Tag: Vitiligo

Vitiligo: Learning to Love My New Look

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By Melissa M., as told to Keri Wiginton

I was 8 years old when I started getting these little white speckles on my knees. I really didn’t think anything of it at first. But then, the spots grew to the size of a half-dollar. Things progressed pretty quickly after that.

My mother took me to a doctor who diagnosed me with vitiligo. Even though I was only a child, he didn’t show me much sympathy. Instead, he told me there weren’t any treatments and dismissed my questions. It was a horrific experience that scared me away from dermatologists for decades.

Childhood was tough on me in lots of ways. But I’ve gone through therapy and found some really amazing friends since then. It’s because of that strong support system that I’ve come out the other side of vitiligo celebrating my skin.

But it took me some time to get here.

How Life Changed After My Diagnosis

I hid the white spots on my arms and legs for a while. I wore long pants and long-sleeved shirts year-round. And even though my parents barely had enough money to make ends meet, they found a way to pay for coverup and concealer.

My mom and I would wake up super early. Then, we’d use makeup to cover the vitiligo on my face and neck as much as possible. She wanted me to have some sense of normalcy, but that process got to be too expensive.

I started rocking my spots in about seventh or eighth grade. It wasn’t easy. That’s partly because, along with vitiligo, I was on the heavier side. And I was a biracial kid living in Vermont. I stuck out like a sore thumb and got bullied all the time.

Before vitiligo, I was a confident child who made friends easily. I tried to keep that up as I headed towards high school. But it’s hard to be social when people are laughing, spitting, and drawing on you.

Some kids thought they were doing me a favor by coloring my white spots with brown marker. Others tried to wipe the vitiligo off my body. Then, there were the people who didn’t want to sit next to me because they thought they might catch something.

All that took a toll on my mental health. But I’ve gone through a lot of personal growth since I was a kid. Now I feel perfect in my skin and have nothing to hide. It’s liberating.

Learning to Love My Spots

Things started to change in my late 20s and early 30s. People started asking me sincere questions and weren’t put off by my skin. Some would tell me my vitiligo was beautiful and the contrast in pigment only highlighted my features.

At first, I thought they were poking at me. Because I’d been made fun of for so long and never celebrated my skin, it felt strange for someone else to do it. But now, I

feel like they must’ve been placed in my life to help me unlock pieces of myself. And now, I’m wide open.

I owe some of this growing confidence to my most recent partner. They’ve really helped me come out of my shell even further.

For example, I’ve started wearing clothes that show off my spots and doing photo shoots. Sometimes, the makeup artist will try to cover up what they think are flaws. But I’ll have to stop them and say I actually want to enhance my vitiligo.

I’ve also started posting more about vitiligo awareness on Instagram. The response has been incredible. I’ve had people tell me I’m gorgeous, and that I should shout about my skin from the rooftops. I have yet to have a single nasty comment or message sent to me. That’s huge.

In the future, I’m sure I’ll come across people who won’t like what I’m doing. But the fact that I’ve had so much support in such a short time tells me I’m in the right place doing the right thing at the right time.

It makes my heart sing that there’s so much visibility around vitiligo now. And I want to be part of that movement. I want that one person or kid to see me and think, “Oh my gosh, I have that! She’s not ashamed of her skin, so why should I be?”

Adjusting to Life with Vitiligo

I’ve lived with a chronic skin condition for so long that I can forget I have it. But some everyday things are a challenge for me. For example, I can get a second- or third-degree sunburn just from going outside.

It’s harder for me to spend time in the sun because I have less pigment protecting parts of my skin. And regular sunblock doesn’t work all that well for me. But if I do go out, I need to reapply it every 30 minutes. Then I need to let it dry. That can turn a fun day at the beach into a frustrating one.

Vitiligo also makes my eyes sensitive to light. And I have white patches in my hair. If I ever dye it, those spots end up losing color pretty fast.

