Vitiligo - Symptoms And Treatment

Hello friends I am Dr. Sumit Gupta, Consultant Dermatologist and Vitiligo Specialist at Skin Innovation clinics, New Delhi.

Today we are going to talk about vitiligo. Vitiligo is a very common disorder characterized by white patches on the skin which can happen anywhere on the body. It is fairly common and can affect about 1-2 % of the whole population. It occurs due to loss of melanocytes or destruction of melanocytes which are the pigment-producing cells of our skin. Melanocytes produce melanin which is the pigment which causes the pigmentation or the color of our skin and due to autoimmune mechanism these melanocytes undergo destruction and the white patches are formed. Basically, the skin loses its capacity to re-pigment.

Talking about treatment, for the treatment of vitiligo we first need to characterize and classify the patient according to the diseases condition that the patient is suffering from. Whether the patient has non-segmental vitiligo or segmental vitiligo. Segmental vitiligo normally occurs only on one part of the body affect only one part and does not even cross the midline. Non-segmental vitiligo, on the other hand, can occur anywhere on the body. Apart from this we also need to make sure whether is the disease is stable or is it progressive? By progressive we mean whether the regions are increasing its size or new regions are coming up or whether there is absolutely no activity. Whatever regions are there , they are not increasing for the past several months.

Also, we need to make sure that the person is not suffering from any other disease, any other autoimmune disease, especially. And, the kind of treatment that would be suitable for their age, for their kind of site where the legions are. Treatment of vitiligo often has two major pillars- one is stabilization and other is de-pigmentation. If the disease is not stable as if it is increasing its size the regions are increasing in size or in number then we try to stabilize it. For stabilizing we use certain creams or certain medications. Oral medications or sometimes even whole body narrowband phototherapy which would stabilize the region by affecting the autoimmunity which is causing destruction of melanocytes.

Once the disease is stable, reasonably stable then we move on to repigmentative maneuvers. Which can be again targeted phototherapy, certain creams, some kinds of phototherapy which takes help of UV rays from the sun, some kind of specialized phototherapy which is excimer lamp or targeted phototherapy or sometimes we take help of surgical maneuvers. Surgery which we commonly like to perform for stable vitiligo is a non-cultured melanocytes suspension transfer technique where we take a small graph of skin normally pigmented skin and from the thigh or from the buttocks and then we process it from some ways so that melanocytes can be extracted from that graft. Those melanocytes are then prepared into a suspension and the suspension id can be applied onto the white patches.

If the disease is stable,  then the white patches eventually re-pigment in during the course of time. But all this treatment modality is able to cure a sizable number of Vitiligo patients and the treatment overall is very effective. Majority of vitiligo patients can be treated effectively by the treatment modality is available to us contrary to the popular belief. Thank You!