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Suggest Remedy For Presence Of White Spots On Face And Hands

Posted on Mon, 3 Aug 2015

Question: Dear doctor , I had white spots on face since 1991 .I took medication for this till 2002 after that i stoped as no increse in white spot also no decrease . Since spots were small didn't worry too much. Now since last week july 2015 i noticed white apots on hand . Once spot is prominent of 5 mm by 5mm side and others are dots like shape and few areas looker light in colour may be appearing soon.I went to skin specialist and he gave omnacortil-40 on friday and saturday after breakfast and sunday , tuesday , Thursday Trioxsalen ( Trikare-25 ) and take sunbath after 2 hrs of consuming this and one cream(Ezimet craem i.e. mometasone cream IP) to apply daily night. I wish to know is these medicines safe as I read omnacortil 40 is very dangerous medicine . Also sir i would like to ask taking vitamin B12- 500 mcg and folic acid- 1.2 mg (1200 mcg) both twice daily with 1mg vitamin C is helful in this case . Can i take these vitamin if there is no harm as doctor did not prearibed it.
Please advise what to do.these spots giving tension. If the light colured spots grow up then it will b very bad . Last question if the cream given by doctor is applied in areas whre no white spot , will it cause any side effect. Please doctor advice what to do.

Answered by Dr. Ilyas Patel (5 hours later)

Brief Answer:
Upload the photos and answer...

Detailed Answer:
Hi,

Welcome to HCM...

Before I give advice,I would like to come to some diagnostic conclusion. So, please upload the photos of affected parts..face and hands.

And please answer few questions...

- family history of such white spots?
- symptoms like itching,burning or pain?
- please describe the lesion..spots,patches,white,lightly white,rough,scaly....
- present history of any systemic disease like DM,thyroid diseases or other?
- history of any medicine you take?
- history of bad habit like smoking,beverages..?
- occupation?

I await for your answers and photos...ok

Thanks..

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ilyas Patel (11 hours later)

family history of such white spots?
Ans. No history of white spots.Only I am having such spot in my entire family.

- symptoms like itching,burning or pain?
No symptoms of itching ,burning, or pain.Feel on skin is normal .

- please describe the lesion..spots,patches,white,lightly white,rough,scaly....
Spot on left hand is white and clearly visible also on right hand one small spot is clearly visible .Some dot like spots are also present on left hand.Some places spots are light white colour .All spots are scattered on both hands .

- present history of any systemic disease like DM,thyroid diseases or other?
No history of diseases only problem I am facing is my stomach remain normally upset. Some days I go to toilet 5-6times in a day .Normally loose motion and after motion stomach is not clear .This problem is from many years but some times it increases too much. May be because of this my tummy is out and increasing .

- history of any medicine you take?
Took homeopathy medicine for stomach.Has little effect . If condition becomes bad I take Redotil and ornof 1 tab daily for 2-3 days.

- history of bad habit like smoking,beverages..?
I take alcohol .Last 6 months consumption is very low can say negligible but before that i.e. from XXXXXXX 2014 till dec 2014 I use to take 1 bottle of whiskey on every saturday night .

- occupation?
I am working as marine engineer on ships normally on ships for 6 months in a year.In diet get all frozen stuff .I eat chicken only some times fish also.

Answered by Dr. Ilyas Patel (7 hours later)

Brief Answer:
Vitiligo most probably

Detailed Answer:
Hi,

Welcome back..

Thanks for the answering and the clear photos..

After looking at the photos, I feel that most probably you may be having vitiligo. On the face areas, hairs are whitened in vitiliginous patches. The lesions are not increasing in size. So it can be called stable vitiligo. However, few new spots have emerged on other areas like hands and forearms. As family history is negative, I think you are less likely to have wide spread vitiligo. So, please do not worry. You have taken proper treament from your dermatologist. But, I would like to add and remove some medicines...

- continue.... tab trioxalen 25 mg daily in morn
- avoid omnacortil tab..
- add..tab levamisole 50 mg daily at night
- continue..folic acid and B12
- avoid vitamin C
- apply tacrolimus oint 0.1% like tacroz forte oint thrice a day on the patches
- avoid mometasone application

Vitiligo is an autoimmune depigmenting skin disease with genetic influence. Exact cause is not known. Trauma might trigger the disease,so please avoid even trivial trauma. I strongly recommend to take treatment under observation of dermatologist.

Kindly stop to take beverage.

Have patience..for the good result..

I hope this would help you. Still,any query..you may ask.

Thanks.

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ilyas Patel (33 hours later)

Dear doctor ,
Thanks for your valuable medical advice . Please advise how much B12 and folic acid should be taken everyday. Also I have few doubt regarding omnacortil 40 .Dr.I consulted said this will stop the spread of vitiligo and if I avoid this will there b chance that vitiligo spread will b more.
I was just reading about medicines prescribed by you .Sir on internet it is showing levamisole 50 mg is used for treating " colon cancer " and ointment tacrolimus ointment is for " echezma " .This has created some confusion. Doctor please suggest what to do .

with regards

Answered by Dr. Ilyas Patel (5 hours later)

Brief Answer:
Daily single tab of vitamin B12 and folic acid may be taken.

Detailed Answer:
Hi,

Welcome back...

- Daily single tab of vitamin B12 and folic acid may be taken.
- I do not use oral steroid in my patients due to side effects after long time and dependency. So, I advise you to avoid it.
- levamisole is an immunomodulator and used in varieties of diseases like aphthous ulcers, warts, molluscum contagiosum,alopecia areata, cancers, herpes progenitalis, , immunocompromised diseases...
- levamisole might stop the spread of vitiligo patches.
- tacrolimus is also effective in many skin diseases like eczema, pityriasis XXXXXXX lichen planus,lichen striatus,psoriasis,alopecia areata and many other diseases
- tacrolimus is found to be very effective in vitiligo. So, do not be confused...

Please follow my suggestions under observation of dermatologist. I hope you got my answer. Still, any query..you are welcome.

Thanks....

Dr. Ilyas Patel MD

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Shanthi.E