When we talk of treating vitiligo , we must understand very clearly that Vitiligo is a generalized abnormality of the immune system which pathes of white color n the skin. And that it is relative;y simple to manage these white patches in the skin, but there is hardly an acceptable permanent cure of the basic underlying  problem. It means that the treatment of vitiligo is not a very simple and straight forward issue.

That should not however be taken as a negative point . Vitiligo poses no health or life threat to you.  it is basically a cosmetic problem and local treatment of the cosmetically important white patches is all that is required in most of the cases.  It may in fact be wiser  not to waste your money and time in search of a permanent generalized cure for your vitiligo.

You (and your physician) can choose from the following options in the  treatment of vitiligo


Home Remedies

Majority of the patients will try a home remedy as vitiligo treatment, at least once in their lifetime. They range from simple dietary modifications to the ingestion of psoralens. The benefits are as variable as the nature of remedies. The most effective of all home remedies of course is the use of psoralens, but an unsupervised use of these potent herbs can lead to very unpleasant side effects, which may preclude their further continuation.

Alternate Treatments

Herbal Remedies

Herbal remedies employ various herbal components which contain psoralens. Psoralens is widely used substance for vitiligo treatment.

Psoralens are a group of naturally occurring, substances, which can sensitize human skin to the tanning effect of UV light (Sun light), thereby enhancing pigmentation. It is for this important quality, that they have been used with success for vitiligo treatment since ages.

Psoralens are found naturally in many herbal components. There have been isolated from fig, parsley, West Indian satinwood and celery etc. but seeds of Psoralea corylifolia are the most extensively used source of psoralens in herbal as well as Indian ayurvedic systems of alternate medicine.

1. Oral Psoralen Therapy

It is commonly used even as a domestic remedy for vitiligo treatment, in which the plant Psoralea corylifolia is ingested in various recipes. A common example is soaking the plant parts in water over night and drinking the water in the morning.

The remedy is fairly effective vitiligo treatment when combined with sun exposure, but very few people will continue to use it because of the following reasons.

Extremely unpleasant taste
Large quantities are usually required for oral intake which is very cumbersome
intolerance and side effects in form of nausea and allergic symptoms
Unwanted pigmentation of the whole body
The pigmentation is usually temporary which is lost gradually on cessation of treatment
Precautions: Psoralen is a very potent substance, and should not be used without adequate knowledge in its use.

2. Topical psoralen therapy

Application of the medicine on target skin area is a very wise and convenient alternative to oral ingestion. It can sensitize the skin even locally, which would subsequently gain color on sun exposure.
Various methods of local applications are recommended by different authorities e.g. extracts, oils and concoctions, in which the substance is used alone, or in complex recipes along with other herbal materials.
Anti-Vitiligo which is currently the most potent treatment for vitiligo contains Psoralea corylifolia in the strength of 8% W/W, along with three other constituents which modulate and enhance the action of this photo sensitizer. This combination has yielded almost permanent re-pigmentation compared with the temporary effect of oral psoralen therapy.

Homeopathy

Homeopathic system of medicine like the allopathic medicine, believes vitiligo to be a systemic disease with localized expression. They however differ in the treatment approach, because homeopathy does not offer any localized topical remedy for vitiligo treatment. It aims at detection and restoration of abnormalities in the constitution of the body. This necessarily means that the patient has to be treated and supervised by homeopathic a professional.

Ayurvedic

Ayurvedic is an Indian system of medicine which utilizes herbal, and natural products as well as heavy metals and surgical techniques for healing purposes. The treatment approach for vitiligo is however similar to the herbal approach. Some of the experts also recommend therapeutic vomiting and purgation for vitiligo.

Prescription Medicine

Prescription medicines are those therapies which are regulated by public laws and their sales is generally prohibited without prescription form a medical professional. Their advantages and side effects are scientifically studied and have a large evidence base to back them up.
This system has been relying mainly on the local use of very potent steroids which offer a temporary relief, but their high potential of side effects is prohibitive. After the scientific evidence in favor of psoralens however, these substances are also being exploited in various ways. The main disadvantage of prescription medicines however is that they are very expensive. They also lag in their efficacy because they lack the mastery in using psoralens, which is commonplace for the herbalist.

Topical Steroid Therapy

Steroids are fairly potent suppressor of immunity and can hence be of benefit in auto-immune diseases. They are commonly used in the form of topical creams and ointments during the early stages of vitiligo. Milder steroids are used for the children and potent ones for the adults. They are usually recommended for a period of three months and the effect is generally temporary. Local and systemic side effects may limit the use of these agents for prolonged duration.
Steroids are chemically related to cortisol, the major hormone produced by adrenal glands. They are less potent than psoralen photochemotherapy in the treatment of vitiligo.

Psoralen Photochemotherapy

Psoralens are a group of naturally occurring, substances, which can sensitize human skin to the tanning effect of UV light (Sun light), thereby enhancing pigmentation. It is for this important quality, that they have been used with success, to treat vitiligo since ages.


Surgical Therapy

Autologous skin grafts

The pigment containing skin from one area of the body is surgically shifted to an area where there is no pigment. The success is usually not predictable and the result may be more un-acceptable than the base-line. When the cost, the hassle and the risk of surgical complications like scarring and infection are added, it becomes a fairly risky option to go for vitiligo treatment.

Skin grafts using blisters

It is a variation in the technique of skin grafting, in which blisters on the pigment containing skin are artificially created and then cut out to be transplanted at the required site. The risk of scaring is less than the standard technique, but success in the form of re-pigmentation is not very encouraging.

Autologous melanocyte transplants

The pigment containing skin from one area of the body is surgically shifted to an area where there is no pigment. The procedure has shown some promise, but is not widely available, because it is still in its experimental stages.

Tattooing

Tattooing is not a traditional vitiligo treatment but used as a camouflage technique, it is done with artificial pigments which are deposited into the skin, with the help of traditional tattooing needles or by surgical techniques in present scientific era. The accuracy of color match shall depend upon the skill of the person doing it. It will work best for darker skins, and the color may become lighter with the passage of time. There are risks of serious infections spreading with tattooing through traditional methods. Tattooing should only be carried out by certified and licensed professionals.

Vitiligo Treatment with UVB

Vitiligo is a little understood skin disorder in which white patches appear on the skin. It may sound harmless and simple enough but this happens because the melanocytes, pigment-producing cells, stop production of the pigments. This puts the affected individual at a high risk of developing serious ailments like skin cancer as there is no protection from sun damage.

Although there is no known cure or home remedies for the disorder, phototherapy has given sufferers of vitiligo some hope for a normal life. This line of treatment has in fact been around for millennia, with traditional methods employing sunlight and plants containing natural psoralens. This method of treatment has come to be the most promising for patients with vitiligo.

Ultra violet light or UV light can be classified into different types with varying wavelengths and energy. UVA and UVB are two such types that have been used to treat vitiligo. Research suggests that treatment with UVB light is particularly effective. UVB in natural sunlight is quite low but it has high energy and can cause greater damage to the skin. When used in a controlled environment however it can be extremely beneficial.

UVB phototherapy is conducted through irradiation with short wave ultraviolet radiation. The patient stands undressed in a cubicle or cabinet, with fluorescent light tubes, that is specially designed for treatment of the entire body. UVB treatment may involve broadband or narrowband UVB, but narrowband has come to be more preferable.

Although one of the most effective vitiligo treatments, patients and practitioners alike need to exercise caution as the skin can sustain damage very easily, and the process could also be slow, taking several months for any visible improvement.

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