Vitiligo treatment

Vitiligo is a chronic ( which last longer) autoimmune disorder ( means body's immune system mistakes its own tissue as foreign tissue and attacks )that causes patches of skin to lose pigment or color, in simple words in this disease, body's immune system attacks its own melanin producing cells ,leading to loss of pigment. The term vitiligo is derived from “vitium” ,meaning defect or” blemish”

Causes

Vitiligo is said to be multifactorial , where both genetic and environmental factors play the role together, sunburn emotional distress, exposure to chemical , can trigger the condition as mentioned by National institutes of health

SIGNS AND SYMPTOMS

1. The only sign of vitiligo is the presence of a pale patchy area of depigmented skin, which is usually seen on extremities.

2. The skin lesions are more prominent on face, hands and wrist, the loss of skin color is mostly noticeable around the body orifices such as mouth, eyes nostrils, genitalia and umbilicus

CLASSIFICATION

• Segmental vitiligo ;This type of vitiligo is more prevalent in teenage years, it is most often unilateral.

• It is much more stable in course as compared to non segmental ,and its association with autoimmune disease appears to be weaker as compared to generalized vitiligo.

• Non segmental vitiligo is the most common type of vitiligo, in this type you will find symmetry in the location of patches, unlike segmental vitiligo ,it can occur at any age.

Non segmental vitiligo ; includes following

• Universal vitiligo -as the name suggests, in this case the depigmentation , encompasses most of the body

• Generalized vitiligo -this the most common pattern , here you will find wide and randomly distributed area of pigmentation

• Focal vitiligo- this type of vitiligo, is mostly common in children. where you will find one or few scattered macules in one area

• Acrofacial vitiligo; in this type ,fingers and periorificial areas are involve

• Mucosal vitiligo - depigmentation of only mucous membrane

Treatment

First line of treatment

Treatment includes steroid applications and ultraviolet light, in combination with creams are considered to be first line of treatment .Lesions located on hands , feet and joints are the most difficult to repigment, those on the face are easiest to return to natural skin color , as skin on face is thinner.

Second line of treatment

Phototherapy is considered the second line of treatment for vitiligo. The sun emits two types of radiation UVA and UVB. UVA radiation encompasses 95% and UVB is 5%,UVB radiation has a short wavelength and can reach only the outer layer of skin called epidermis .The UV light used in phototherapy is the same type of light emitted from the sun. Your provider will control the strength of the light and monitor the length of time.

Treatment takes a few weeks if the spots are on the face or neck, and not more than 3 years, if the spots are on hand and feet and have existed more than 3 years ,it can take a few months.

Phototherapy sessions are done 2-3 times in a week, a combination of UVB phototherapy with other topical treatment improves re- pigmentation, but a serious potential side effect includes risk of developing skin cancer as an overexposure to phototherapy.

In PUVA treatment, psoralen, a drug which increases the skin sensitivity to UV light is used, then exposing the skin to UVA light, PUVA may cause , side effects such as sunburn or skin freckling

DEPIGMENTATION is considered in cases of extensive vitiligo , in this unaffected skin is depigmented with tropical drugs like monobenzone,mequinol, or hydroquinone, to render the skin an even color ,it is essential to follow sun safety guidelines for life , to prevent severe sunburn and Melanomas, depigmentation takes a year to complete

Homeopathic treatment for vitiligo

Homeopathic medicine includes a holistic approach to the understanding of the patient and integrates this approach , to provide individualized treatment. The advantage of this treatment is that it does not have any side effect

The range of action of homeopathic medicine aims to strengthen the action of the immune system through the primary understanding that symptoms are an attempt by the immune system to achieve balance. The basis for homeopathy is that any substance (plant, animal, mineral, or metal) that can affect the human health can serve as a medication, when in the right form. The lesions may firstly stop spreading, and existing lesions do not increase in size, and no new lesions appear.

However, for an optimal response to homeopathic treatment to occur, treatment should begin when the body has not suffered the effects of the disease for long and before the immune response becomes irreversible.

In the 14 cases of vitiligo treated with homeopathy and presented in this case series, Reference.

The longer the time that elapsed between the onset of vitiligo and the homeopathic consultation, the more difficult it was to obtain a good clinical response. The cases of vitiligo that presented in the advanced stages required more homeopathic remedies and in a correct sequence to see clinical change.

Vitiligo