Vitiligo can be treated through four different currently available options i.e. normal skin bleaching with relevant creams (to get rid of normal skin pigment to develop relatively even color), restoration of patient’s normal skin color, cover-up and sunscreens.

1 – Sunscreens:

There are two basic goals of this Vitiligo treatment method i.e. to limit the normal pigmented skin’s tanning and to protected unpigmented skin to get burn from the sun reaction. It is recommended that sunscreens should not use the sun protection factor less than SPF 30, because it doesn’t blocks erythema only but also avoid DNA of the skin cells to get affected from the sunlight.

2 – Cover-up:

The goal of cover-up Vitiligo treatment method (with make-up or dyes) is to hid white macules of the skin, just to make Vitiligo relatively less visible. It has been noted that some patients found camouflage and self-tanning lotions very useful for this disease.

3 – Restoring Normal Skin Color:

This kind of Vitiligo treatment can consist on whole body treatment or spot treatment.

3.1 – Spot Treatment: Topical Corticosteroid Creams

Certain topical corticosteroid creams are recognized as simple, practical and safe initial treatment. A patient should receive response within two months of the treatment and if it is not so, it’s unlikely to get result from this treatment method. Every two months of physician monitoring is required in this treatment method for signs of skin thinning (early steroid atrophy).

3.2 – Spot Treatment: Topical Oxsoralen

Topical Oxsoralen (8-MOP) is generally recognized as much more complicated to use for this diseases. It is said about Oxsoralen that it is highly phototoxic (it actually cause a sunburn), which generally lasts for around 3 or more days. Oxsoralen is recommended to perform only for small spots as an office procedure and by the experienced physicians only. This kind of Vitiligo treatment requires minimum of 15 treatments to initiate a response and overall process can lasts for minimum of 100 treatments.

3.3 – Spot Treatment: Mini Grafting

Mini grafting can be a useful treatment method but for refractory segmental macules of Vitiligo only. It actually involves transplanting the Vitiligo affected area from normal skin of the patient. Sometimes PUVA is required (shortly after finishing this procedure) just to unify the spliced sites’ color. This procedure sometimes gets restricted in donor sites of the generalized Vitiligo, in those patients who’ve limited Vitiligo affected areas. “Pebbling” of spliced/joined site may occur.

3.4 Whole Body Treatment: PUVA Photochemotherapy (Oral Psoralens + UVA Irradiation)

Oral Psoralen + UVA (also called PUVA) treatment method is recognized as more practical method to treat more widespread Vitiligo. This kind of Vitiligo treatment may be done with artificial UVA (at an approved phototherapy facility or in the office of the physician) and Oxsoralen-Ultra or Trisoralen, or with trimethylpsoralen (trisoralen) and sunlight.

PUVA therapy cannot be started before taking ANA blood tests and ophthalmologic examination. This kind of treatment should be initiated with 0.6 mg/kg as outdoor therapy and should not be 2 days in a row but recommended practice is twice weekly. Sunlight exposure should start with 3 minutes and then should be increased to 5 minutes per treatment until the patient gets any sign of treatment response. This treatment has been noted causing koebnerization in a very few cases. Treatment options are 0.6 mg/kg of Trisoralen (little nausea, not very phototoxic, variably absorbed) or 0.4 mg/kg of Oxsoralen-Ultra (significant risk of nausea, effective potentially very phototoxic, well absorbed).

Initial exposure of the UVA should be 1.0 J and an increment of between 0.5 and 1.0 J should be applied in every treatment until the patient receives phototoxicity response. The sustaining UVA dose should be recommended (after receiving initial response) until reasonable repigmentationis not developed over the Vitiligo affected area.

PUVA is generally recognized as 85% effective treatment method in more than 70 percent patients who got treated Vitiligo of their trunk, legs, upper arms, neck and head through this treatment method. This treatment is not very helpful in treating feet and distal hands, and therefore this method is not worth using for these body parts. Genital areas should not be treated and therefore, must be shielded. Macules usually stay in the absence of sunburn or injury that actually have totally repigmented and if the treatments are discontinued, macules will slowly reverse especially if they are less than fully repigmented. Therefore, it is recommended to maintain treatment process.

Acute dryness, hyperpigmentation, sunburn, GI upset and nausea are recognized as the risks involved in Vitiligo treatment through PUVA. It is advised to use oral PUVA treatments in the patients only under the age of 10 years. It is also noted that this treatment method is more successful in the patients with high motivation who clearly have understood the benefits and risks involved in this treatment method and have reasonable objectives. PUVA is not actually a 100 percent cure to this disease. Therefore, the development of new Vitiligo macules is not noted in the patients who respond well in result of this treatment method.

4 – Topical Creams To Remove Normal Skin Pigment and Unify Skin Color

The basic aim of depigmentation is generally recognized as to unify patient’s skin color, virtually all over the patient’s body and those who reject the PUVA option, who cannot use PUVA or who have failed PUVA. Monobenzylether of hydroquinone 20 percent cream (also named as Benoquin) bleaching is recognized as the irreversible, permanent process. Benoquin is not recommended to bleach in normal pigmentation on certain areas because it may not be correlated with distant depigmentation and it is likely that distant and new white macules of the Vitiligo patient will take a few months of bleach to develop.

Benoquin bleaching is generally implanted twice-daily and it has possible side effects. The success rate of this Vitiligo treatment method is around 93 percent. There will be a focal repigmentation in an occasional patient if he periodically follows sun exposure, but a time period of a month or so is required by the local use of Benoquin to get affected.

