction of not seeing my vitiligo. I’ve been using the brand Vitiligo Cover lotion for over 8 years and it has made all the difference in the world to me. When I have it on- which is all the time, lol- I forget about my vitiligo. Best of all, I wear what I want, when I want, because no one can see my white patches…unless I want them to.
Depigmentation may be an option for you if you have vitiligo that covers more than half of your skin. Depigmentation therapy lightens the unaffected parts of your skin to match the areas that have already lost color. For this treatment, you apply a medication called monobenzone ether of hydroquinone twice a day to the areas of your skin that still have pigment. Treatment continues until the darker areas of your skin match the already-depigmented areas.
Treatments that stimulate melanocyte multiplication
NB-UVB PhotoTherapy (Narrow-band ultraviolet B)
Phototherapy with NB-UVB has been described as a safe and effective treatment for a variety of severe skin conditions, including nonsegmental vitiligo, where the treatment can stimulate melanocytes and repigment vitiliginous lesions.
I had short-term success using this treatment with the Excimer Xtrac laser done at my dermatologist’s office. While undergoing treatment I did see a lot of new freckling in my white patches, but after the treatments stopped much of the freckling faded; however, I have heard from many other people that the laser treatment did stimulate pigmentation that lasted.
This may sound like a radical idea, but it works. One summer I sat outside for 30 minutes each day and I repigmented like crazy. Of course, once the summer was over, like my laser treatments, the many new freckles faded. I did go to a tanning spa a couple of times afterwards to see if the artificial UVA lights would work, but I stopped quickly because my already pigmented skin was darkening quicker than the vitiligo areas which then became more pronounced. I was embarrassed to be seen by the one person working the counter, so that was the end of that. Silly, I know. But embarrassment can stop of from doing a lot of things that may be good for us.
Treatments that are used to stop the release of chemical signals (neurotransmitters) that cause melanocyte death.
In this case, corticosteroids are also considered the main treatment. Topical corticosteroid therapy. Corticosteroids may help return color to your skin (repigmentation), particularly if the medication is started early in the disease. Milder topical corticosteroid cream or ointment may be prescribed for children and for people who have large areas of depigmented skin. It may take as long as three months of treatment before you begin to see any changes in your skin’s color. This treatment is easy and effective, but your doctor needs to monitor you closely for side effects, such as thinning of the skin (atrophy) and streaks or lines on your skin (skin striae). Calcipotriene (Dovonex), a vitamin D derivative, also may be used topically and is sometimes used with corticosteroids or ultraviolet light.
Treatments that use drugs to stop the production or imbalance of internal chemicals (biochemicals) that cause melanocyte death.
Corticoids are the main drug in this group.
Surgical therapies for vitiligo
Autologous skin grafts.
This type of skin grafting uses your own tissues (autologous). Your doctor removes tiny pieces of skin from one area of your body and attaches them to another. This procedure is sometimes used if you have small patches of vitiligo. Your doctor removes very small sections of your normal, pigmented skin, often containing a small hair, and places them on areas that have lost pigment. Possible complications include scarring, a cobblestone appearance, spotty pigmentation or failure of the transferred skin to repigment.
In this procedure, your doctor creates blisters on your pigmented skin, primarily by using suction. The tops of the blisters are removed and transplanted where a blister of equal size has been created and removed in an area that has no pigment. Blister grafting may cause a cobblestone appearance and scarring, and the area may not repigment. However, there’s less risk of scarring with this procedure than with other types of skin grafting.
Tattooing implants pigment into your skin with a special surgical instrument. For the treatment of vitiligo, tattooing is most effective around the lips and in people with dark skin. Sometimes the tattoo color doesn’t match skin color closely enough. Additionally, tattoo colors fade and they don’t tan.