And I definitely still get looked at when I’m out in public. I’m a momma to 19-year-old twin boys, and they tend to notice the stares more than I do. They’ll point it out because they get upset. But I usually just smile, wave, or say hello to the onlookers.

Sometimes, I’ll hear a child ask their mom about my skin. I may turn around and get down on their level, while of course keeping my distance. And I’ll tell them I was born with two colors instead of one, and isn’t that cool? That’s not exactly how vitiligo works. But often, they’ll turn back and admire their own skin. The stigma is gone at that point. They know there’s no reason to be afraid.

But I still catch people looking at me with disgust. And sometimes, I’ll walk up to them and say, this is vitiligo. Would you like me to spell it for you? Because if you’re going to stare for that long, you must have questions. If I tell you what it is, then you can do your own research.

Melissa M., 40, is a vitiligo advocate. She’s lived with the condition for 32 years. You’ll find her rocking her spots under the handle @TheSpottedBeauty on Instagram. She lives in central North Carolina.

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December 30, 2022
Vitiligo: More Than Just a Cosmetic Condition

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By Lauri Vargo, MD, assistant professor of dermatology, University of Nebraska Medical Center, Omaha, as told to Susan Bernstein

Vitiligo is largely a chronic disease with an unpredictable course, so treatment can be challenging for many people. Every person responds differently to different medications. First, I establish their goals and expectations for their treatment.

The mainstay of treatment for vitiligo starting out includes different topical creams, light therapy, and oral steroids. But the world of dermatology is ever-evolving, so new treatments are emerging now for vitiligo. If we need to, we can turn to a toolbox of newer treatments. There is a lot of good research and evidence behind some of our older therapies for vitiligo, and most dermatologists will start with these treatments.

Vitiligo May Be Autoimmune

What causes vitiligo is still largely unknown. We think there’s an autoimmune component to it. Vitiligo is typically associated with other autoimmune conditions. Going through your history is extremely important in vitiligo. Autoimmune thyroid disease is one of the most common conditions we see in someone who has vitiligo.

There are some newer therapies for vitiligo, and I typically use those when we haven’t seen any improvement with the older treatments. We have to weigh all of the risks and benefits of any treatment. We have to think about the potential side effects of any treatment, and cost is also a big issue for some patients.

There are many new and exciting medications in dermatology, but access to them can be a big barrier. Older therapies are better covered by insurance. I don’t want to offer someone a topical cream that they can’t afford when they go to pick it up at the pharmacy.

Start With Topicals and Light Therapy

For vitiligo, we start with topicals and light therapy. We create each treatment plan on an individual basis because vitiligo can be a hard, frustrating condition to treat. People typically have lifelong disease and must continue their treatment. There’s no guarantee that we will be able to restore [skin] pigmentation or that your skin will return to normal.

One of the newer medications for vitiligo are janus kinase inhibitors, also known as JAK inhibitors. None of these are currently FDA approved for the treatment of vitiligo, but this will likely soon change.

With this new class of oral and topical medications, we have to address the potential side effects that come along with treatment.

Excitingly, we do have a topical version of one of these medications called ruxolitinib, which is currently used in eczema treatment. There have been some encouraging studies for it in the treatment of vitiligo, including facial vitiligo.

Typically, when we use topicals, we don’t get as concerned about systemic side effects. However, with these topical JAK inhibitors, including ruxolitinib, we are still unsure [how much of the drug you absorb through your skin] and how it could relate to potential side effects. That’s still a question.

Protect Eyes and Skin

There are other health risks for people who have vitiligo. Our melanocytes are cells that give us our pigment and protect our skin from the sun. So when you lack pigment-producing cells, you’re at greater risk for sunburn. I talk to all of my patients with vitiligo about how extremely important it is to keep skin covered and to protect your skin from burns. People with vitiligo don’t have that barrier to protect their skin from the sun’s rays.

