One of the many skin conditions that not only affect the appearance of the patient but also cause emotional and mental distress is vitiligo. This may take a toll on a person’s self-esteem and confidence and affect their social life.
The Esthetic Clinics in India offer multiple treatment options to alleviate the symptom of vitiligo and restore the skin’s color and texture. Patients can schedule an appointment with Dr. Rinky Kapoor for consultation, examination, and evaluation of their condition and to determine the most suitable treatment for them.
What is Vitiligo
When the cell that produces pigment melanin, called melanocytes, are destroyed, the skin loses its natural color, and the person is said to have vitiligo. The condition causes symptoms such as the development of white or depigmented patches on the skin.
The condition, which is believed to be an autoimmune disorder, can appear anywhere in the body, but mostly on the face, hand, arms, legs, and around the genital area. Autoimmune means that the body’s immune system mistakenly attacks the cells that produce the pigment melanin.
Vitiligo can affect anyone, including people of all races and both sexes. It can also begin at any age, although it often starts in childhood or young adulthood. The condition might not be life-threatening or contagious, but it can cause emotional distress and affect a person’s self-esteem and quality of life.
Diagnosis of Vitiligo
Alongside other additional tests, the diagnosis is usually based on a combination of the patient’s medical history and a physical examination of the skin.
The doctor may use a special lamp known as a wood lamp, to look for areas of the skin that are depigmented or white. The lamp emits ultraviolet light, which makes the areas of vitiligo fluoresce differently than normal skin and appear more prominent. He/ she may also use a handheld medical device called a dermatoscope to magnify the view of the skin.
If there are signs of vitiligo, the doctor may perform a skin biopsy to confirm the diagnosis. In this procedure, he/ she will take a small sample of skin and examine it under a microscope to look for the absence of melanocytes. Blood tests may also be performed to rule out other autoimmune disorders that may be associated with vitiligo.
Signs and Symptoms of Vitiligo
The most obvious and probably only sign of vitiligo is the appearance of white or depigmented patches on the skin. These patches can be small or large and can appear anywhere on the body. However, they will most commonly be seen on the face, hands, arms, legs, and genitals.
The patches also come in different shapes. They may appear to be round and oval and have well-defined or irregular edges.
Besides the loss of skin color, there are no other physical symptoms to detect vitiligo. The patches are also usually asymptomatic. However, patients may experience itching, tingling, or a burning sensation in the affected areas.
Vitiligo can occur anywhere on the body, including the eyes, mouth, and hair. The depigmented patches can also be seen in the mucous membranes of the mouth, nose, and genitals. In some cases, hair that grows on the affected skin may lose its original color to white or gray.
People of all ages and genders can be victims too. For some people, the condition starts when they are younger and the progression varies from one individual to another. Some patients may experience rapid spread of the patches and others slow or no progression at all.
Types of Vitiligo
There are three main types of vitiligo and the type a person has depends on factors such as the pattern and location of the depigmented patches on the skin.
Non-segmental Vitiligo: Non-segmental vitiligo is probably the most common type of vitiligo affecting a large percentage, at least 90%, of vitiligo cases. How it happens is that the depigmented patches get distributed symmetrically on both sides of the body, and tend to be more prominent in areas exposed to the sun.
The “generalized” pattern is the most common type of non-segmental vitiligo. This is where the patches appear on different parts of the body, including the face, hands, arms, legs, and trunk. Other patterns that can appear include “acral” and “mucosal” vitiligo. Acral vitiligo affects the hands and feet, and mucosal vitiligo affects the mucous membranes of the mouth, nose, and genital area.
Segmental Vitiligo: The second type of vitiligo is called segmental vitiligo. As the name suggests, this is the opposite of non-segmental vitiligo. Patients with segmental vitiligo experience it only on one side or segment of the body. It mostly affects children and/ or young adults, and often appears as a single, large patch, which may stabilize or disappear on its own even without treatment.
Mixed Vitiligo: Mixed vitiligo combines the characteristics and symptoms of both non-segmental and segmental vitiligo. Patients with this type of vitiligo experience depigmented patches distributed asymmetrically on different parts of their body.
The course and effectiveness of the treatment prescribed depend on the type of vitiligo a person has. Generally, segmental vitiligo is more stable and may be less responsive to treatment compared to non-segmental vitiligo. Mixed vitiligo, on the other hand, can be more challenging to treat, and may require a combination of different therapies to be tailored to the individual patient’s needs.
