Vitiligo is a skin condition that produces noticeable white patches on the skin. Melanin is the chemical substance within the body that allows for coloring of the skin. The amount of melanin produced determines if a person will be light-skinned or dark-skinned. When melanin is no longer produced by the body, due to cell destruction or dysfunction, the absence of skin color can be seen covering the surface of the body with these white blotchy spots. Because many patients are uncomfortable with their appearance as the result of vitiligo, there are many medical treatment options available.
Corticosteroids are often used in the treatment of vitiligo because they encourage the production of melanin. The production of melanin can help to restore the absence of color to natural skin tone. While corticosteroids can be given in either oral or topical form, patients suffering from vitiligo are usually given topical treatments. Because corticosteroids have other benefits and side effects, it is best for patients with vitiligo to direct corticosteroid treatment directly toward the affected areas of the body. Corticosteroid treatments usually produce results in about 3 months. However, it is important for patients to pay attention to any changes occurring in the skin, such as streaking or thinning.
Immunomodulators are topical medications used to enhance the production of melanin. The most commonly used immunomodulators in cases of vitiligo are tacrolimus and pimecrolimus. This treatment method uses a combination of topical ointment and ultraviolet light exposure. When the two are used together, it is supposed to increase the production of melanin, thus returning the skin to its normal condition. The only problem with this treatment option is that it does require excessive exposure to ultraviolet radiation, which can cause serious forms of skin cancer.
Depigmentation therapy takes treatment in the opposite direction of corticosteroids and immunomodulators by lightening the unaffected areas of the skin (natural skin tone), matching it in appearance to the effects of vitiligo. Applying a topical substance called monobenzene ether of hydroquinone to the natural skin tone effectively removes pigmentation in those areas, causing the absence of color from the skin. This is a permanent treatment method, and it generally causes a life-long sensitivity to the sun.
Skin grafting can be used to treat vitiligo by removing skin from one area of the body to another. By removing small areas of pigmented skin to areas of the body devoid of pigmentation, the areas affect by vitiligo can be restored to their natural coloring. Because this requires a great deal of moving the skin, it is best used as a treatment option for patients that are only minimally affected by vitiligo.
It is important to note the intended purpose of treatment options for vitiligo is to give the skin tone a more natural appearance, either by reducing the natural darker tone of the skin or enhancing the skin tone caused by vitiligo. Depending on which treatment method is chosen, results can take up to 2 years to be fully noticed.