I recommend that people with vitiligo or anyone use a sunscreen that’s SPF 30 or above, broad-spectrum, and water-resistant. It’s really important to apply enough sunscreen to your skin and to reapply it also. Most people don’t apply enough sunscreen to their skin. You need to apply 1 ounce of sunscreen at a time. That’s enough to fill a shot glass. You should reapply it every 2 hours or after sweating or swimming.

Ultraviolet protection factor or UPF clothing is another thing I recommend. You can find these clothes at many stores these days. This clothing provides extra protection from the sun. It’s really becoming popular with kids, too. Kids are wearing rash guards when they play outdoors. Because we have pigment-producing cells in our eyes, too, it’s important for people with vitiligo to use sunglasses to protect their eyes when they are out in the sun as well.

Not Just a ‘Cosmetic’ Condition

Our skin is our biggest and most visible organ. People with any skin condition are at increased risk of low self-esteem and a decrease in their quality of life because of their skin condition. People with vitiligo often are affected by this. I think it’s important for me to educate my patients with vitiligo, especially children, so they can explain what vitiligo is to other people, such as on the playground or in school. I want them to be able to feel comfortable with the skin they’re in. Adults with vitiligo, too, and all of us, are prone to self-esteem issues when it comes to our skin’s appearance.

I notice that a lot of people talk about vitiligo therapies as “cosmetic treatments” or vitiligo as a “cosmetic condition.” I feel that the term “cosmetic” suggests that we are taking something normal and enhancing it. But with vitiligo, we are treating your skin condition just as we would any other health condition you have.

If you have vitiligo symptoms, coming in for a diagnosis from your dermatologist is important. That’s because other skin conditions can mimic or look like vitiligo. There are some rarer conditions we want to rule out first. There are some allergic skin conditions that can look like vitiligo.

Makeup and Self-Tanners

One thing I talk about with my patients is a makeup product called Dermablend to cover up skin. You may also use self-tanning products with dihydroxyacetone. Using a self-tanner product is completely OK if you have vitiligo. You can use it to cover up skin lesions if you want a more even appearance. If you go out and get a tan, you will only tan the rest of your skin.

I often recommend light therapy to people with vitiligo. This is one of my favorite treatments for this condition. It’s also called phototherapy. It’s a treatment that uses directed ultraviolet rays. Sometimes, when I recommend light therapy, my patients say, “Aren’t you a dermatologist? I thought the sun is bad for your skin!” But this type of light therapy should only be done as directed by a dermatologist.

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November 4, 2022
Cream May Restore Skin Pigmentation in People With Vitiligo

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By Denise Mann

HealthDay Reporter

MONDAY, Oct. 24, 2022 (HealthDay News) — For the millions of people who live with vitiligo, a disease that robs the skin of its natural color, a newly approved cream called ruxolitinib (Opzelura) is quickly becoming a game changer.

The U.S. Food and Drug Administration approved ruxolitinib for vitiligo in people aged 12 and older in July. The drug, part of a class known as Janus kinase (JAK) inhibitors, targets JAK, a molecule involved in the development and progression of vitiligo.

About half of folks with vitiligo who used the cream got 75% or more pigment back on the face and 50% or more pigment back on their whole body after a year of use, the study found. More than one-third of adults and more than 50% of adolescents in the study said their vitiligo was no longer noticeable or a lot less noticeable after a year.

“This is a major milestone as ruxolitinib cream is the first treatment that’s FDA approved to re-pigment patients with vitiligo,” said study author Dr. David Rosmarin, a dermatologist and vice chair for education and research in the department of dermatology at Tufts Medical Center in Boston.

An autoimmune disease that occurs when the body misfires against its own skin cells, vitiligo can be mild or severe and found anywhere on the body, although it typically affects the face and hands. Vitiligo affects people of all skin types but is often more noticeable in people with darker skin.

