Existing Therapies for Vitiligo – What You Need to Know

If you or someone you know suffers from vitiligo, then you are all too aware of the negative effects this skin condition can cause. Vitiligo creates white patches of skin that some patients find embarrassing. It can cause people to hide their skin, avoid wearing revealing clothing, or even shun certain social interactions. Vitiligo is a disease that can scar you deeply, interfering with all aspects of social and professional life.

Scientists and researchers are working on new treatments for vitiligo, and some of them appear very promising. But there are already several therapies and methods that currently exist which you may want to consider if you suffer from vitiligo.

In this article, we will explain some of these existing treatments and break down the positives and negatives of each one:

Avoiding Stress

There are a wide number of genes that make a person predisposed to vitiligo. However, being predisposed does not necessarily mean that you will be affected. The absolute majority of patients refer to their vitiligo as having been triggered by a stressful event. The stress they experienced simply resulted in an autoimmune reaction. Their own T cells (which generally are programmed to remove dysfunctional cells) started destroying their healthy pigment cells aka melanocytes. As the melanocytes disappeared, so did the melanin that gives the skin its pigmentation.  

The stress patients experienced may have been emotional (a divorce or the loss of loved one), intense sunlight (a vacation in Australia), chemical (summer jobs at a paint factory), a wound (dog bite), etc. While you may be able to temper vitiligo, the symptoms may come back as you get re-subjected to stress. Staying symptom-free will require a very holistic approach to your health. Mitigating stress, eating well, and exercising are just as important as the medical therapies presented in this blog.

Camouflage or makeup

One of the first methods that people suffering from vitiligo often consider is simply covering up the white patches with makeup or other cosmetic products. This can be an effective technique, depending on the severity of the issue and the location of the lesions. The downside is that this method is only a temporary fix. It tends to work well in places were we are used to wearing makeup, like our face. Camouflaging hands is more difficult, however, as it prohibits work, touching, shaking hands, etc. Camouflaging the entire body is, considering the amount of makeup needed, often insurmountable.

Corticosteroids

Corticosteroids are used to halt the progression of depigmentation. As steroids have anti-inflammatory properties, they hold back the T cells that attack pigment cells, giving the skin a much needed relief to regenerate. Corticosteroids can be produced naturally by the human body or synthetically in a lab. In the case of vitiligo, corticosteroids are often applied via a topical ointment. While some patients have found success with this treatment, it does not work for everyone. While corticosteroids temper the attack of T cells, they do not boost the presence of pigment cells, per se. Phototherapy is typically used to boost repigmentation. Some of the negative side effects of corticosteroids include atrophy, dyspigmentation, and glaucoma if used for an extended period of time.

UVB and laser therapy

Photo therapies are used to stimulate the growth of melanocytes in the depigmented areas. It is good to remember that repigmentation always requires a source from which pigment cells can regenerate. Small lesions can often be repigmented by the rim simply closing in on the affected area. However, rim growth is limited to 4 -10 mm (the darker the skin, the wider the rim growth).   To be successful, larger lesions tend to require reservoirs of applicable stem cells present in the depigmented area. Hair follicles are often effective sources for repigmentation. Hair follicle driven repigmentation looks like a set of growing freckles reaching out towards one another. The skin may initially be somewhat “cobblestone-like,” becoming more uniform as the light treatment progresses.

Lasers and UVB (ultraviolet 290-320nm) light is often used to stimulate repigmentation. Effective treatment tends to require 2 to 3 treatments per week for a sustained period of time (often one year). Patients tend to achieve considerable savings in both time and money by investing in home-based equipment. Using targeted lasers has the advantage of avoiding the risks associated with full body irradiation.

Skin transplants

Skin transplants are used whenever there are no stem cell reserves in the depigmented lesions. The transplants aim to transfer pigment-producing cells (melanocytes) from normal skin to the skin affected by vitiligo. Transplants may be as small as 1 mm in diameter, placed on regular intervals across the depigmented area. Photo treatment is used to stimulate the growth of melanocytes to fill up the space between transplants. The objective is to achieve a uniform skin tone over time.

Depigmentation

For patients with widespread but incomplete vitiligo on the face and/or other sites, depigmentation therapy may be an option. If the vitiligo has been resistant to other treatment and affects more than 50% of the body, some dermatologists may suggest this technique. One of the benefits of depigmentation is that it is of a permanent nature. But the downsides include the need for strict sun protection to maintain the benefits, slow response time to the treatment, and a need for touch-up sessions. Darkly pigmented people may also feel disconnected from their own social environment.

It is good to remember that effective treatment of vitiligo always requires arresting the progression of the disease, stimulation of repigmentation, and avoiding a relapse. In practice this tends to require a balanced approach between different therapies covered above. It’s important to understand that you do have options for dealing with vitiligo. Of course, as new treatments are developed, better and more effective breakthroughs may provide even more results. But in the meantime, the options listed above could help mitigate some of the symptoms.

Disclaimer: The information on this blog is intended for orientation purposes only. For medical treatment options please consult your dermatologist. 

 

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