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What medicine do you suggest for vitiligo on my hands?

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Posted on Mon, 23 Apr 2012
Question: i ve vitiligo spots onlly on my hands pls suggest any treatment, dr gave me some no name oil and protopic(tacrolimus ointmnt .1%), clobetasol .05% gel. it seemed work on one hand but my other hand got worse specially on knuckles.no one in my family has vitiligo history.
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Answered by Dr. Bharat Chawda (2 hours later)
Hi! Sanraj,

Thank you for the query,

There are different types of vitiligo ,apart from their locations. I would briefly classify them as STABLE (not spreading) & UNSTABLE( spreading) vitiligo.

A stable vitiligo is one which is not spreading since last 6 months to 1 year and patient has not developed any new patches since then.

A unstable vitiligo is one which is either spreading or patient is getting new patches any where in the body.

Your treatment would depend upon what type of vitiligo you have.

In stable vitiligo, one would require steroidal creams or tacrolimus cream to be applied locally and they respond good in small patches. This is what your doctor prescribed you correctly.

But if lesions are multiple and extensive (or limited but not responding to creams), then certain photo toxic tablets (like methoxsalen/8-MOP) can be prescribed. This tablets is given every alternate days and following this after 2 hrs patient has to expose his lesions to either sunlight or specialized UVA light chambers for few minutes. This therapy is called as PUVA therapy. Other than this there are Narrow band UVB light therapy also available(NB-UVB) for vitiligo .The treatment requires long time (may be 6-10 months) for complete re-pigmentation.

Apart from this, in case one has only small and limited lesions then one can go for lasers as well .The latest being EXIMER LASER.

Last but not the least, in small patches (if stable), one can go for surgery as well. This could be either punch grafting or split thickness grafting or melanocyte transplantation or culture (latest).

In case the patches are UNSTABLE and spreading ,patient needs to be given oral steroid to control the spread.This tablet would go along with the above said treatment except the surgery(surgery is not recommended in unstable cases).

So, you have been given the right treatment so far ,but if you are not responding to the treatment now ,then you should go for the alternatives as described above.Kindly consult a dermatologist for proper guidance and treatment.

I hope this answers your query,if you have any further questions ,please write back to us.I would be happy to answer them.

regards,
Dr.Bharat chawda

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Bharat Chawda

Dermatologist

Practicing since :1996

Answered : 988 Questions

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What medicine do you suggest for vitiligo on my hands?

Hi! Sanraj,

Thank you for the query,

There are different types of vitiligo ,apart from their locations. I would briefly classify them as STABLE (not spreading) & UNSTABLE( spreading) vitiligo.

A stable vitiligo is one which is not spreading since last 6 months to 1 year and patient has not developed any new patches since then.

A unstable vitiligo is one which is either spreading or patient is getting new patches any where in the body.

Your treatment would depend upon what type of vitiligo you have.

In stable vitiligo, one would require steroidal creams or tacrolimus cream to be applied locally and they respond good in small patches. This is what your doctor prescribed you correctly.

But if lesions are multiple and extensive (or limited but not responding to creams), then certain photo toxic tablets (like methoxsalen/8-MOP) can be prescribed. This tablets is given every alternate days and following this after 2 hrs patient has to expose his lesions to either sunlight or specialized UVA light chambers for few minutes. This therapy is called as PUVA therapy. Other than this there are Narrow band UVB light therapy also available(NB-UVB) for vitiligo .The treatment requires long time (may be 6-10 months) for complete re-pigmentation.

Apart from this, in case one has only small and limited lesions then one can go for lasers as well .The latest being EXIMER LASER.

Last but not the least, in small patches (if stable), one can go for surgery as well. This could be either punch grafting or split thickness grafting or melanocyte transplantation or culture (latest).

In case the patches are UNSTABLE and spreading ,patient needs to be given oral steroid to control the spread.This tablet would go along with the above said treatment except the surgery(surgery is not recommended in unstable cases).

So, you have been given the right treatment so far ,but if you are not responding to the treatment now ,then you should go for the alternatives as described above.Kindly consult a dermatologist for proper guidance and treatment.

I hope this answers your query,if you have any further questions ,please write back to us.I would be happy to answer them.

regards,
Dr.Bharat chawda