Two studies included in the new analysis involved more than 670 people with vitiligo from 70 centers, primarily in North America and Europe. There were no differences in responses based on race, ethnicity, duration of disease, and/or the amount of vitiligo, among other factors.

“Even patients with vitiligo for over 30 years can still improve with this treatment,” Rosmarin said.

Before the new cream’s approval, dermatologists used topical steroids, topical calcineurin inhibitors, and phototherapy to treat vitiligo, he noted.

“Topical corticosteroids and topical calcineurin inhibitors help some patients, but certainly not everyone and [it] can also have side effects,” Rosmarin said. “Corticosteroids can lighten and thin the skin and we have to limit the use on sensitive body sites like face, genitals, and armpits, and calcineurin inhibitors can sting or burn where applied for some patients.”

Phototherapy involves weekly appointments that are not always geographically convenient, he added.

Topical ruxolitinib caused only mild side effects, including redness and irritation at the application site and mild acne in this study. The medication does carry a black box warning from the FDA due to asmall increased risk of serious infections, major heart issues, clotting, cancer and even death. This warning is based on studies of oral ruxolitinib, which results in much higher blood levels than the cream.

The study was funded by Incyte Corp., which produces ruxolitinib. It was published Oct. 20 in the New England Journal of Medicine.

Vitiligo experts welcome the new medication and are optimistic about the vitiligo treatment pipeline.

Vitiligo has traditionally been understudied despite its dramatic social and psychological impact, said Dr. Victor Huang. He is director of the Vitiligo Clinic at the University of California, Davis.

“The development of this new medication is exciting to the community for the treatment it offers, the validation of the underlying science of vitiligo it represents, and for the novel treatments to come it promises,” Huang said.

“This disease can take a dramatic toll on self-esteem,” he explained. “Half of all patients with vitiligo are diagnosed before the age of 20, and in the pediatric population, teasing, bullying, self-consciousness and embarrassment have been issues for patients.”

There’s also more to it, Huang said.

“My patients report the burden of vitiligo manifesting in the time it takes to apply cover-up in the morning, difficulty with developing intimate relationships, the anxiety of always standing out, dealing with strangers who are afraid vitiligo is contagious, and time away from work to pursue treatments which can involve three-times-a-week visits for phototherapy,” according to Huang.

Dr. Iltefat Hamzavi, a dermatologist at Henry Ford Hospital in Detroit, agreed that this new cream is a big deal for people with vitiligo.

“Vitiligo is one of the most significant psychosocial diseases with an impact on quality of life similar to chronic asthma, and rates of depression are much higher than in the general population,” Hamzavi said. “We never know how well a medication can work in a large group and also how safe it is, [and] we have that information now and that is a tremendous hurdle to overcome for a disease that had no approved treatments.”

Dr. Liv Eidsmo is a professor of translational skin and immunology at the University of Copenhagen, in Denmark. She wrote an editorial accompanying the new study. Topical treatment targets the affected sites directly and lowers the risk of systemic effects, she said.

“Patients with vitiligo finally have the hope of efficient treatments, with several new immuno-modulating drugs in different phases of clinical trials,” Eidsmo added.

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October 24, 2022
Vitiligo: My Life With This Skin Condition

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By Mark Braxton, as told to Kendall Morgan

In 1996, I discovered a small white spot on my thumb. It itched. I thought it was a scab or something. I didn’t think too much about it. Then, I started noticing other small white spots. They were spreading.

The first dermatologist I went to looked at me and walked right back out of the room. He came back in with a pamphlet and said, “This is what you have: vitiligo.” At that time, there wasn’t a lot of information. The doctor gave me a topical cream for it. I tried it for 6 months. It didn’t seem to me it was helping, so I stopped. I felt deflated.

Thankfully, when I went to another dermatologist, it was a different experience. He shook my hand. He knew immediately I wanted to know about the spots. He explained that I have vitiligo, which is a skin condition. It’s not contagious, which is important for people to know. There’s no cure or way to stop the loss of skin color. He told me that it could spread or maybe some of the pigment would come back. Then he asked me a question I didn’t expect, “How is your self-esteem?”

