Vitiligo

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Phototherapy can increase the risk of skin cancer.

The risk of skin cancer is lower with UVB light. The applications, with adequate and gradually increasing dosages of UVB rays, last for a few months and it is possible to obtain a percentage of skin re-pigmentation.

It is recommended not to use UV lamps on the market either because they are not effective enough or because they are not adjustable and, therefore, not safe.

Skin transplants

Skin grafting is a procedure that involves taking a small piece of healthy skin from a body area and using it to cover the area where the skin has been damaged. It can also be used to cover the areas affected by vitiligo.

Skin transplants may be considered for adults if:

  • no new white spots have appeared in the past 12 months
  • the white spots have not worsened in the past 12 months
  • Vitiligo was not triggered by skin damage such as severe sunburn (known as the Koebner response)

An alternative to skin grafting consists in taking an adequate amount (sample) of skin from which to extract the cells responsible for normal color, the melanocytes, to transplant them on the areas affected by vitiligo.These types of treatments are not definitive, carry a risk of scarring and are not suitable for children.

Depigmentation

Depigmentation can be recommended for adults with vitiligo on more than 50% of the body. It consists in eliminating the color of healthy skin using a drug, based on hydroquinone in the form of a lotion, to be applied to normal skin until it is the same color (white) as the depigmented skin. Its continuous use prevents the skin from coloring again.

Hydroquinone can cause undesirable effects such as, for example:

  • irritation
  • burning
  • itch

Depigmentation leaves the skin without any protection from the sun; it is usually permanent but sometimes a discoloration other than that of healthy skin may occur.

Other treatments

The dermatologist can propose other therapies, such as:

  • Other treatmentsexcimer lasers, high-energy light beams, used in the laser treatment of the eye, also used in phototherapy
  • vitamin D analogues, such as calcipotriol, also used in association with phototherapy
    azathioprine, a drug that suppresses the functioning of the body’s natural defense system (immune system)
  • oral prednisolone, a corticosteroid medicine also used in combination with phototherapy; can cause unwanted effects (side effects)

Complementary therapies

There is no evidence to support the effectiveness of herbal remedies (for example ginkgo biloba) in relieving or preventing vitiligo.Additionally, some remedies can react unpredictably with medications or make them less effective.