Vitiligo

VITILIGO TREATMENT SINGAPORE

WHAT IS VITILIGO?

Vitiligo is a skin condition wherein the skin cells in a particular area of the body are destroyed or stop working, resulting in a lack of melanin, causing the region to lose its colour or turn white. 

Vitiligo can affect any region of the body, including sun-exposed areas like hands, feet, face and neck, inside the mouth or nostrils, back of the eyes, within the ear and even the genitals. If the region affected has hair, it may turn grey or white as well. 

Although it can affect almost the entire body, it is not a contagious disorder and cannot be passed from person to another in any way. 

TYPES AND CAUSES OF VITILIGO

There are various types of Vitiligo, depending upon the region of the body it majorly affects:

1. Universal Vitiligo: As the name suggests, this type of Vitiligo affects the entire body.
2. Generalised Vitiligo: When white patches appear symmetrically on both sides of the body, it can be called Generalised Vitiligo. This is the most common type noticed in people, and can occur on any part of the body. It usually starts and stops countless times during one’s lifetime.
3. Segmental Vitiligo: This is when white patches appear on one side of the body, continuing for a year or so, before stopping abruptly. Segmental Vitiligo, unlike the generalised one, appears slower on the body.
4. Focal Vitiligo: In this type, the affected patches only appear in a few regions of the body and are often smaller in size.
5. Acrofacial Vitiligo: This type of Vitiligo mainly affects the face and hands, and occasionally the feet.

The lack of production of melanin by skin cells is the major reasoning behind this disorder. However, the exact cause for this is still unknown to science. Many researchers and doctors over the years have equated the underlying origin of Vitiligo to be any of the following:

• An autoimmune condition 
• Your genetic makeup and heredity regarding Vitiligo
• Stress
• Physical injury or trauma
• Other illnesses
• Sunburns
• Exposure to toxins/chemicals

SYMPTOMS OF VITILIGO

Vitiligo is mainly characterised by the following symptoms:

1. White patches of skin
2. Premature whitening/greying of hair 
3. Loss of pigment in mucous membranes, including those inside the nose and lips
4. Colour change in the retinas

Apart from the physically noticeable symptoms, some may also experience the following along with this condition:

1. Pain or itching
2. Affected mental wellbeing, including increased stress, lower self-esteem and depression

Depending upon the type of Vitiligo you have, the patches of white skin, as well as whitened hairs, can occur at different parts of the body, or the body in its entirety. Having Vitiligo could also increase your chances of acquiring an autoimmune disease. 

 VITILIGO TREATMENT SINGAPORE

In order to know the exact type of vitiligo treatment, that is best suited for your skin, a detailed diagnosis will be required. Your medical history will be examined, along with lab tests as well as a physical exam. 

A UV lamp may also be used to study the patches of skin or even a biopsy. It is imperative that you detail every possible contributing factor that is applicable to you, in order to get the most accurate results. 

Once the diagnosis is complete, a suitable treatment will be presented to you that may be focused either on adding pigment or removing it. Your treatment options will vary depending on the size, the severity and location, and even the number of affected patches. Vitiligo treatments are of various types, such as:

1. Medical treatments

• Topical creams: Some medicated creams, containing corticosteroids or calcineurin inhibitors, can help white patches regain their original colour. Others help slow the growth and occurrence of the patches. However, these medications could display side effects on the body in the long run. Side effects may include skin atrophy, thinning, irritation, or even excessive hair growth.
• Oral medication: There are some oral medications available that could help reverse the effects of Vitiligo. However, do note that they must only be consumed upon proper diagnosis and prescription.
• Psoralen and Ultraviolet A (PUVA) Light therapy: In this procedure, you will be administered a dose of Psoralen, either topically or orally. Following this, UV A light will be shone onto the affected skin, helping it regain its lost colour. You will be asked to avoid sun exposure after the treatment so as to have its effects last longer. Do note that this procedure has its fair share of side effects including sunburn, nausea, itchy skin, and hyperpigmentation.
• Narrowband Ultraviolet B Light therapy: An alternative to the PUVA therapy, this form of light therapy has a more focused approach to treating the affected skin, while also having lesser side effects. With a doctor’s supervision, this procedure can also be administered as part of a home treatment regime.
• Excimer laser treatment: This procedure makes use of lasers to target small patches of skin, rejuvenating them in about 4 months. Excimer laser treatment however, has to be done 2 to 3 times a week, until the results start to show.
• Depigmentation: If more than half of your body is covered in Vitiligo patches, a depigmentation treatment is suggested to you, wherein the unaffected parts of your skin will be made to match the affected regions. This procedure could take up to 2 years and can increase the skin’s photosensitivity. However, the effects of this procedure are permanent.

       2. Surgical treatments

• Skin grafting: This involves transferring a healthy, unaffected portion of skin from one part of the body to the affected regions. However, it could cause infections, scarring and/or failure to regain pigment. An alternative to this involves creating blisters on the healthy skin, after which its top layer is grafted onto the affected patches. This alternative, hence, poses a lesser number of risks. 
• Melanocyte transplants: As the name suggest, this procedure involved removing a specimen of healthy melanocyte cells from one part of the body, culturing them and transplanting them onto the affected regions. 
• Micropigmentation: This involved the tattooing of pigment into the affected patches of skin. The issue with this technique is that it would be hard to match the patient’s original skin tone. 

 Other remedies and therapies

• Sunscreens: Applying sunscreen daily can help protect your skin from excessive sun damage and exposure. Since areas without pigment are more sensitive to sun damage, it is imperative to apply sunscreen to ensure a protective barrier is created, that stops the existing Vitiligo from worsening. 
• Cosmetics: Makeup or tanning lotions could be used on the affected regions to create an even tone. The most effective option would be tanning lotions, as they tend to last longer and can even stay on after exposure to water. 
• Managing mental health: Medications and psychotherapy can help improve the quality of life for many. This can in turn help protect the body from many diseases and disorders, including Vitiligo.

PREVENTING VITILIGO

Although Vitiligo cannot be completely prevented, its effects can be greatly reduced by adopting and following various lifestyle habits, including:

1. Protection from the Sun: By using sunscreens of SPF 30 or higher, you can protect your skin from sun damage that could potentially cause Vitiligo. For added protection, you can also opt to wear UV protectant clothing or a hat. 
2. Vitamin D: Since you are protecting your skin from the sun, the lack of naturally occurring Vitamin D is reduced, and hence supplements can be taken as a substitute.
3. Avoid tattoos: The region in which you plan to get a traditional tattoo could become affected, hence losing its colour and protective nature. 
4. Natural remedies: Various natural remedies can help prevent the risk of Vitiligo. Some include a mixture of lemon and sweet basil, ginkgo biloba paste, and even a mixture of turmeric and mustard oil. 
5. Healthy diet: Adding these foods to your diet could help your immune system battle any indications of an autoimmune disease, including Vitiligo:
   • Bananas
   • Apples
   • Leafy green vegetables
   • Chickpeas
   • Root vegetables
   • Figs and dates

For a Vitiligo Treatment in Singapore consult with Dr. Ang, call  +65 6353 3851.