At that time, I felt good. It was just a couple of small spots. Over the years, as it started to spread and I could see changes, I started to feel more insecure. I have it around my mouth now and all over my body in spots. I stopped wearing shorts. I stopped going to the beach and the pool. I would avoid social settings where people could look at me. It was insecurity and sometimes slight depression and anxiety.

The mental aspect is probably the biggest challenge I’ve dealt with. Vitiligo changed my outlook on myself. I didn’t see myself how others saw me. I struggled socially with friendships and relationships. One of the worst things I’ve found that people can say is that it doesn’t bother them. I understand you may say it doesn’t bother you, but until you walk in my shoes, you don’t understand. You don’t have to look in the mirror watching your body or skin change over time. There’s this fear of the unknown.

I haven’t sought treatment, although it has been offered. The creams I tried at first didn’t seem to help. Light therapy is an option, but it’s time consuming and I didn’t want to risk getting burned. I thought I could do this all on my own. In 2019, I realized I’d been failing. Something a child said helped me start to shift my perspective. I was working at a camp and this little girl told me that I was a butterfly. She identified my spots as a butterfly, as something beautiful.

I decided it was time to open up. I joined the North Carolina Vitiligo Support Community after avoiding it for years. It was the best decision I ever made. For so long, my vitiligo was something that I never talked about. My family and friends didn’t know how I felt about it. I started sharing my journey with other people, and it helped so much.

I’m now one of two leaders for the North Carolina Vitiligo Support Community in Raleigh,. I’m also on the board of directors for VITFriends, which is a national organization that nurtures peer-to-peer relationships in the vitiligo community. I host a podcast called Living Life and Love, where others with vitiligo can share their journey. I found that sharing my own journey with such a large audience released me from a personal prison I’d been living in for too long.

Having this skin condition has opened my eyes in many ways. I’ve come to a place of acceptance. I’ve learned how to live with vitiligo and love myself. Some days are still hard if someone whispers or stares too hard. Kids are often curious and that’s OK. I try to educate people about what vitiligo is.

When it comes down to it, my skin looks different, but I still have interests, hobbies, and talents. I enjoy writing poetry and short stories. I like to paint and draw and be creative. I’m a big fan of science fiction and superheroes. We all have much more in common than we don’t. I’ve gone from being insecure to being secure in myself. I often say that it’s a process for all of us in the vitiligo community. Every journey is different. Everyone has a story to tell.

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October 3, 2022
Vitiligo: Challenges for the Newly Diagnosed

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By Nada M. Elbuluk, MD, as told to Susan Bernstein

One of the most challenging aspects of generalized vitiligo is how much it will progress. This is different for each person. People who are newly diagnosed often ask: “How much will it spread or how stable will it be?” Some people may have stable disease for years. But others may have vitiligo that spreads at any point in their lifetime. If you’re on treatment, this can help your condition stay stable. If not, you can develop new patches.

[Choosing to camouflage vitiligo] is a very personal decision. Each person with vitiligo handles this differently. Some people want to conceal it. Other people are more comfortable with the way their skin looks and they don’t want to wear makeup. First, we will have a conversation about camouflage. I want to know how you feel emotionally about your skin’s appearance. I may also ask, “Do you want to begin treatment, or have your treatments not responded?” There are makeup products for vitiligo that you can acquire over the counter. Some people also use self-tanners that help to camouflage the areas of skin.

I also direct people to different support resources that are available, such as the Global Vitiligo Foundation. They have a section on their website about support resources for patients with vitiligo, as well as support groups across the nation. It may help you manage your feelings to meet with other people who also have vitiligo. Talking with others in a support group can be a very supportive, positive experience. There are online support groups for vitiligo, too. I try to suggest credible sources of information online.

