Vitiligo is a common, chronic (long-term) skin condition that causes a loss of pigmentation in patches of the skin. People with this condition will develop pale areas that fade into white patches caused by a reduction in the amount of melanin. Melanin is the pigment that gives skin its colour. Vitiligo is a non-catching skin condition that can affect any area of skin, but most commonly occurs on the face, neck and hands, and in skin creases.
It affects around 1% of the population and can develop at any age, often causing distress to sufferers because of its unusual appearance. Vitiligo occurs when the cells that produce melanin die or stop functioning. The extent and rate of colour loss is unpredictable, and it can occur on any part of the body. Sometimes it also affects the eyes, ears, hair and the inside of the mouth. Vitiligo can sometimes cause other problems too. The pale areas of skin are more vulnerable to sunburn, so it's important to take extra care when in the sun and to use a sunscreen with a high sun protection factor (SPF). Vitiligo can affect a person’s self-esteem especially if it affects areas of skin that are exposed.
Vitiligo is caused by the lack of a pigment called melanin in the skin. Special skill cells called melanocytes produce melanin. In vitiligo these cells stop working properly and so not enough melanin gets produced to maintain the normal colour of your skin and hair. It is not known exactly why these melanocyte cells disappear but there are associated conditions and risk factors for developing vitiligo.
Until recently, vitiligo patients have had few effective treatment options available to them, with cosmetic camouflage being the most successful. Now, however, The London Dermatology Centre is proud to offer medically-proven treatments that give the skin the best chance of repigmentation. No drug can stop the process of vitiligo, but some medications, either used alone or combined with light therapy, can help to improve the skin's appearance.
Our vitiligo clinic is run by leading dermatologist Dr Sunil Chopra who has many years of experience in treating vitiligo patients, both in the NHS and in private practice.
During your initial consultation, Dr Chopra will thoroughly assess your vitiligo and go through your medical history before discussing your treatment options with you. The best treatment will depend on the extent of your vitiligo and which parts of the body are affected.
A topical corticosteroid can help to control inflammation, prevent the spread of the white patches and may help to repigment the skin, particularly if you start applying it early on in the disease. It can take several months to see a change in the skin's colour. Corticosteroid cream is effective and easy to use, but side effects include skin thinning or the appearance of streaks on the skin.
Other topical treatments for vitiligo include pimecrolimus and tacrolimus. These medicines are used to treat eczema but can also be used to help reduce the appearance of vitiligo by restoring pigment in the skin. Side effects can include making the skin more sensitive to sunlight, a burning sensation when applied to the skin and facial redness when consuming alcohol.
Phototherapy can be used when topical treatments such as steroids have not worked or if there are extensive patches of vitiligo. In this treatment the affected areas are exposed to ultra-violet light. At the London Dermatology Centre we use narrow-band UVB therapy (a type of phototherapy) to reduce the appearance of vitiligo. Narrow-band UVB therapy is used for treating vitiligo among many other skin conditions. Phototherapy treatments can be carried out up to three times a week depending on your individual skin type and distribution of the vitiligo. Light therapy is now considered the gold standard of treatment for vitiligo that covers more than 20% of the body. The best results with this process are achieved on the face, trunk and limbs.
Combined Light Therapy and Medication
This vitiligo treatment, known as PUVA, combines a drug called psoralen with light therapy (photochemotherapy) in the form of either UVA or UVB light. The drug is taken orally or applied to the affected skin before light therapy is then administered. Psoralen makes skin more sensitive to the light, so at the end of this procedure the skin turns pink. When the skin heals, a normal skin colour appears. This combined treatment is not recommended for children under 12.
With repeated treatments, good results in repigmenting vitiligo can be achieved with this method. You may need to visit the clinic up to three times a week for six to 12 months to see best results. To achieve a balanced, natural skin tone, it can help to frequently apply sunscreen for one to two days after each treatment. You should also wear UV-protective sunglasses and avoid direct sunlight.
This procedure, which involves removing the remaining colour around the affected skin, is suitable for patients with very extensive vitiligo. It may also be used if other treatments have failed. The treatment involves using medications such as hydroquinone and monobenzone to reduce small amounts of unaffected areas of skin, gradually lightening it so that it blends with the areas affected by vitiligo. Therapy is undertaken twice per day for nine months or possibly longer. Skin contact with other people should be avoided for at least two hours after applying the medicine so that it is not transferred to them. Depigmentation can permanently make your skin extremely sensitive to sunlight.
Medical camouflage, also known as paramedical skin camouflage or skin cover up solutions is a non-surgical intervention to help conceal or diminish the appearance to skin that has become impaired due to an accident, surgery, or dermatoses that may have altered the pigmentation. Medical camouflage for skin is reassuring to an individual who may not find immediate results from an ongoing treatment. Providing the best medical camouflage solutions not only helps to diminish the appearance of vitiligo, it has also been found to improve confidence and reduce distress, helping those to overcome physical and emotional limitations.
Prior to seeking any help for vitiligo, be sure to visit a registered skin doctor that specialises in this condition to avoid possible side effects from treatment, which include blistering, itching, over-darkening of the skin, sunburn as well as an increased risk of cataracts and skin cancer.
We understand that Vitiligo can be a difficult condition to live with, particularly if it occurs on the face, as it so often does. We aim to give you the best possible results with our treatment plans and extensive experience in treating this skin condition.
When you make an appointment at The London Dermatology Clinic, your consultant will examine your affected areas and discuss what you have already tried to reduce it. The treatment which they recommend will depend on various factors including where on the body the Vitiligo occurs, how much of the body it affects, as well as what you have already tried.
Your natural skin tone and skin type is also a deciding factor in finding the most appropriate treatment for your Vitiligo. We will also consider how much your condition affects your day-to-day life, and what your desired results would be.
When your consultant recommends a treatment plan, they will explain their reasons for selecting this treatment and are always happy to answer any questions you might have. They may give you several options and explain the benefits of each one for you, so you can make the decision as to which route you would like to go down.
After your initial consultation, you may wish to think about your options before booking in your treatment, which is completely fine and often, advisable. We want to make sure you feel at ease and comfortable with the route you decide to take. You can also contact our team if you have any further questions during this time.
Make an Appointment
Please contact our clinic in London on 0207 467 3720 to make an appointment with leading dermatologist Dr Chopra. Equipped with many years of experience in treating vitiligo patients, he will evaluate your individual skin condition and discuss the treatment options with you. You may also send an email to firstname.lastname@example.org and our team will respond to your questions or appointment request as soon as possible.
Content by Dr Sunil Chopra and Rebecca Perris.
Listen back to Dr Chopra's recent interview about vitiligo on the BBC Asian Network: