Vitiligo, also known as Leukoderma is a condition that puts the sufferer through a lot of social and emotional stress. It is characterized by odd looking white patches that may develop and remain localized to a specific part of the body or rapidly spread covering larger areas. Vitiligo can develop at any age and afflicts both men and women alike.
Therefore doctors and skin specialist in Delhi are considered the best people for the treatment of vitiligo.
It is very embarrassing when patches appear on visible areas of the body especially the face, hands, legs etc. and could lead to depression, lowered self-confidence and self-esteem. Vitiligo can have a huge impact on one’s mental, emotional and psychological well-being and it is, therefore, vital to promptly address the situation before it progresses further.
You would like to know that vitiligo treatment in Delhi is mostly suggested and appreciated by the patients residing in and across Delhi.
Causes of Vitiligo
Surprisingly, the causes of vitiligo are yet to be precisely established, but most of the research so far points to the following:
- An autoimmune disorder – the patient’s immune system becomes overactive and destroys the melanocytes
- Genetic oxidative stress imbalance
- A stressful event
- Harm to the skin due to a critical sunburn or cut
- Exposure to some chemicals
- A neural cause
- Heredity – family link
- A viral cause.
Vitiligo is not transmittable; in other words, it is not contagious, people cannot catch it from each other.
Less than 1% of the population is affected by the appearance of vitiligo in their skin.3 It has no age, sex or ethnic discrimination, but studies have concluded that a larger percentage of cases seem to start around the age of 20.
Vitiligo signs and symptoms vary considerably from person to person. It is more pronounced in people with dark or tanned skin. Some may only acquire a handful of white dots that develop no further while others develop larger white patches that join together affecting larger areas of the skin.
Different Types of Vitiligo
- Focal: This type is characterized by one or more areas of pigment loss in a confined area.
- Segmental: This type manifests as one or more areas of pigment loss on only one side of the body. It occurs most commonly in children. This type of vitiligo is not associated with thyroid or other autoimmune disorders.
- Mucosal: Mucous membranes alone are affected.
- Acrofacial: Depigmentation occurs on parts away from the centre of the body such as the face, head, hands and feet.
- Vulgaris: This is characterized by scattered patches that are widely distributed.
- Mixed: Acrofacial and vulgaris vitiligo occur in combination, or segmental and acrofacial vitiligo and/or vulgaris involvement is noted in combination.
- Universal: This is complete or nearly complete depigmentation.
Symptoms and causes
The main sign of vitiligo is a patchy loss of skin colour. Usually, the discoloration first shows on sun-exposed areas, such as the hands, feet, arms, face and lips.
Vitiligo signs include:
- Patchy loss of skin colour
- Premature whitening or greying of the hair on your scalp, eyelashes, eyebrows or beard
- Loss of colour in the tissues that line the inside of your mouth and nose (mucous membranes)
- Loss of or change in colour of the inner layer of the eyeball (retina)
Vitiligo can start at any age but often appears before age 20.Depending on the type of vitiligo you have, the discoloured patches may cover:
- Many parts of your body.With this most common type, called generalized vitiligo, the discoloured patches often progress similarly on corresponding body parts (symmetrically).
- Only one side or part of your body.This type, called segmental vitiligo, tends to occur at a younger age, progress for a year or two, then stop.
- One or only a few areas of your body.This type is called localized (focal) vitiligo.
It’s difficult to predict how your disease will progress. Sometimes the patches stop forming without treatment. In most cases, pigment loss spreads and eventually involves most of your skin. Rarely, the skin gets its colour back.
Skin layers and melanin
Vitiligo occurs when pigment-producing cells (melanocytes) die or stop producing melanin — the pigment that gives your skin, hair and eyes colour. The involved patches of skin become lighter or white. Doctors don’t know why the cells fail or die. It may be related to:
- A disorder in which your immune system attacks and destroys the melanocytes in the skin
- Family history (heredity)
- A trigger event, such as sunburn, stress or exposure to industrial chemicals.
