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How to treat vitiligo

How to treat vitiligo
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Vitiligo treatments vary greatly in their application, but they all aim for the same thing: evening out skin tone so the non-pigmented patches are not so obvious. With the melanocytes responsible for melanin dead, there is no way to actually increase the melanin in skin, though some treatments in some people have managed to reverse the condition. (It’s not impossible!)

Phototherapy – UVB
Using ultraviolet lamps at home is one of the most common, easiest ways to treat vitiligo, with daily treatments. Clinical visits are the best recommendation for treatment as you are monitored and reviewed by a medical professional. If large areas of skin are affected, this will have to be done in a clinical setting, perhaps in a hospital, with full-body treatments. Results can be unpredictable and undependable, but some people get excellent results.

Phototherapy – UVA
UVA treatment is most often done in hospitals. Drugs (psoralen) are used to increase the skin’s sensitivity to UV light, then the skin is treated with high doses of UVA light. Many sessions are required, with results seen in six or 12 months after treatment twice a week. UVA light treatments can be helpful for some people.

Using cosmetics to blend skin tones
If vitiligo is mild, foundation-type skin-coloured make-up can be worn to cover the pale patches. There are some very good body make-up brands available, as they are often used in performance art or modelling to cover tattoos, bruises, or blemishes. Many foundations last a full day on the face, but body creams can last many days on the body, and be waterproof.

Depigmentation is the process of depigmenting the rest of your body to match your pale patches, turning yourself paler. This is done using strong lotions or ointments such as hydroquinone, mequinol, or monobenzone. Depigmentation is usually a long-lasting treatment, and can alter the skin’s strength (weakening it). Sun protection is a must after this treatment. The treatment can take a long time – over a year sometimes, depending on original skin tone.

Topical corticosteroids
Steroid ointments can help stop the spread of the white patches, with some cases reported of total restoration of original skin colour (meaning melanocytes were revived/renewed). If this treatment isn’t improving skin, then it should be stopped. If improvements are seen, take breaks in treatments to avoid damaging skin.

Calcipotriene (Vitamin D cream)
Calcipotriene is a form of vitamin D (Dovonex) which is used on the skin, often with corticosteroids or UV treatments. It doesn’t come without side-effects, which can be rashes, itching, or dryness.

UVA and UVB therapy can be used with psoralen, which makes the skin more susceptible to UV rays. The skin heals, and the melanocytes may return to normal function. Treatments must be done a few times a week for up to a year.

Pigmentation can be tattooed onto your skin, and works very well on darker-skinned people. Skin matching can be an issue, as can fading – skin doesn’t fade, but tattoos do. It may need to be repeated after many years. It’s naturally a more painful option, but anaesthetics can be used to dull the needles somewhat. Not for the faint of heart!

Research is continuing into the cause and treatment of vitiligo, so watch this space. New drugs are being developed, and the role of the immune system is being investigated.

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