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Suggest treatment for symptoms of vitiligo

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Posted on Wed, 8 Jun 2016
Question: Dear Doctor, I am XXXXXXX from XXXXXXX this is regarding my daughter aged 7 years. 2 years back skin below the left eye started turning white, we consulted a dermatologist near by who after checking the thyroid functioning, which was normal gave a tablet to be taken once a week & a topical onitment (Tacrolimus 0.03% w/w) to be applied daily. This after 4 months didn't give us an result then the doctor prescribed Melbild solution ( Deca-Peptide solution 5ml) to be diluted 1:1 with water & applied on the affected areas & to be exposed to the sun light for 15 minutes with this the skin started turning pink color & it was causing burning sensation to my daughter, so we discontinued the treatment. We then consulted once more Dermatologist who diagnosed it to be Earlier Vitiligo & prescribed Steriods along with antioxidants which we were not ready to take, fearing it to cause health issue to my daughter. From then we consulted Homeopathy, Ayurveda & what not but we could not get permanent remedy for this problem. Now the white patches have spread to the upper eye lid & the skin below the eyes both sides. These white patches are also seen on the palm & further when ever their is a cut or a wound after healing the portion of the skin becomes white. So Kindly suggest me the solution to this issue with out causing any major side effects to her body. Her daily activities & academics are good. No other health disorders noticed by us. Thanking You, With Regards, XXXXXXX XXXXXXX
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Answered by Dr. Kakkar S. (23 minutes later)
Brief Answer:
Spreading vitiligo; Oral and topical treatment need to be combined

Detailed Answer:
Hello XXXXXXX Thank you for writing to us

I am dr.kakkar(dermatologist). I have gone through your query and I have also reviewed the Images.

Yes, this is vitiligo. Since new patches are forming therefore the disease is active in her case.
Treatment has to be appropriate according to the severity of disease which would include both topical and oral medications.
In her case I would suggest that she be started on a course of Oral steroids for a few weeks (pulse steroids i.e oral minipulse for 4-8 weeks) to arrest the progress of disease.
In addition I would suggest Oral psoralens e.g Trimethoxypsoralen (Trimop forte 25 mg) every alternate days followed by sun exposure for 15-30 minutes.
Topically she may use Tacrolimus forte 0.1% ointment, twice daily for the patches.
These are prescription medications and I suggest that you talk to her dermatologist for the needful.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. (1 hour later)
Thank you doctor for your suggestions. By putting her on Oral steroids, will their not be any health related side effects? also I would like to know weather this can be cured completely once for all or this can only be maintained in this present form. Once exposed to sun light will their be any burning sensation in those white patch areas?
doctor
Answered by Dr. Kakkar S. (4 hours later)
Brief Answer:
Replies to specific queries

Detailed Answer:
Hi.

Oral steroids are much safer in pulse dosing as compared to daily dosing. Definitely there are side effects with oral steroids (more commonly with longer courses) but these side effects can be monitored and minimized by taking under the supervision of a doctor.
As far as vitiligo is concerned, it is an unpredictable disease. Patients may either respond partially Or the patches can come back after seemingly complete cure. Widespread vitiligo specially which has an early onset in childhood is more difficult to treat completely.
Sun- exposure should not exceed the prescribed time or else it may cause phototoxicity.


Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

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Suggest treatment for symptoms of vitiligo

Brief Answer: Spreading vitiligo; Oral and topical treatment need to be combined Detailed Answer: Hello XXXXXXX Thank you for writing to us I am dr.kakkar(dermatologist). I have gone through your query and I have also reviewed the Images. Yes, this is vitiligo. Since new patches are forming therefore the disease is active in her case. Treatment has to be appropriate according to the severity of disease which would include both topical and oral medications. In her case I would suggest that she be started on a course of Oral steroids for a few weeks (pulse steroids i.e oral minipulse for 4-8 weeks) to arrest the progress of disease. In addition I would suggest Oral psoralens e.g Trimethoxypsoralen (Trimop forte 25 mg) every alternate days followed by sun exposure for 15-30 minutes. Topically she may use Tacrolimus forte 0.1% ointment, twice daily for the patches. These are prescription medications and I suggest that you talk to her dermatologist for the needful. Regards