Vitiligo Surgery

What is the treatment?

Vitiligo is a dermatological condition that is characterized by white patches of skin on several parts of the body. The condition is caused due to the destruction of melanocytes which are the cells that are responsible for skin pigmentation. It may also be due to autoimmune thyroid disease. The condition may be mild with one or two spots or may be severe with depigmentation in larger areas of skin. It is common in people with autoimmune disorders, is not contagious, and is not always progressive in the affected persons. Vitiligo is a long-term skin condition that cannot be cured.

However, with a few treatments, the visibility of the white patches can be made less obvious and less visible. The skin’s appearance can be improved with some drugs taken alone or along with light therapy. The drugs can never stop the process of vitiligo, but they can restore the lost pigmentation. Medications include usage of topical corticosteroids which help to get the color back on the skin. Some dermatologists prescribe Vitamin D along with corticosteroids. In the case of patients with smaller patches or in the early stages of vitiligo, medications that affect the immune system are prescribed. Other treatment options available are light therapy and laser therapy. Surgical options are available as well which are usually prescribed when other treatments don’t work.

How is the treatment done?

Vitiligo is classified into two types: Segmental and Non-segmental vitiligo. Segmental vitiligo is less common and more noticed in early age groups. This type of vitiligo is non-symmetrical. Non-segmental vitiligo occurs in 90 percent of the affected persons and is symmetrical and are more common in areas that are regularly exposed to the sun. While non-segmental vitiligo may not respond to topical treatments, the more stable and less erratic segmental vitiligo responds quite well to topical treatments.

Topical treatments include topical creams that contain a corticosteroid, and medications containing calcineurin inhibitors. The topical creams can be used along with Vitamin D as well. Light Therapy or Phototherapy is a preferred treatment when the condition is in its early stages and is confined to a smaller area. A light therapy with UVB radiation can be performed at home itself with a small lamp. In fact, home treatment is much preferred as the patient can use the lamp daily which improves the results. A light therapy with UVA radiation, however, is performed at the doctor’s clinic. Before the therapy, the patient is to orally take a medication which will increase the skin’s sensitivity to UV radiation. When the patches are small, skin camouflaging can be done with cosmetic coloured creams and make-up. When the condition is widespread, depigmentation is advised, which uses strong topical lotions. Skin grafting is a surgical procedure in which healthy patches of skin are used to cover the depigmented areas. Tattooing is another option where the pigment is planted into the skin.

Who is eligible for the treatment? (When is the treatment done?)

Anyone who has been diagnosed with the condition can undergo treatment for vitiligo. Vitiligo is a continual skin problem and differs in the intensity and magnitude in each patient. An expert should be consulted before deciding on the treatment option. Although a complete cure for the condition is not possible the treatments can be opted for to minimize the visible effects of the skin condition. As in any illness or medical condition treating early will give pronounced results, vitiligo too, if treated early can be kept under control. Especially children and young adults should be given treatment on a diagnosis of the condition.

Who is not eligible for the treatment?

Vitiligo is likely to affect 1 percent of the global population, and the condition may run in families. While the topical treatments and phototherapy can be offered to adults and young adults of all gender, the surgical options must be thought about before undergoing the treatment. The surgeon will assess the patient’s conditions before suggesting the surgical treatment of vitiligo. The surgical treatment is not a good option for children and for those who can scar easily. For children, topical treatments can safely be opted for after a consultation with a dermatologist. Phototherapy with UVA radiation can be administered to a child of over 12 years of age. However, the risks and benefits are carefully weighed before going for the treatment.

Are there any side effects?

Different side effects have been reported with different treatment options. In the case of topical corticosteroids and other topical creams, a possible serious side effect is skin atrophy. The skin becomes very thin, dry, and fragile and hence, the usage of topical creams has to be discontinued after the prescribed period. Also, the patients need to be regularly monitored by the medical practitioner. The oral medication, psoralen that increases the skin sensitivity to UV radiation may affect the eyes. Hence, eye examinations before and after the treatment are essential. Possible side effects of surgical treatment include cobble-stone like skin and infection.

What are the post-treatment guidelines?

In general, anyone with vitiligo must avoid being in the hot sun. Wearing protective clothing and use of high-factor sunscreen will be of help. Avoid getting skin injury as white patches tend to increase in the injured area. Other than these, there are no specific measures to be taken care of post any treatment for vitiligo. However, regular monitoring of Autoimmune conditions and thyroid function is necessary. Also, care is to be taken in a case of psychological depression.

How long does it take to recover?

Vitiligo is not completely curable, and treatments can only minimize the visible white patches and improve the skin conditions. Hence, a continual monitoring is required, and the treatments are to repeated according to the advice of a dermatologist.

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