Vitiligo Treatment Option 2: Depigmentation & Surgical Therapies
Depigmentation Surgical Therapies
The goal of treating vitiligo is to restore the function of the skin and to improve the patient’s appearance. Therapy for vitiligo takes a long time—it usually must be continued for 6 to 18 months.
The choice of therapy depends on the number of white patches and how widespread they are and on the patient’s preference for treatment.
Each patient responds differently to therapy, and a particular treatment may not work for ever yone.
This page considers:
Depigmentation & Surgical Therapies
Depigmentation involves fading the rest of the skin on the body to match the already white areas. For people who have vitiligo on more than 50 percent of their bodies, depigmentation may be the best treatment option.
Patients apply the drug monobenzylether of hydroquinone (monobenzone or Benoquin*) twice a day to depigmented areas until they match the already depigmented areas. Patients must avoid direct skintoskin contact with other people for at least 2 hours af ter applying the drug.
The major side effect of depigmentation therapy is inflammation (redness and swelling) of the skin. Patients may experience itching, dry skin, or abnormal darkening of the membrane that covers the white of the eye. Depigmentation is permanent and cannot be reversed. In addition, a person who undergoes depigmentation will always be abnormally sensitive to sunlight.
All surgical therapies must be viewed as experimental because their effectiveness and side effects remain to be fully defined. Autologous Skin Grafts In an autologous (use of a person’s own tissues) skin graft, the doctor removes skin from one area of a patient’s body and attaches it to another area.
This type of skin grafting is sometimes used for patients with small patches of vitiligo. The doctor removes sections of the normal, pigmented skin (donor sites) and places them on the depigmented areas (recipient sites). There are several possible complications of autologous skin graf ting. Infections may occur at the donor or recipient sites.
The recipient and donor sites may develop scarring, a cobblestone appearance, or a spotty pigmentation, or may fail to repigment at all. Treatment with grafting takes time and is costly, and most people find it neither acceptable nor affordable.
Skin Grafts Using Blisters
In this procedure, the doctor creates blisters on the patient’s pigmented skin by using heat, suction, or freezing cold. The tops of the blisters are then cut out and transplanted to a depigmented skin area.
The risks of blister grafting include the development of a cobblestone appearance, scarring, and lack of repigmentation. However, there is less risk of scarring with this procedure than with other types of graf ting.
Tattooing implants pigment into the skin with a special surgical instrument. This procedure works best for the lip area, particularly in people with dark skin; however , it is difficult for the doctor to match perfectly the color of the skin of the surrounding area.
Tattooing tends to fade over time. In addition, tattooing of the lips may lead to episodes of blister outbreaks caused by the herpes simplex virus.
Autologous Melanocyte Transplants
In this procedure, the doctor takes a sample of the patient’s normal pigmented skin and places it in a laboratory dish containing a special cell culture solution to grow melanocytes.
When the melanocytes in the culture solution have multiplied, the doctor transplants them to the patient’s depigmented skin patches. This procedure is currently experimental and is impractical for the routine care of people with vitiligo.