Vitiligo is a type of autoimmune disorder characterised by the loss of melanin-producing cells called melanocytes from the skin's surface. Melanin is a pigment produced by melanocytes, the expression of which gives everyone a particular skin colour.
Vitiligo is the most common disease that is associated with skin de-pigmentation, and it can occur at any age. The reasons behind vitiligo include both genetic and non-genetic or environmental factors. The loss of melanocytes occurs due to its destruction, resulting in decreased melanin production. The destruction of melanocytes might be caused due to various autoimmune or cytotoxic reasons and can be managed through some available vitiligo treatment modalities.
Treatment of Vitiligo
Once vitiligo is diagnosed, there are several therapies that can be offered to control & cure this disease. The treatment offered includes much of topically applicable creams and systemic medicines. Some types of light therapies, such as phototherapy and laser therapies, are also used to treat vitiligo. However, the most common vitiligo treatments are topical creams and surgical interventions for localised or segmental vitiligo.
The following treatment options are recommended for vitiligo:
- Topically applicable creams – Topical treatment with corticosteroid creams is recommended as it might help start re-pigmentation at the affected site. This treatment works particularly for new lesions and body areas with good sun exposure. Other topical therapies include topical calcineurin inhibitors and topical vitamin D3 analogues, which are used in combination with certain other medicines.
- Medicines – Medicine is particularly provided to those which work for the immune system and reduce inflammation. Corticosteroid pills and injections are also prescribed as per the needs of the patient. Systemic corticosteroid treatment along with tacrolimus in some hard-to-treat segmental vitiligo.
- Phototherapy – It is one of the effective options for vitiligo treatment that includes Narrow-Band UVB Phototherapy and is given 2-3 times a week. This therapy suppresses the immune system and increases the melanin synthesis process. This therapy is better than psoralen and phototherapy as it reduces the side effects due to psoralen. PUVA irradiation is also done to suppress the immune system and make a conducive environment for melanocyte formation. Excimer Laser is used to treat limited vitiligo patches.
- Surgical therapies – Surgical therapies are limited to small or segmental vitiligo patches. Different types of surgical methods are used to restore melanisation in the affected areas, including - suction epidermal graft, non-cultured epidermal suspensions, punch grafting, thin dermo-epidermal grafts, and cultured epidermis with melanocytes. All these techniques have proven their efficacies in re-storing melanin pigmentation.
- New therapies – Some emerging therapies for easy and efficient vitiligo treatment are Afamelanotide inhibitor, JAK inhibitor therapies, and topical ruxolitinib.