Vitiligo Treatment Options in India
The Esthetic Clinics in India offer multiple treatment options for vitiligo. Patients should know that the treatments don’t intend to cure the condition as vitiligo can’t be cured. Instead, it works to restore color to the depigmented patches of skin and to prevent the spread of the disease.
A couple of factors go into the treatment an individual chooses. Some of these factors are the type and severity of vitiligo, the location and extent of the depigmented patches, the patient’s age, and their overall health.
Here are the common vitiligo treatment options:
Topical corticosteroids: Topical corticosteroids are creams or ointments that contain corticosteroid medications. They are usually applied directly to the depigmented patches of skin and work by suppressing the immune system and reducing inflammation to help restore the color of the skin. They are most effective when used in the early stages of vitiligo and on small areas of the body.
Topical calcineurin inhibitors: These are also creams and ointments that work by suppressing the immune system and reducing inflammation. They contain medications like tacrolimus and pimecrolimus and can be used on more sensitive areas of the skin, such as the face and genitals.
Phototherapy: During phototherapy, the skin is exposed to ultraviolet (UV) light to help stimulate the production of melanocytes and increase the production of melanin. The treatments can be performed at a vitiligo treatment clinic using a special lamp or light box. It may also be administered at home by a professional using a handheld device. Narrowband UVB and excimer laser therapy are some of the most common types of phototherapy for vitiligo.
Psoralen plus UVA (PUVA) therapy: During this treatment, the patients take a medication called psoralen, to make the skin more sensitive to UVA. The practitioner then exposes their skin to UVA light to help stimulate the production of melanocytes.
Surgery: Some popular surgical options for vitiligo include skin grafting and blister grafting. In skin grafting, healthy skin is transplanted to the depigmented area, while in blister grafting, blisters are induced on the healthy skin and then transplanted to the depigmented area. Surgery is often prescribed for patients who have stable vitiligo and where other treatments haven’t been effective.
Cosmetics: There are multiple camouflage cosmetic treatments that can be used to cover the depigmented patches and make them less noticeable. Such include creams, which are also particularly useful for patients with vitiligo on the face and hands.
Note that not all treatments would be suitable for everyone. The type of treatment prescribed will depend on multiple factors such as the type, progression, and location of the affected skin.
Experienced dermatologists and cosmetologists like Dr. Rinky Kapoor can perform a diagnosis and thorough assessment to determine the best course of action to achieve the desired results. They will also discuss the potential benefits and risks of each treatment option with their patient to determine the best approach for their individual needs.
What to Expect Before and During a Vitiligo Treatment
Here are a couple of things that the patient may expect to happen before and during the treatment:
- Before Vitiligo Treatment
Consultation with a dermatologist: Before any treatments, the patients always have a consultation with the doctor. This helps the practitioner understand the skin concerns of the patients and what their goals are. It also gives a chance to the practitioner to enlighten the patients about the benefits of the treatment, the risks associated, and what can be realistically achieved.
Examination and medical tests: After the consultation, the practitioner will then perform a thorough physical examination to detect any signs of vitiligo, and depending on the type of treatment recommended, he/ she may go ahead to perform medical tests, such as blood tests or skin biopsies.
Preparation for treatment: Once the initial consultation and tests are done, and the treatment determined, the patient will be provided with a set of instructions that they will need to follow before treatment starts. They may be asked to avoid certain medications or supplements, stay out of the sun, and wear protective clothing.
- During Vitiligo Treatment
Topical medications: For patients receiving topical medication, the doctor will give a set of instructions on how to apply the medication, how often, and for how long. This may be done multiple times a day for several weeks or months before results start to show.
Light therapy: For patients receiving light therapy, they may need to visit the dermatologist’s office or a specialized vitiligo treatment clinic for treatment sessions.
Surgical procedures: Surgical procedures may also be prescribed depending on the type and extent of the condition. Some common procedures for vitiligo include skin grafting and melanocyte transplantation. Anesthesia may be administered and patients may need to stay in the hospital for a short period of time. Recovery time varies depending on the type of surgery and the patient’s individual healing process.
Follow-up appointments: After starting treatment, regular follow-up appointments will be set to monitor the progress and adjust the treatment plan if necessary. Additional treatments or modifications to the treatment plan may be recommended depending on the patient’s response to the treatment.
