Vitiligo Treatment

Medical therapies
A. Corticosteroid Therapy,
Different routes of corticosteroid therapy

1. Topical
2. Oral
3. Intralesional (ILS)

Topical corticosteroids are commonly used as first-line treatment in children and adult.
Mechanism of action can be anti-inflammatory and immunomodulatory

B. Topical calcineurin inhibitors

Tacrolimus and Pimecrolimus.
They are immunomodulators.

C. Oral Immunosuppressive Agents

D. Topical PUVA Therapy

PUVA, also commonly referred to as phototherapy, is effective for those vitiligo patients with less than 20 percent of their bodies covered with vitiligo patches.(Vitiligo Treatment Pune) In this treatment, a thin film of a substance called psoralen is applied onto the depigmented skin for about 30 minutes before the skin is exposed to UVA light.when the skin is exposed to UVA, it turns into light pink.As the skin begins to heal, the normal color of a patient’s skin starts the return

E. Oral PUVA

Oral PUVA is recommended to patients, having more than 20 percent of their entire skin covered by depigmented vitiligo.In this method, an oral dosage of psoralen is taken around two hours before exposure to UVA light

F. UVB Phototherapy

Broadband UVB(290-320 nm)
Narrow band(311 nm)

G. Excimer Lase

The 308-nm excimer laser represents the latest advance in the concept of selective phototherapy in the treatment of chronic stable vitiligo.It is recommended when the lesions involve less than 20 percent of the body.Treatment is given twice or thrice weekly for 10-15 sittings.It acts through immunomodulation by affecting T cells.

H. Depigmentation

If half or more than half of skin is covered with vitiligo.
Monobenzone ether of hydroquinone.

Few other procedures Phenolisat

In this procedure, we apply phenol over vitiligo patch.
Phenolisation, actually produce controlled wound over vitiligo patch.so on healing, patch of vitiligo shows gradual repigmentation

Platelet Rich Plasma

PRP is an in-office,non-surgical autologous treatment derived from the pt’s own blood.
we deliver powerful platelet-derived growth factors into the vitiligo lesion.
Growth factors regulate the normal population density of melanocytes in the skin (Vitiligo Treatment Pune). so they are required for the normal proliferation and maintenance of melanocytes.

Dermabrasion with laser or medication

It produces controlled wound over vitiligo patches. It induces activation, proliferation, and migration of melanoblast from the border area. So it actually helps in gradually repigmentation over vitiligo patch.

Surgical Therapies of Vitiligo Treatment Pune

These therapies can be used on areas of skin with stable vitiligo conditions.

A. Mini-punch grafting

In this method, small and thick skin grafts are planted on the discolored areas of the skin. Topical PUVA is then used to propel the process of stimulation.

B. Thin split thickness grafts

The technique is similar to mini-punch grafting but instead of taking a thick slice of skin, a thinner section is taken. It is usually used to treat the lips and hands.

C. Suction blister grafting

In this method, the dermis is separated from the epidermis, using a special suction device that inadvertently causes blisters.The separated epidermis is then placed on the vitiligo section of the skin.There is less scarring.

D. Melanocyte transplantation (non-cultured melanocyte-kerationcyte transplantation procedure)

It involves separating skin cells from normal skin and transplanting on white spots as a cell suspension after removal of the upper layer of skin superficially.
The difficult to treat areas like bony surface, areola, genitals, and knuckles can be treated with excellent results.