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7 ways dermatologists can help treat vitiligo

Vitiligo describes a sudden loss of melanin in the skin that leads to milky-white, irregular patches of depigmentation. While there is no cure for vitiligo, the American Academy of Dermatology endorses several treatment options.

What do pop-legend Michael Jackson, actor Jon Hamm and top model Winnie Harlow have in common? These famous stars all suffer from a lifelong, often life-altering skin condition called vitiligo.

Vitiligo describes a sudden loss of melanin in the skin that leads to milky-white, irregular patches of depigmentation. While there is no cure for vitiligo, the American Academy of Dermatology endorses these treatment options:

1. Topical medicines

Depending on the range and scope of your vitiligo, a board-certified dermatologist may prescribe a mild topical corticosteroid cream or ointment for repigmentation. These topical medicines, which include cortisone, resemble the hormones produced by your adrenal glands.

Most patients need to apply the topical corticosteroid to the white patches of skin for at least three months before they see results. This treatment is simple and safe, but a dermatologist is essential to prevent side effects, such as skin shrinkage and streaks or lines on your skin.

2. Cosmetics

A common approach to vitiligo is to sidestep more traditional forms of medical treatment by leveraging the camouflaging power of custom-shaded cosmetics. Make-up, skin dyes and self-tanning products reduce the appearance of vitiligo. While natural-looking results may take some product honing and practice to master, cosmetics provide a safe, side-effect free alternative to other treatment methods.

3. Light treatment

Restore lost color to your skin with the power of light treatment. Repigmentation with light treatment has proved effective for about 70 percent of patients who are treated with an excimer laser, according to the AAD. Excimer laser treatments are most effective for treating small areas of vitiligo.

Other forms of light treatment use a light box to treat widespread vitiligo symptoms. Light treatment is most effective on the face, and least effective on the hands and feet. Patients with severe vitiligo can use light treatment in combination with topical corticosteroids to maximize results. While light treatment does not provide permanent results, light therapy is one of the most effective ways for restoring lost pigment to the skin.

4. Narrowband Ultraviolet B therapy

One of the hot topics in vitiligo treatment is the relatively new nbUVB phototherapy treatment. This light therapy approach is prescribed to vitiligo patients in cases where more than 20 percent of the skin surface is affected by vitiligo. Narrowband UVB phototherapy treatment is medically effective and has proven to offer safer and more long-lasting results than alternative phototherapy treatments. Narrowband UVB phototherapy treatment is effective for the majority of patients with vitiligo and has virtually no negative side effects. There are even some nbUVB systems that provide long-term regimentation in the privacy of a patient’s home.

5. Surgery

The American Academy of Dermatologists supports several surgical techniques for restoring pigment to affected areas caused by vitiligo. Surgical techniques are appropriate for patients who haven’t found good results with light therapy and topical medicines. The most common surgical approaches include skin grafting and melanocyte transplants. With skin grafting, normal skin acts as donor tissue, and grafts are surgically transplanted on areas of vitiligo. The new skin grafts start producing pigment. The success rate for skin grafting is 80-90 percent.

Melanocyte transplants involve surgically extracting melanocytes and keratinocytes (the cells of the top layer of skin) under local anesthesia from the patient. Once gathered, these cells are grown in a culture overnight. The cells are then applied on the vitiligo patches.

6. Depigmentation

One less common approach for treating vitiligo is called depigmentation. This treatment removes the remaining pigment from the skin, leaving the patient with completely white skin. Patients might opt for this treatment method when they have little pigmented skin left. Depigmentation also smooths skin color for a patient who already has white skin. Treatment involves applying a cream once or twice a day that gradually removes the remaining color. This is not a fast process, taking 1-4 years.

7. Unconventional treatment

Unconventional treatment options may not have conclusive evidence that they offer results, but some patients have reported success with repigmentation through certain vitamins, minerals, amino acids and enzymes. In a clinical trial, researchers found that the herb Ginkgo biloba may restore skin color and stop vitiligo from worsening.

How you treat your vitiligo is a decision influenced by its location, your age, your health and individual preferences. Ask questions to figure out what approach will work best for you by speaking to one of the board-certified dermatologists at Gardens Dermatology & Cosmetic Surgery Center to discuss your goals and concerns.

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