The skin, which actually is bleached with the Benoquin, gets the same chalk-white color as it is noted in Vitiligo macules, during the end-stage of this treatment method. Most of the patients who go for this treatment method are seen satisfied with the finality and uniformity of the results. A common wish of an occasional patient is to take between 30 and 60 mg beta-carotene to the skin. There is no side effect of beta-carotene other than an uncommon risk of diarrhea.

Sunburn may be a risk factor for the patients who undergo Benoquin bleaching. Therefore, they are advised to avoid midday sun exposure and do not go in the sunlight without using a high-SPF sunscreen. There are no documented long-term untoward effects among those patients who used monobenzylether of hydroquinone as their skin bleaching treatment method.

When the Treatment is to be Initiated?

As far as the treatment of the disease is concerned, it has to be initiated as quickly as possible.

Certain Cases with No Treatment

There are certain cases, in which no treatment is required. Doctors decide it for those patients who are fair skinned and have few lesions. In these cases, doctors nonetheless recommend the sunscreen.

If Vitiligo Lesions Untreated, What Happens Then?

It is noticed that the white lesions might develop gradually or in some cases rapidly and even they do not develop at all. It has been seen that many patients who have vitiligo but they live the routine normal life.

Any Treatment for Vitiligo Available?

Unfortunately to mention it that still the medical science has not developed any solution or permanent treatment for Vitiligo Cure. But the scientists are working quite hard on this matter and hopefully they will get one soon.

At What Stage Doctors Prescribe Corticosteroids?

Prior to prescribing of a topical steroid, the dermatologists take a number of decisions first. The considerations, which come in between, include the stage of the disease, anatomic site, patient age, cost, frequency of application, side effects, number of refills, and the specific medication. Since corticosteroids are used extensively and there exists huge scientific information about them, they are mostly considered the first line treatment in this disease called ‘Vitiligo’.

How the Potency of Topical Steroids Medications Determined?

To determine the anti-inflammatory properties of topical steroid medications, vasoconstrictor assay happens to be the standard. Although the assay is the one that measures merely the biological function of the medicine, it is widely famed as the amount of vasoconstriction that associates with the potency of the steroids.

The Effectiveness of Topical Corticosteroids

Talking about the review of a number of clinical trials, topical steroids get linked with few of the repigmentations and they might be effective in returning the pigments to smaller areas of the skin which got affected by the skin disorder ‘vitiligo’. The corticosteroids are used normally along with other treatments.

The Side Effects of Using the Corticosteroids

There are side-effects of using corticosteroids like the potent corticosteroids often cause getting the skin thinned and creating stretch marks, telangiectasia, hypertrichosis (excessive growth of hair), and acneform papules.

The Effectiveness of Topical Treatment in Kids

It should be noted that the aggressive treatment of corticosteroids should not be used in the kids. For the little children, doctors often recommend the sunscreen and cover-up measures. They can be used in the kids but they have to be carefully monitored.

The Effectiveness of Corticosteroids Treatments in Adults

In the adults and the patients above the age of 12, the mid-potency of topical corticosteroids like fluticasone propionate ointment or mometasone cream are the best and effective but they are to be used once a day and the treatment should last for 4 to 6 months. If the repigmentation is witnessed, then the treatment has to be continued till no further response is found.

Other Topical Treatments for Vitiligo

The doctors or dermatologists have welcomed the latest introduction of non-steroidal group of topical immunomodulators. Pimecrolimus and tacrolimus for the vitiligo treatment. And they are being used for treating the disease.

Recommending Phototherapy

Doctors often go for prescribing the phototherapy treatments when topical treatment seem less effective and even the phototherapy can be used with topical medications as well.

Although still there is no treatment at all for vitiligo, but the early vitiligo and medical screening treatment can stop or slow the process of depigmentation.

When the doctor learns that you have vitiligo, he/she will ask about your medical history then. The vital factors in the medical history include:
•    Vitiligo’s family history
•    The appearance of rash, spots of sunburn or other skin trauma which emerge within two to three months of the beginning of depigmentation
•    Early graying of the hair like before 35 years
•    Physical disease

Additionally, the doctor may also ask you if you or your entire family had any kind of autoimmune disease. It will also be asked if your skin is sensitive when exposed to the sun. The doctor will then also take a tiny sample of your skin for biopsy. A blood sample will also be taken.

Vitiligo disease leaves the skin with white or pale patches, which later develop into more on all over the body. Initially they emerge in tiny sizes and also in one or two numbers but soon they turn into more and the size widen.

The medical science has been continuously working hard to get solution for Vitiligo treatment but in the midst, the disease have nonetheless some solution which are not permanent but effective like anti vitiligo oil, cream, cosmetic surgery, UV therapy and the likes.

By using these treatments, patients can have the disease faded away from the skin but after some time the patches start appearing again.

Clinuvel US vitiligo study first positive observations were done on the 21 patients living with non segmental Vitiligo. Then under CUV 102 protocol, two classifications of the patients were done for the study – first 50% of the patients enrolled were undergoing repigmentation treatment with narrowband ultraviolet B therapy where the rest of the 50% were under the treatment for NB-UVB alone.

The study shows that the initial observation in the 21 patients reveals that the dosing of afamelanotide (16mg implant) in combination with NB-UVB on monthly basis possesses the capability of achieving the speedy and deeper pigmentation of vitiliginous skin lesions.

The study also reveals that the skin disorder ‘Vitiligo’ is a disease that loses the melanin production in body which results in the loss of white or off-white depigmented skin lesions. The non segmental vitiligo affects more than 45 million patients around the world and leaves the patients in psychological and emotional suffering.

For further details, please visit:

http://vitiligocover.com/first-positive-observations-from-clinuvel-us-vitiligo-study/