Best Vitiligo Treatment in Delhi, India

Vitiligo is a skin condition characterised by the loss of skin colour, leading to the appearance of white patches on the skin. The pigment responsible for imparting colour to the skin, called melanin, is destroyed in vitiligo. It is not contagious or life-threatening, but it can affect a person's confidence and appearance. Vitiligo appears as smooth white areas called macules when less than 5 mm, and patches when larger than 5 mm in size.

Types of Vitiligo

Vitiligo can be of six types, differing from person to person:

• Generalised: It is the most common type in which the macules can be distributed at various parts of the body. 
• Segmental: In this type, the patches are restricted to a single segment of the body or a specific area, such as the arms or face.
• Mucosal: This type involves mucosal surfaces such as the genitals or mouth. 
• Focal: in this  variety, the macules are restricted to a specific body part.
• Trichome: This type has a white or colourless centre, with an area of lighter pigmentation, surrounded by normal skin. 
• Universal: This is another rare type of vitiligo, in which more than 80% of the skin loses its pigment.

Symptoms of Vitiligo 

The symptoms and signs of vitiligo include:

• Patchy loss of skin colour affects the face, feet, arms, and other body parts. It may also affect the mouth and genitals. 
• Whitening of hair over the white patch is also a sign of vitiligo.
• Patches may appear on the eyelashes, scalp, eyebrows or beard.
• Loss of colour of the mucous membranes such as the mouth, inner lining of the nose, and genitals. 

Vitiligo can affect any age group but has been diagnosed most commonly in people less than 30 years of age. 

Causes of Vitiligo 

Melanocytes are cells that produce a pigment called melanin. This melanin imparts colour to the skin. When these cells are damaged, die, or stop producing melanin, the skin, hair, and eyes pigment is lost and hence appears white. It is poorly understood why melanocytes die or fail to perform their function. However, some factors that may be responsible include: 

• An immune system disorder in which the immune system attacks normal body cells, misinterpreting them as foreign bodies. 
• Having a family history of vitiligo
• A triggering event, such as physical or emotional. Some examples are sunburn or trauma to the skin with chemicals and others.
• Neurogenic factors: A substance released in the skin by nerve endings that is toxic to melanocytes. 
• Self-destruction: Melanocytes sometimes destroy themselves due to triggers that cause vitiligo. 

Sometimes, a combination of the above-listed causes can also lead to vitiligo. 

Diagnosis of Vitiligo

Diagnosing vitiligo is generally straightforward as the characteristic white patches on the skin are usually noticeable. However, a doctor may use a Wood's lamp, which emits ultraviolet (UV) light on the skin, to rule out other skin conditions.

Some skin conditions that may resemble vitiligo include:

• Chemical leukoderma: Exposure to industrial chemicals can damage skin cells, resulting in discoloured patches on the skin.
• Tinea versicolor: This is a yeast infection that causes  spots on the skin that show fluorescence only under UV light.
•  Albinism: This is a hereditary condition in which the melanin production is compromised, affecting the skin, hair, and eyes.
• Pityriasis alba: This condition begins as red and scaly skin areas that fade into scaly lighter patches of skin.

If a doctor suspects vitiligo, they may also perform a skin biopsy to confirm the diagnosis. During a biopsy, a small sample of skin is taken from the affected area and examined under a microscope. This can help rule out other skin conditions and confirm the diagnosis of vitiligo.

Vitiligo Treatment 

In general, vitiligo treatment aims to control the progression of the condition and prevent repigmentation. In the case of vitiligo universalis, where more than 80% of pigment is lost, the aim is to achieve uniform skin tone through depigmentation therapy. 

Common treatments for vitiligo include repigmentation therapy, camouflage therapy, light therapy and surgery. In all cases, counselling is recommended to restore self-confidence.

Camouflage Therapy

This is most commonly in the form of  makeup that helps camouflage the depigmented areas. If the hair has been affected, hair colours help. Depigmentation therapy with monobenzone helps with the extensively spread disease.

Repigmentation Therapy

Repigmentation involves restoring the skin's colour to its original form. This can be achieved with oral or topical corticosteroids. However, results may take up to 3 months to be visible. In addition, it is essential to monitor any side effects that may develop due to prolonged use of corticosteroids, such as skin thinning or striae/stretch marks.

Other options include:

1. Topical vitamin D analogues.
2. Topical immunomodulators such as calcineurin inhibitors.

Light Therapy

Some beneficial light therapies include:

1. Narrow-band UVB light
2. Excimer lasers
3. Combination of oral psoralen and UVA

Surgery

Surgery often involves skin grafting procedures, taken from one part of the body and used to cover another body part. However, this requires the condition to be stable . 

Micropigmentation is a popular choice that has now become quite popular in society. This procedure is similar to tattooing and is employed to conceal vitiligo patches.

Counselling

Vitiligo often causes psychological distress and may affect a person's confidence, outlook and social interactions. Counselling can help build self-esteem, confidence and courage to face the world.  

Complications of Vitiligo

People who have vitiligo carry an increased risk of complications, such as:

• Social, emotional or psychological distress
• Sunburn

Prevention for Vitiligo 

The cause of vitiligo is questionable. Hence, it is difficult to determine its prevention. However, it is generally safe to protect oneself from sun exposure and industrial chemicals and to take excellent care of the skin. 

Vitiligo Outlook

Vitiligo is a condition which goes through active as well as stable phases. Timely diagnosis and professional treatment helps both in stabilising the condition and repigmentation. Areas such as the face respond better than hands and feet.

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