Dealing With Vitiligo

A young girl through the stages of vitligo. The final picture is of total depigmentation

Photo credit: ABC news

Out of all the pigmentation issues out there, vitiligo is one of the most extremes. Vitiligo not only affects a person physically but also emotionally. I can only imagine how tough it can be to have your skin depigment slowly. Thankfully, there are lot of treatment options out there and many ways to camouflage it.

Vitiligo is a very complex pigmentation disorder, that has many triggers. It involves the destruction of the melanocyte function in the skin. The entire depigmentation process happens very gradually.  Initially being small, the patches grow over time and can sometimes change color (go from a lighter skin tone, to a bright pink, to completley white). They are most prominent on the face, neck, hands and feet.

Different variations of vitiligo can occur as well. Localized vitligo is one of the most common, where only one particular area is depigmented. Dermatologists and physicians analyze the symmetry, segmental (or non-segmental) pattern of vitiligo to determine the progression (or lack of progression. Vitiligo can simply remain stagnant).

Since there are so many possible ways vitiligo can develop, treatment is usually universal for all cases. In the instance of total depigmentation, monobenzone can be used to speed up the whole process. Monobenzone is a cytotoxic substance (harmful to cells) but that is how it acutally benefits vitiligo patients. The toxicity exerted on the cells is what contributes to the abnormal melanocyte function, and ultimnatley the significant reduction of skin color.

Monobenzone is a substance I have blogged about before. My opinion on it is that is a valid treatment option for vitiligo, but not for any other reason. Fading of melasma or brown spots should not be treated with monobenzone. I've mentioned this story before on the Hydroquinone & Monobenzone post, but two girls from the Bright Skin Forum got a hold of monobenzone with the intention of using it as an all over skin lightener. The combination of large surface area usage, the heavy cytotoxic element of monobenzone and using it for several months triggered vitiligo in their skin. Shockingly, their vitligo spread fast in a symmetry pattern. I still remember their post on Bright Skin. The panic and regret in their words just radiated from my computer screen. I could feel it.

That is why monobenzone is a substance that only a dermatologist or physician should prescribe and give directions for.

According to many dermatologists, auto-immune disorders and inflammation (internal and external) can play a huge role in developing vitligo. Obviously this does not apply to all sub categories, but many can develop vitligo through various mutations or extreme stressors. An example is the two girls who misused monobenzone.

I've been researching into the various auto-immune disorders that could trigger vitiligo. There is a lot of information out there. I will post the links at the bottom, I highly recommend them. Whether you have vitiligo or not, it is very fascinating to see how this complex disorder is triggered.

Sunscreen is pivotal for vitligo patients - I would say even moreso than any other pigmentation abnormality (including melasma). There was a study recently done stating that vitiligo can actually reduce the risk of skin cancer. The argument is that the root of skin cancer is linked to the melanocyte, and obviously without the melanocyte, the risk of getting a mutation or hastening of the genetic mutation is decreased. It's better to be safe from sun burn and other potential problems. The sun, though healthy and so incredibly vital in some ways is not be soaked up by our skin. High PPD sunscreen is a must.

The emotional impact of vitiligo is something I can only read about it. Much like melasma, which is so stubborn to treat, vitiligo can make people feel hopeless about themselves. Fortunatley there are a lot of support groups out there, and now with advances in dermatology, the treatments out there are more diverse than just monobenzone.

Psoralens and corticosteroids have been common treatment options for vitiligo patients for decades. They have been proven to help regenerate pigment both topically and systemically.

Another popular and widley used treatment is Novitil. It naturally restores the pigmentation production in the skin. A host of other topicals that help to regenerate the function of the melanocytes are out in the market: Drula Pigment Cream, Vitiligo ProTopic, and the somewhat famous Anti Vitligo. Anti Vitiligo contains high strength psoralean corylifolia, and other herbal extracts which slowly bring color back.

UV products like like UV light lamps are also used. Narrow band UVB light is exposed to affected areas through short wave lengths. This has become an increasingly popular option for areas on the body.

Certain vitamin and ayurvedic treatments have surfaced like the Leucoderma Kit. There also many Chinese herbal pills that claim to disrupt the depigmentation.

For great information, check out these resources:

Multi-auto immune diseases and vitiligo

Vitiligo: a retrospective comparative analysis of treatment modalities in 500 patients

Treatment of vitiligo with UV-B radiation vs topical psoralen plus UV-A

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