Vitiligo : What is it? What are the treatments available

Dr Aastha Gupta award winning dermatologist from AIIMS says that proper treatment when started early is important to stop the spread of the disease and to achieve repigmentation in vitiligo and NBUVB therapy available at Jaypee Hospital is a very safe and effective modality for treatment of vitiligo.

What is Vitiligo?

Vitiligo is a skin disease in which pigment-producing cells of the skin, known as 'melanocytes' are destroyed. Melanocytes produce 'melanin' which imparts brown colour to our skin and loss of these cells leads to loss of the skin colour leading to white patches.

Is Vitiligo hereditary? Is vitiligo transmissible to family members or contacts?

The inheritance pattern of vitiligo is complex. On an average vitiligo affects approximately 1% of the population and there is five-fold higher risk of developing vitiligo if one has a close relative afflicted by the disease. However, it is not contagious, which means that it does not spread by touch to other family members.

Why does one get vitiligo?

Although the reason for this is not fully understood it is believed to be an 'autoimmune' condition in which the body's own immune system rejects some of its own cells. As a result, thyroid disease and other autoimmune conditions are more common in individuals with vitiligo.

Are there any triggering factors for the disease?

Appearance of vitiligo has been seen after emotional stress or some major illness. Also, repeated trauma such as rubbing or scratching the skin may trigger vitiligo. However, it is important to note that diet does not appear to play any role in the appearance or continuation of the disease.

How does vitiligo look?

Vitiligo presents as milky white patches on skin which are asymptomatic. It may be accompanied by loss of colour of the hair overlying the area. Vitiligo can affect different areas of the body and depending on the area of involvement, it is classified into

  • Focal Vitiligo: when a small-localized area of skin is involved.
  • Lip-Tip Vitiligo: which involves lips and the tips of the fingers/toes.
  • Generalized Vitiligo: when a large area of body is involved.

How can Vitiligo be treated?

Although there is no cure for vitiligo, getting treatment can slow its progress and in many cases prevent further spread of the disease. Also proper treatment with regular follow up can help regain colour in the white patches. Choice of therapy depends upon the number, site and extent of involvement and patient convenience.

Medical Treatment

Medical treatment includes oral medications such as steroids and other immunosuppressive drugs which stop the disease from spreading further and topical creams containing steroids, tacrolimus, peptides or psoralens which help to regain pigmentation.

Ultraviolet light therapy

Ultraviolet light therapy includes exposing the affected area to ultraviolet A (UVA) or Ultraviolet B (UVB) therapy. UVA therapy is usually given along with a drug called as psoralen. The drug is used orally or can be applied topically and the affected area is then exposed to UVA light.

Another very effective therapy is light treatment using narrow band UVB (NBUVB). In this treatment the patients skin is exposed to focused beam of NB-UVB light delivered by the UVB chamber and it has dual benefit of both stopping the disease from spreading and also causing re-pigmentation of the white patches. This treatment is extremely safe and can be given safely to even children< 12 years of age and pregnant females. This therapy is the first line treatment used world-wide for patients with generalized vitiligo and is available at very few centres in India including our hospital.

Surgical Therapy

This is usually done when the disease is stable i.e. not increasing in size or number for at least one year. Surgical treatments include taking skin grafts from one area of the patient’s body and transplanting the entire skin or the melanocytes to the affected area. Various surgeries for vitiligo include punch grafting, suction blister grafting, and the latest non-cultured melanocyte cell suspension surgery which is also performed at our hospital.

Dr. Aastha Gupta
Department of Dermatology
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