Any suggestions for the treatment of vitiligo?
His skin disease Michael Jackson has.
The goal of treatment of the disorder skin of vitiligo is to restore the function of the skin in order to improve the appearance of the patient. Therapy for vitiligo takes a long time – usually must be continued consistently for 6-18 months to see results. The choice of treatment depends on the number of white spots and how they are generalized and patient preference for treatment. Each patient responds differently to therapy, and a particular treatment may not work for everyone. The only way to find out what works best for you is to test, test and test. Medical Therapies Topical steroids Steroids may be useful in repigmentation of the skin (returning the color to white patches), especially if you start early in the disease. Corticosteroids are a group of drugs similar to hormones produced by the adrenal glands (such as cortisone). Doctors often prescribe a mild topical corticosteroid cream for children under 10 years of age and a stronger one for adults. Patients must apply the cream to the white patches on the skin for at least three months before seeing any results. It is the simplest and safest treatment but not as effective as psoralen photo (see below). Your doctor will check you closely for side effects such as skin shrinkage and skin striae (streaks or lines on the skin). Photochemotherapy Psoralen photochemotherapy psoralen (psoralen plus ultraviolet A therapy, or PUVA) is probably the most beneficial treatment available for vitiligo. The goal of therapy is PUVA repigmentation white patches. However, much time and care must be taken to avoid side effects, which sometimes can be serious. Psoralens are drugs that contain chemicals that react with ultraviolet light to cause darkening of the skin. The treatment involves taking psoralen by mouth (orally) or applied to the skin (topically). This is followed by carefully planned exposure to ultraviolet A (UVA) light from a special lamp or sunlight. Patients often receive treatment their doctors' offices so they can be carefully monitored for any side effects. Patients should minimize exposure to sunlight at other times, after that. Topical psoralen photochemotherapy with topical psoralen is often used for people with a small number of depigmented patches (affecting less than 20 percent the body). It is also used for children 2 years of age and older who have localized patches of vitiligo. Treatments are performed in the doctor's office under light artificial tanning once or twice a week. The doctor or nurse applies a thin coat of psoralen to the patches of depigmentation of the patient in about 30 minutes before UVA light exposure. The patient is then exposed to an amount of UVA light that turns the affected area pink. The doctor usually increases the dose of UVA light slowly for several weeks. Over time, the pink areas fade and a more normal skin color appears. After each treatment, the patient washes your skin with soap and water applies a sunscreen before leaving the doctor's office. There are two major potential side effects of topical PUVA therapy: (1) severe sunburn and blistering and (2) too much repigmentation or darkening of the treated patches or the normal skin surrounding the vitiligo (hyperpigmentation). Patients can minimize their chances of sunburn if they avoid exposure to direct sunlight after each treatment. Hyperpigmentation is usually a temporary problem to disappear to stop treatment. Oral Psoralen Photochemotherapy Oral PUVA is used for people with more extensive vitiligo (affecting more than 20 percent of the body) or for people not responding to topical PUVA therapy. Oral psoralen is not recommended for children under 10 years of age due to an increased risk of eye damage such as cataracts. For oral PUVA therapy, the patient takes a prescribed dose of psoralen by mouth about 2 hours before exposure to artificial light or sunlight UVA. The doctor adjusts dose of light until the treated areas become skin that are pink. Treatments are usually given two or three times a week, but never two days in a row. For patients who can not go to a center of PUVA, the doctor may prescribe psoralen to be used with natural sunlight exposure. The doctor will give instructions to the patient care in carrying out treatment at home and monitor the patient during scheduled checkups. Known side effects of oral psoralen include burns, nausea and vomiting, itching, abnormal hair growth, and hyperpigmentation. Oral psoralen photochemotherapy may increase the risk of skin cancer. To avoid sunburn and reduce the risk of skin cancer, patients undergoing oral PUVA therapy should apply sunscreen and avoid direct sunlight for 24 to 48 hours after each treatment. Patients should also wear sunglasses UVA protection for 18 to 24 hours after each treatment to avoid eye damage, especially cataracts. Depigmentation Depigmentation involves fading the rest of the skin on the body to match the already white areas. For people who have vitiligo on more 50 percent of their bodies, depigmentation may be the best treatment option. monobenzylether Patients apply the drug hydroquinone (monobenzone o * Benoquin) twice a day to pigmented areas until they match the already depigmented areas. Patients should avoid skin-to skin contact with other people at least 2 hours after applying the medication. The main side effect of depigmentation therapy is inflammation (redness and swelling) of the skin. Patients may experience itching, dry skin or abnormal darkening of the membrane that covers the white of the eye. Depigmentation is permanent and can not be reversed. In addition, a person suffering depigmentation will always be abnormally sensitive to sunlight. Surgical Therapies All surgical therapies must be viewed as experimental because its effectiveness and side effects remain to be determined. Autologous skin grafts an autologous (use of a person's own tissues) skin graft, the doctor removes skin from one area of a patient's body and attaches it to another area. This type of skin graft is sometimes used for patients with small patches of vitiligo. The doctor removed sections of normal, pigmented skin (donor sites) and places them in the depigmented areas (recipient sites). There are several possible complications of the graft autologous. Infections can occur in the donor or recipient sites. Receiving sites and donors can develop scarring, a cobblestone appearance, or irregular pigmentation, or may fail to fully pigmented. Treatment with grafting takes time and is costly and most people find it acceptable nor affordable. Use blistering skin grafts in this procedure, the doctor creates blisters on the patient's pigmented skin by using heat, suction, or freezing cold. The top of the blisters will cut and transplanted to a depigmented skin area. The risks of blister grafting include the development of a cobblestone appearance, scarring, and lack of repigmentation. However, there is less risk of scarring with this procedure than with other grafts. Micropigmentation (Tattooing) Tattooing implants pigment in the skin with a special surgical instrument. This procedure is ideal for the lip area, particularly in people with dark skin, however, it is difficult for the doctor to perfectly match the color of the surrounding skin. Tattooing tends to fade over time. In addition, tattooing of the lips can lead to episodes outbreaks of blisters caused by herpes simplex virus. autologous melanocytes In this procedure, the doctor takes a sample of the patient's normal pigmented skin and placed in a petri dish containing a special cell culture solution to grow melanocytes. When the melanocytes in the culture solution have multiplied, the transplant patients medical patches of depigmentation of the skin. This procedure is currently experimental and is impractical for routine care of people with vitiligo skin disorder. Additional Therapies People with sunscreens skin disorder vitiligo, particularly those with fair skin should wear a site that provides protection for both UVA and UVB forms of ultraviolet light. Sunscreen helps protect skin against sunburn and damage long term. Sunscreen also minimizes tanning, which makes the contrast between normal and depigmented skin less noticeable. Cosmetics Some patients with impaired skin covered with patches of vitiligo with patches of depigmentation, makeup or self-tanning lotions. These cosmetic products can be particularly effective for people whose vitiligo is limited to exposed body areas. Dermablend, Lydia O'Leary, Clinique, Fashion Flair, Vitadye, makeup and offer Chromelin or dyes that patients may find helpful for covering up depigmented patches. Many counseling and support groups for people with vitiligo skin disorder find it helpful to get counseling a mental health professional. People often find they can talk to your counselor about issues that are difficult to discuss with anyone else. A mental health counselor also can offer support and help patients cope with vitiligo. It may also be useful to attend a vitiligo support group
Michael Jackson – truth about his vitiligo… RIP Michael