Emotional Impact of Skin Color Changes

Research has conclusively shown that you can have a profound psychosocial and emotional impact from vitiligo. For one, you no longer feel that you have control over how you look — how your skin appears. Vitiligo changes your skin’s color, and you may develop white patches anywhere on your body, including your face. There is also a great deal of variability in vitiligo and how extensive it is on your body. People also feel uncertain about their vitiligo’s progress: Will I have a flare? Will these patches get bigger?

Vitiligo can affect people of all skin colors. I have patients of all colors. We see it in both

adults and children. It can first appear earlier in life, but it can develop when you’re an adult. For children, it can be difficult to understand what is happening to them, and it can also be difficult for other children they are around to understand it.

Therapy and support groups for people living with vitiligo can be very helpful. It depends on the degree to which you are affected, but seeing a psychologist or psychiatrist can be helpful, too. We encourage any individual who is feeling any negative emotions to seek medical care.

Famous Role Models Decrease Stigma

Winnie Harlow was one of the first people with vitiligo to be public about it in a proud way. She is beautiful and a successful model, and she often models without using makeup to cover her vitiligo. This has helped decrease the stigma of vitiligo. There has been a positive wave in recent years about self-acceptance in general. People are starting to accept beauty in all forms which is so important. CoverGirl also recently selected their first spokesmodel with vitiligo. Mattel released a Barbie doll with vitiligo. You are seeing retail stores and marketing campaigns using models with vitiligo.

Self-acceptance of your vitiligo doesn’t take away the need to have treatment options for those who want them. But everyone should know that they are beautiful and have self-worth. It’s important to educate our society about vitiligo. People may ask you if it is contagious — it is not. My patients also ask if it is hereditary. While there is a genetic and hereditary component to vitiligo, the chances of it occurring in the next generation is low. There is less than a 10% chance that you will pass it down to your children.

Protect Your Skin From Sun Exposure

If you are not treating it and just choose to live with your vitiligo as is, then you may not need to see your dermatologist regularly. If you are on treatment, or if you have vitiligo that is spreading quickly, then usually, you should see a board-certified dermatologist every couple of months just to monitor your condition and any changes.

My message to anyone who questions if they have vitiligo or if they’ve been diagnosed with vitiligo is to see a board-certified dermatologist, particularly one who specializes in vitiligo treatment. Again, it is completely up to each person if they want to seek treatment for it or not. Your dermatologist can guide you and talk you through all of your options.

If you have vitiligo, you should wear a sunscreen of 30 SPF or higher, just as we would recommend to anyone. We used to worry that people with vitiligo were at increased risk of skin cancer. However, with more research, we have found that this is not the case, and in fact, you’re at lower risk of melanoma. Still, we recommend sunscreen as a general precaution, and if you’re out in the sun all day, reapply it every 2 hours.

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October 3, 2022
Vitiligo: Treatment Options and Innovations

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By Bassel H. Mahmoud, MD, PhD, as told to Susan Bernstein

Vitiligo is mainly an autoimmune disease of the skin that targets pigment-producing cells called melanocytes. This results in patches of depigmentation in the form of chalky white areas on the skin that can range from very small to very large, even covering most of the skin surface.

Vitiligo affects anywhere from 0.5% to 2% of the population, both adults and children, and affects people of all ethnic groups and all skin types. Vitiligo, although most of the time considered a cosmetic problem, can have a devastating psychological effect on patients and can affect their quality of life.

Treatments for vitiligo include topical and systemic immunosuppressant medications. The one that may be best for you depends on how extensive and active your disease is. There is also phototherapy, which uses ultraviolet light and laser. Other options include surgical treatment.

Immune T cells Attack Pigment Cells

Recent research studies have looked at the pathogenesis of vitiligo, which simply means the chain of events leading to this disease. These studies showed that vitiligo is an interferon-gamma driven disease leading to recruitment of CD8-positive T cells. These are cytotoxic T cells that engage with the melanocytes, or cells producing pigment in the skin, and kill them. Now that we have a better idea of how vitiligo occurs, we can develop better treatments to address this process. These newer treatments target and block these chains of events.