People with vitiligo may be at increased risk of:
- Social or psychological distress
- Sunburn and skin cancer
- Eye problems, such as inflammation of the iris (iritis)
- Hearing loss
Many treatments are available to help restore skin colour or even out skin tone. Results vary and are unpredictable. Some treatments have serious side effects. So your doctor may suggest that you first try improving the appearance of your skin by applying self-tanning products or makeup.
If you and your doctor decide to treat your condition with a drug, surgery or therapy, the process may take many months to judge its effectiveness. And you may have to try more than one approach or a combination of approaches before you find the treatment that works best for you.
Even if treatment is successful for a while, the results may not last or new patches may appear.
No drug can stop the process of vitiligo — the loss of pigment cells (melanocytes). But some drugs, used alone or with light therapy, can help restore some skin tone.
- Creams that control inflammation.Applying a corticosteroid cream to affected skin may help return colour, particularly if you start using it early in the disease. You may not see a change in your skin’s colour for several months.
This type of cream is effective and easy to use. But it can cause side effects, such as skin thinning or the appearance of streaks or lines on your skin.
Milder forms of the drug may be prescribed for children and for people who have large areas of discoloured skin.
- Medications that affect the immune system.Ointments containing tacrolimus or pimecrolimus (calcineurin inhibitors) may be effective for people with small areas of depigmentation, especially on the face and neck.
This treatment may have fewer side effects than corticosteroids and can be used with an ultraviolet B (UVB) light. However, the Food and Drug Administration has warned about a possible link between these drugs and lymphoma and skin cancer.
- Combining psoralen and light therapy.This treatment combines a plant-derived substance called psoralen with light therapy (photochemotherapy) to return colour to the light patches. After you take psoralen by mouth or apply it to the affected skin, you’re exposed to ultraviolet A (UVA), UVB light or excimer light. These approaches tend to have better results than just medication or just light. You may need to repeat treatments up to three times a week for six to 12 months.
- Removing the remaining colour (depigmentation).This therapy may be an option if your vitiligo is widespread and other treatments haven’t worked. A depigmenting agent is applied to unaffected areas of skin. This gradually lightens it so that it blends with the discoloured areas. The therapy is done once or twice a day for nine months or longer.
Side effects can include redness, swelling, itching and dry skin. Depigmentation is permanent, and you’ll always be extremely sensitive to sunlight.
Surgery may be an option for you if light therapy doesn’t work. Surgery can also be used with those therapies. The goal of the following techniques is to even out your skin tone by restoring colour.
- Skin grafting.In this procedure, your doctor removes very small sections of your normal, pigmented skin and attaches them to areas that have lost pigment. This procedure is sometimes used if you have small patches of vitiligo.
Possible risks include infection, scarring, a cobblestone appearance, spotty colour and failure of the area to recolour.
- Blister grafting.In this procedure, your doctor creates blisters on your pigmented skin, usually with suction. He or she then removes the tops of the blisters and transplants them to an area of discoloured skin.
Possible risks include scarring, a cobblestone appearance and failure of the area to recolor. And the skin damage caused by suctioning may trigger another patch of vitiligo.
- Tattooing (micro-pigmentation).In this technique, your doctor uses a special surgical instrument to implant pigment into your skin. It’s most effective in and around the lips in people with darker complexions.
Drawbacks include difficulty matching the skin colour and potential for the tattooing to trigger another patch of vitiligo.
Potential future treatments
Treatments being studied include:
- A drug to stimulate colour-producing cells (melanocytes).Called afamelanotide, this potential treatment is implanted under the skin to promote the growth of melanocytes.
- A drug that helps control melanocytes.Prostaglandin E2 is being tested as a way to restore skin colour in people with localized vitiligo that isn’t spreading. It’s applied to the skin as a gel.
- A drug that reverses loss of colour.Tofacitinib, an oral drug typically used to treat rheumatoid arthritis, has shown some potential as a treatment for vitiligo.
Limited studies show that the herb Ginkgo biloba may return skin colour in people with vitiligo. Other small studies show that alpha-lipoic acid, folic acid, vitamin C and vitamin B-12 plus phototherapy may restore skin colour for some people.
As with any over-the-counter (nonprescription) treatment, check with your doctor before trying alternative medicine therapies to be sure they won’t interact badly with other treatments you may be using.