Source: Beijing Zhongke Vitiligo Hospital
Vitiligo is one of the most common dermatological disorders, appearing as one or more white macules or patches and affecting up to two percent of the population worldwide. The undesirable aesthetic properties of vitiligo, especially facial, may result in significant negative psychosocial effects, particularly a rate of depression twice that of the general population.
No drug can stop the process of vitiligo — the loss of pigment cells (melanocytes). But some drugs, used alone or with light therapy, can help restore some skin tone.
Creams that control inflammation. Applying a corticosteroid cream to affected skin may help return color, particularly if you start using it early in the disease. You may not see a change in your skin's color for several months.
This type of cream is effective and easy to use. But it can cause side effects, such as skin thinning or the appearance of streaks or lines on your skin.
Milder forms of the drug may be prescribed for children and for people who have large areas of discolored skin.
Medications that affect the immune system. Ointments containing tacrolimus or pimecrolimus (calcineurin inhibitors) may be effective for people with small areas of depigmentation, especially on the face and neck.
This treatment may have fewer side effects than corticosteroids and can be used with ultraviolet B (UVB) light. However, the Food and Drug Administration has warned about a possible link between these drugs and lymphoma and skin cancer.
Combining psoralen and light therapy. This treatment combines a plant-derived substance called psoralen with light therapy (photochemotherapy) to return color to the light patches. After you take psoralen by mouth or apply it to the affected skin, you're exposed to ultraviolet A (UVA), UVB light or excimer light. These approaches tend to have better results than just medication or just light. You may need to repeat treatments up to three times a week for six to 12 months.
Removing the remaining color (depigmentation). This therapy may be an option if your vitiligo is widespread and other treatments haven't worked. A depigmenting agent is applied to unaffected areas of skin. This gradually lightens it so that it blends with the discolored areas. The therapy is done once or twice a day for nine months or longer.
Side effects can include redness, swelling, itching and dry skin. Depigmentation is permanent, and you'll always be extremely sensitive to sunlight.
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