Brief Answer: Vitiligo treatment Detailed Answer: Hello and Welcome to healthcaremagic I am Dr. Kakkar. I have gone through your concern and understood it. Vitiligo is a condition characterized by the autoimmune destruction of melanocytes, resulting in loss of pigmentation. In vitiligo, there is a partial or total destruction of melanocytes, initially only of the epidermis and later even of the hair follicle, which acts as a reservoir for providing melanocytes during repigmentation. Vitiligo can be of various types depending on the distribution of lesions: 3 types commonly seen are: -Focal Vitiligo -Segmental Vitiligo -Generalised Vitiligo Judging from the distribution of the lesions, you seem to be having a generalised type of vitiligo, where patches are widespread and symmterical involvement is common (e.g Bilateral arms, bilateral legs, trunk and torso etc) Medical therapies are the primary treatment for vitiligo. To enumerate them, they can be divided into topical and oral. --Topicals e.g Topical steroids, Topical immunomodulators like Tacrolimus, Topical PUVA (Melanocyl lotion)etc --Oral e.g Oral PUVA(Melanocyl tablets), NB-UVB phototherapy, Oral steroids etc. For generalised vitiligo, as seems the case here, Phototherapy remains the mainstay of treatment e.g NB-UVB and PUVA. NB-UVB is the most preferred form of therapy for patients with generalised vitiligo since it is safe, effective, well tolerable and gives long lasting results/re-pigmentation. It can also be given in children and even pregnant ladies because of its safety profile. Disadvantages with NB-UVB Phototherapy are: -It requires to be adnministered 3 times in a week for several weeks. -It is expensive. Topical are an adjuvant to systemic treatment and include topical steroids and topical immunomodulators like tacrolimus. They accelerate the response to systemic therapy. At last, I would want to say that Vitiligo is a remitting and relapsing condition and no one can predict the future course of the disease. Treatment is directed at repigmenting the already existing patches with the most appropriate modality suitable for the particular type of vitiligo. Sometimes it responds very well at certain body sites like trunk, limbs and face but remains resistant OR responds slowly at certain body areas like lips(perioral), fingers, palms, soles and scalp etc The duration of phototherapy varies according to the severity/extent of vitiligo. There is no fixed duration for phototherapy. It is individualized for each patient. The duration can vary from a few weeks to a few months depending on the response. Phototherapy can be continued even for maintenance after a satisfactory response. Topical therapy is only for the existing patches of vitiligo and the duration depends on the response. The decision to stop treatment is made usually after satisfactory repigmentation of the patches is achieved OR most of the patches is achieved. For a few resistant patches of vitiligo that remain, Phototherapy can be continued with a topical psoralen Or hand help NB-UVB phototherapy unit, rather than exposing the whole body. Topical therapy is usually continued along with phototherapy. The surrounding dark skin is usually a side effect of phototherapy and fades away gradually in a few weeks, once the treatment is over. This manifest as tanning and is only up to a limit. This is not much of a concern usually with NB-UVB than it is with PUVA Hope this answers your query regards

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Brief Answer: Vitiligo treatment Detailed Answer: Hi NB-UVB is increased by 10%-12% in every sitting till the dose which shows faint erythema and perifollicular repigmentation. Thereafter it is kept constant. The time of exposure is dictated by the dose of UVB that is to be given per session Pimecrolimus, calcipotriol are absolutely safe. Some patients can experience mild/transient irritation but it subsides on continued treatment. Herbel medicines are not approved for vitiligo, therefore I wont ask my patients to use them. Lukoskin(defense ministry researched, D.R.D.O) is also actually a psoralen, so it is no different from phototherapy. I think one should stick to the Allopathy because there are so many trials/studies in medical journals and approval for use throughout the world, rather than go for herbal medicines. Its not a good idea to combine allopathy and herbal together because there can be adverse events. regards

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Brief Answer: Vitiligo treatment Detailed Answer: Hi. Sorry, but I have no idea about homeopathy. For that you need to ask a separate query to a homeopath. In my view, it is not a good idea to combine topical allopathy and oral homeopathy because you will utilizing a part of homepathic treatment and a part of allopathic treatment, therefore it may be that both become ineffective when not utilized to the full potential. I think you should give a fair trial to phototherapy (NB-UVB) Regarding depigmentation, the ingredient which is commonly used is monobenzyl ether of hydroquinone, which cause irreversible and complete destruction of melanocytes. It is available as a topical cream and has to be used twice daily. It will produce a complete depigmentation and therefore a chalk white color/complete depigmentation. It cannot be used to just lighten the color OR match up tone regards

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Brief Answer: Vitiligo treatment Detailed Answer: Hi. There are no restrictions to any of the foods nor are there any specific foods that you should take in vitiligo. Yes, you can use a sunscreen at those areas which are not affected by vitiligo. You can also use a moderately potent topical steroid e.g fluticasone propionate cream, twice daily over hyperpigmented spots. regards take care.

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