Suggest treatment for symptoms of vitiligo
Spreading vitiligo; Oral and topical treatment need to be combined
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.
Replies to specific queries
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.
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