Vitiligo Surgery

Causes of Vitiligo

Vitiligo usually affects the skin on the body but other areas such as the scalp, lips and genitals can also be affected. Patches of hair can turn white. It develops because colour producing cells in our skin called melanocytes, die. Scientists have not completely understood why these cells die. Multiple factors such as genetics, a faulty immune system which attacks its own cells (auto-immunity), and increased free radical-induced damage (oxidative stress) may be causative. Certain factors such as skin injury and severe sunburn can cause development of new patches in a predisposed individual.

There are some factors which have been implicated in aggravating Vitiligo, though no definitive proof has been found for any of these; they include emotional stress, pregnancy and illness. Deficiencies of vitamin B12, folate, copper and zinc have been associated. Those whose parents have Vitiligo and associated autoimmune diseases are more likely to get it as compared to the general population. Though in most cases there is no family history of the condition. Anyone can get this skin disorder.

Myths about Vitiligo

Historical Status and Myths about Vitiligo History of Vitiligo is found way back to even Buddhist literature [624-544BC] which quotes it as “Kilasa”and says, people suffering from it were not eligible for ordainment. Its social implication is also mentioned in Rigveda saying people suffering from Switra[Vitiligo] and their progenies are disqualified to marry. Literature from around the world have mentioned its occurrence and the difficulty to treat it. There had been a misleading association of it with being contagious too. But, in the modern era of medicine and technology, the disease has been dealt with an altogether different approach and thats why today we are able to get the results which might be unbelievable for the past. Still, being such an old disease, there are so many myths associated with Vitiligo, which must be addressed logically.

Food and drinks– Many believe that Vitiligo can be aggravated by milk or any white food, or sour foods commonly known as Khatai, or fish with milk and many weird combinations. The reality is, we have not found any such proven thing.

Disabilities- Vitiligo is purely a disease of the skin and does not influence the physical and mental abilities.

Contagious- It was thought to be so. But the reality is that Vitiligo cannot be transmitted through touch, sharing personal items, saliva or intercourse.

Incurable- As our old literatures have mentioned it to be incurable, people strongly believe so. But in the modern times, Vitiligo can be treated very well, with the use of modern therapies and innovations, and thousands of patients have shown great recovery.

Treatment Options

• Excimer Laser 308 Ra
• Narrow Band – B
• PUVA
• Targeted Phototherapy – Livia & Lumera
• Hand and Foot UV Phototherapy Units
• Non Cultured Melanocyte Transplant
• Erbium Yag Laser assisted punch grafting

Excimer Laser 308 Ra

This is the latest advance in the concept of selective phototherapy.It emits a wavelength of 308 nm using xenon and chlorine gases. It is supposed to be a breakthrough in treatment,but the results are variable depending on the location of the patch and other factors.

Narrow Band – B

Narrow Band UVB plays a key role in control of the disease activity by activating and proliferating the melanocytes followed by upward migration of melanocytes to nearby epidermis. Given under guidance, it is very safe even in pregnancy and kids.

PUVA

Full Body UVA System (PUVA) given along with Narrow band UVB has proven to give promising results in patients specifically type 5 skin. PUVA therapy is coadministered with psoralens and decapeptides to get the most optimal results.

Hand and Foot UV Phototherapy Units

These are the units designed for the hairless areas like hands and feet. The extremities are the tough areas, so a concentrated beam can help the regimentation faster.

Non Cultured Melanocyte Transplant

NCMT is a great breakthrough in surgical interventions of less responding vitiligo areas like extremities, lips and at the same time, if performed on a stable and well responding patients on bigger areas like shins, hands and face, it gives brilliant and aesthetically beautiful results over a very short time. NCMT is preferred over other surgical interventions nowadays because of cosmetically better results and fast recovery.