Recently developed drugs for vitiligo that have shown promising results are Janus

kinase (JAK) inhibitors. Examples include ruxolitinib and tofacitinib. Both are immune-suppressing medications that disrupt the cytokine signaling in the interferon-gamma pathway. Some of these new medicines can be used at topic creams or taken by mouth. It does take a few months to start seeing repigmentation of the vitiligo skin.

Many conventional treatments are still used and can be effective for vitiligo, such as oral and topical corticosteroids, which can have side effects if taken for a longer period of time, even topical steroids. The main side effect of topical steroids is skin atrophy, thinning of the skin. Calcineurin inhibitors, such as tacrolimus, are nonsteroidal alternative topical treatments, and they do not have the risk of skin thinning.

Light and Laser Treatments

Phototherapy is also a common, conventional treatment for vitiligo. The most used is narrow-band ultraviolet B light. It’s effective and relatively safe when used under supervision of a board-certified dermatologist. Another type of phototherapy is called PUVA, which is still used in some countries, but studies show that if it’s used for too long, it can cause skin cancer.

Previously, phototherapy treatments were done only at the dermatologist’s office two to three times a week. While it only takes a few seconds to a few minutes to get the treatment, you would still have to leave your work or school to come to your doctor’s office. Now, there are home phototherapy devices available, including many that are covered by insurance with a dermatologist’s prescription.

There is also a laser treatment for vitiligo called excimer laser. You must go to your doctor’s office for this treatment. A machine is used to target the vitiligo areas of the skin with an excimer laser. This treatment is in the ultraviolet range, but it’s a laser, not light. It’s stronger and can have a good effect on the areas that do not respond to treatment with UV light. You need to get the treatment two to three times a week.

New Cell and Tissue Transplant Surgeries

Cell transplant surgery is an option for recalcitrant vitiligo, which means when your vitiligo patches fail to respond to other conventional medications or light therapies. There are very few places in the U.S. that offer this surgery; one of them is at our department of dermatology at the University of Massachusetts. In vitiligo, there is a loss of the melanocytes in your skin, but the hair follicles in this area may have it and act as a reservoir of melanocytes. But if the hair also becomes white, then the reservoir of melanocytes is lost, and this vitiligo area will not respond to conventional therapy, and this is when a cell transplant procedure would yield the best outcome.

One type of surgical treatment is tissue transplant, such as punch grafting from normal skin and applying it to the vitiligo area. But the surface area to treat with this type of transplant is very limited. Also, the outcome is not optimum as it can cause a “cobblestone” look, which may be cosmetically unacceptable.

The other type of surgical option, which is the one I perform, is a cell transplant technique. We take a small amount of normal skin from a donor area, usually a hidden area on the body such as the upper thigh or buttock. Then, we extract the melanocytes from it and suspend them in a solution. While doing this step, we use a laser to resurface the vitiligo areas. Then, when the cells are ready, we apply them to the vitiligo patches and cover them with a bandage. This technique only requires a small area of skin to be taken from the donor site to cover a much larger area of vitiligo, which is a major advantage. The outcome leads to homogenous repigmentation without the cobblestone effect. The procedure is all done under local anesthesia as an outpatient procedure. The complications are minimal with excellent outcomes.

Talk About Your Options

When a patient with vitiligo comes into our office, they are counseled regarding the nature of their condition, different treatment options, techniques, and complications in detail. Then we come up with the best treatment plan for you. There are also many resources to help you understand vitiligo and treatment options that can be found on the American Academy of Dermatology’s website, so please visit www.aad.org for more information on skin, hair, and nail health, and www.umassmed.edu/vitiligo/ for our Vitiligo Clinic and Research Center at UMass.

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October 3, 2022