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Surgical Management of Vitiligo

Written by
Dr. Suvash Sahu
and medically reviewed by iCliniq medical review team.

Published on Jul 28, 2016 and last reviewed on Sep 07, 2018   -  1 min read

Abstract

Abstract

Surgery for vitiligo is a good option for a patient who is not responding to medical treatment. But, patients are not aware of this option. This article discusses about surgical management of vitiligo.

Surgical Management of Vitiligo
Contents

Vitiligo, also known as white patch disease, is characterized by amelanotic or hypomelanotic patches anywhere over the body. Till date, there is no definite etiology known for vitiligo. This skin disease has great social consequences in our modern society in spite of it being non-contagious in nature.

Stages of Vitiligo

Vitiligo can be divided into three stages:

  1. Active or progressive stage.
  2. Stable or quiescent stage.
  3. Repigmenting stage.

Surgical Treatment for Vitiligo

Various modalities have been used to treat vitiligo, which include phototherapy, photochemotherapy, topical and systemic steroids, immunomodulating agents like Levamisole, calcineurin inhibitors like Tacrolimus, etc. Many patients get complete repigmentation with medical treatment, but a vast number of patients do not respond satisfactorily to medical treatment. Hence, the need for surgical treatment is required.

Surgical treatment for vitiligo is indicated when the diseases is stable and resistant to conventional medical therapy. The advantage of surgical treatment is that it provides long-lasting pigmentary cover over a short period of time.

There are various surgical modalities such as

  1. Punch grafting.
  2. Thin split thickness skin grafting.
  3. Suction blister grafting.
  4. Tattooing.
  5. Dermabrasion.
  6. Cultured skin grafting.
  7. Others, including trypsinised autologous grafting, excision, etc.

Surgical treatment for vitiligo is indicated for patches resistant and stable for at least one year of time. If small area or small patches are depigmented, then it can be treated with the punch grafting and suction blister grafting. If large area or large patches are involved, then thin split thickness skin grafting, dermabrasion and culture techniques like melanocytes transplantation are useful.

To know more about the treatment options of vitiligo, consult a vitiligo specialist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist/vitiligo

 

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Frequently Asked Questions


1.

What Are the Various Triggers of Vitiligo?

In vitiligo, the primary cause is the immune system destroying the melanocytes in the skin. So any trigger to the immune system has a high probability of causing vitiligo. Other triggers are sunburn and altered emotional distress.

2.

Can I Get Rid of Vitiligo?

Unfortunately, there is no definitive cure for vitiligo. Treatments can only help in reducing the course of the disease. Various methods cover up the skin’s hypopigmented areas to give an esthetic appearance in the affected individual.

3.

Is Vitiligo Hereditary?

Yes, vitiligo is noted to be hereditary. In various studies, it is said to be because of the interaction between genes and unknown underlying environmental factors or triggering factors.

4.

How Quickly Can Vitiligo Spread in My Body?

In certain people, the hypopigmented patches do not spread. But in the majority of people, the white patches usually spread to other areas of the body. Likewise, in a certain group of individuals, vitiligo spreads slowly, where it takes many years. For some, it also spreads quickly. It is really hard to predict the spread of vitiligo.

5.

Can Emotional Stress Trigger Vitiligo?

Yes, both emotional stress and physical stress can trigger vitiligo. It is a complex skin disease that involves a combination of faulty genes and varied environmental factors.

6.

Can Vitiligo Go Away by Itself If Left Untreated?

Vitiligo reduces by itself very rarely. Sometimes, in certain people, little or all of the lost pigment eventually returns on its own, and the white patches completely disappear. However, in the majority of people, the hypopigmented skin patches last and grow larger if vitiligo is not treated adequately.

7.

Is Vitiligo a Sexually Transmitted Disease?

It is a common myth about vitiligo that it is a sexually transmitted disease. The fact is that it is not a contagious condition, and it cannot spread from activities like touching. It can also not spread through saliva, inhalation, blood, sexual intercourse, or sharing of personal items.

8.

At What Age Does Vitiligo Start?

Vitiligo can start at any age, but vitiligo first appears between 20 and 30. The hypopigmented patches may initially begin on the affected individual’s face above his or her eyes. It can also occur in the neck, armpits, elbows, genitalia, hands, or knees. These hypopigmented patches often develop symmetrically, and it can spread over the affected person’s entire body.

9.

Does Vitiligo Show Immediate Symptoms?

Yes, vitiligo shows immediate symptoms. The following are the most common signs of vitiligo:
- A patchy loss of skin color, which initially starts to appear on the hands, face, and areas around body openings like the nose, ear, and the genitals
- Premature graying of the hair on the affected individual's scalp, eyelashes, eyebrows, and even their beard.
- Loss of pigment in the tissues that histologically line the inner surface of the mouth and nose.

10.

Does Vitiligo Aggravate With Age?

Vitiligo is a complicated condition which has only a very few scientific evidence. This condition can initiate at any age and can become more severe over time. There are no studies to show that vitiligo is associated with aging.

11.

What Are the Other Conditions Similar To Vitiligo?

The following are the various skin conditions that are often misdiagnosed as vitiligo.
- Idiopathic guttate hypomelanosis.
- Nevus depigmentosus.
- Albinism.
- Piebaldism.
- Melasma.
- Tinea versicolor.
- Progressive macular hypomelanosis.
- Pityriasis alba.

12.

What Foods Should Be Avoided in Vitiligo?

Avoiding the following foods can prevent vitiligo from becoming severe.
- Alcohol consumption.
- Blueberries.
- Citrus fruits.
- Caffeinated drinks.
- Curd and associated dairy products.
- Fish.
- Fruit juices.
- Gooseberries.

13.

What Are the Symptoms of Mild Vitiligo?

In a person with mild vitiligo, the hypopigmented patches are noted to be small, and they usually appear as segmental or focal patterns. Those small hypopigmented patches are also noted to appear in one or a very few areas only.

14.

Can I Get Rid of Vitiligo Naturally?

Yes, certain natural remedies can reduce the symptoms of vitiligo. Turmeric is one of the effective home remedies for vitiligo. Turmeric should be used along with mustard oil. It results in the stimulation of the skin’s pigmentation. It is advised to be applied for 20 minutes on the affected area. This method should be repeated twice a day for positive results.

15.

How Do I Recognize the Symptoms of Vitiligo?

If you suspect to have vitiligo, you might experience one or more than one of the following symptoms:
- Patchy loss of skin color.
- This hypopigmentation will initially appear on your hands, face, and areas around body openings.
- Premature whitening or graying your hair.

16.

How Can I Stop Vitiligo From Spreading?

Topical steroids can be applied as cream or ointment on your skin. This method can stop the spread of the hypopigmented patches. It can also help in restoring some of your original skin colors. However, you are not supposed to use this without a doctor’s prescription, as these drugs consist of potential side effects.

17.

Is Vitiligo a Contagious Disease?

No, vitiligo is not a contagious disease. It can affect individuals who only have a defective gene and environmental triggers. It can never spread from body secretions.

18.

What Foods Help in Relieving Vitiligo?

Intake of the following foods can help in relieving vitiligo.
- Bananas.
- Apples.
- Leafy greens and vegetables.
- Garbanzo beans.
- Root vegetables, such as beets, carrots, and radishes.
- Dates.

Last reviewed at:
07 Sep 2018  -  1 min read

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Dr. Suvash Sahu

Dr. Suvash Sahu

MBBS, DNB (DERMATOLOGY,LEPROLOGY& VENEREOLOGY)

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