Potential Risks and Side Effects of Vitiligo Treatment
At The Esthetic Clinics, the dermatologist or cosmetologist administering the treatments will inform the patient of the possible risks and side effects of the different treatments. The type and severity of the complications and side effects depend on the treatment used and the individual patient’s reaction to the treatments.
Here are some potential risks and side effects patients may experience:
Topical steroids: Patients who use topical steroids for a long time may experience skin thinning, stretch marks, and an increased risk of infection. In rare cases, high-potency steroids may cause elevated blood sugar, weight gain, osteoporosis, and other systemic effects.
Topical calcineurin inhibitors: These medications can cause burning, stinging, or itching at the site of application.
Psoralen plus ultraviolet A (PUVA) therapy: While PUVA therapy is an effective treatment for vitiligo, patients who undergo it may experience skin redness, itching, and burning. If used for a long time, it may increase the risk of skin cancer and premature skin aging.
Narrowband ultraviolet B (NB-UVB) therapy: NB-UVB therapy can cause skin redness, itching, and burning, or blistering and hyperpigmentation in rare cases.
Excimer laser: Patients who undergo excimer laser may experience temporary redness, itching, and blistering at the site of treatment. In some cases, there is a risk of scarring or permanent changes in skin pigmentation.
Surgery: Surgical procedures like skin grafting and melanocyte transplantation can cause scarring, infection, and loss of skin color.
Vitiligo Treatment Aftercare
How a patient takes care of themselves is important as it plays a big role in how they heal and achieve results. The healthcare provider will provide some aftercare precautions and guidelines to maximize the effectiveness of the treatment and minimize the risk of complications.
Here are some guidelines that the patients should follow:
Protect the skin: Once treated, patients should protect the skin from potential harm-causing agents, especially UV rays. Avoiding exposing the treated area to direct sunlight and wearing protective clothing, such as hats and long sleeves, when outside is vital. They should also use sunscreen with a high SPF regularly to protect the skin from UV rays.
Follow medication instructions: In cases where topical medications are prescribed, the doctor will give precise instructions on how to apply the treatment such as the frequency and duration of use. Patients should follow all these instructions carefully, and notify their doctor in case of any side effects or skin irritation.
Attend follow-up appointments: Usually, the doctor schedules follow-up appointments after the treatment to monitor the body’s response to the treatments and make the necessary adjustment whenever needed. Patients should attend all the appointments.
Maintain good overall health: Observing a healthy diet and exercising regularly ensure the body gets all the vitamins and minerals it needs for a strong immune system. This can help improve the effectiveness of the treatment. Patients are also advised to avoid smoking and excessive alcohol consumption, as these can interfere with the healing process.
Manage stress: Stress can exacerbate vitiligo symptoms and interfere with the healing process. Exercises such as yoga and meditation can help manage stress levels.
Seek support: Besides being physically distressing, vitiligo can also be emotionally and mentally challenging. Patients may benefit from seeking support from family, friends, support groups, or professionals.
Following these aftercare guidelines can help ensure the success of vitiligo treatments. If any concerns or complications arise after the treatment, it is important that patients immediately notify their provider, for the necessary course of action to be taken.
Alternative and Complimentary Treatments
There are no proven alternative or complementary treatments for vitiligo in India. However, some people choose to try other therapies in addition to conventional medical treatments. It is important for patients to discuss this with a medical professional to ensure they are not worsening their situations.
Here are some common complementary treatments that have been suggested for vitiligo:
Herbal Remedies: Herbs such as ginkgo biloba and khellin, have been suggested as potential treatments for vitiligo. In case a patient decides to try this as a complimentary treatment, they should talk to their doctor first.
Acupuncture: During acupuncture, there is the insertion of fine needles into specific areas of the body to stimulate the flow of energy and promote healing. While there are some studies that have suggested that acupuncture may be helpful for treating vitiligo, the evidence is limited and more research is needed.
Ayurveda: Ayurveda is a traditional system of medicine from India that uses herbs, dietary changes, and other therapies to promote health and well-being. For vitiligo, some Ayurvedic practitioners may recommend treatments such as drinking a mixture of herbs and spices or applying herbal pastes to the skin. There is still no scientific evidence to support the use of Ayurveda for vitiligo.
Homeopathy: Homeopathy is a system of medicine that uses highly diluted substances to stimulate the body’s natural healing abilities. Patients need to talk to their doctor before trying any homeopathic remedies, to get professional medical insights and ensure they are not promoting the risk of other complications and adverse side effects.