Vitiligo is a complex skin condition in which the immune system mistakenly attacks melanin cells, which are responsible for giving color to our skin, resulting in the appearance of distinct white spots. These spots may spread throughout the body, affecting physical appearance and causing psychological challenges.

Can vitiligo be treated and what are its causes?

While the exact triggers of vitiligo are not fully understood or confirmed, research suggests the following possible causes: 

• Autoimmunity: A mistaken attack by the immune system on melanin cells.
• Genetic factors: Having a family history of autoimmune diseases.
• Other diseases, such as: skin cancer or lymph nodes.
• Environmental factors: severe sunburn, exposure to chemicals, emotional stress and tension.

Identifying the underlying causes is crucial in developing customized treatment strategies that address the core of the problem.

You may be interested in: The causes of vitiligo are as white as snow, but it causes embarrassment

As for treatment, although there is no inevitable cure for vitiligo, the available treatments aim to:

• Slow or stop the progression of the disease.
• Stimulating the regrowth of pigment-producing cells (melanocytes).
• Unifying skin tone, for a more aesthetic and harmonious appearance.

Let us discuss together the available methods of treatment and learn about the latest medical findings in the treatment of vitiligo.

Methods of treating vitiligo

The quickest way to treat vitiligo usually involves a combination of treatments tailored to the individual's condition.

Topical treatments for vitiligo: the first line of defense

Traditionally, the first approach to managing vitiligo has involved the use of topical medications, which can be applied directly to the affected areas of skin.

• الكورتيكوستيرويداتCreams and ointments containing cortisone in different concentrations are often the first choice for treating localized vitiligo or vitiligo in its early stages.
• Calcineurin inhibitorsThe most famous are pimecrolimus and tacrolimus, which can be effective in restoring pigmentation, especially in sensitive areas, such as the face and neck.
• نظائر فيتامين د: Compounds such as calcitriol, which is derived from vitamin D, have shown promise in improving vitiligo when used in conjunction with other topical treatments or phototherapy.

While topical treatments can be effective, especially for limited or early-stage vitiligo, they may not be sufficient for more widespread or treatment-resistant cases.

New vitiligo treatment

Ruxolitinib cream is the first FDA-approved treatment to restore pigment in Vitiligo patients Chronic ones.  

Ruxolitinib cream targets the inhibition of Janus kinase (JAK), stopping the body's immune response that destroys melanin-producing melanocytes.

It is worth noting that it is permitted for use in patients aged 12 years and above.

Get to know What is vitiligo?

Laser treatment of vitiligo

Laser treatment involves the use of a highly focused UVB beam from an excimer laser;

The procedure is painless and easily performed in a doctor's office, but requires multiple sessions for best results.

The laser can reach areas that would be difficult to treat with standard phototherapy and has shown good results, especially on the face and neck.

Lasers are not the only phototherapy. Phototherapy initially emerged through the use of controlled exposure to narrow-band ultraviolet light or UVA and the drug sulfurin (PUVA), as valuable tools in the management of vitiligo. 

Phototherapy is often used in conjunction with other treatments, such as topical medications, to enhance the effectiveness and speed of the repigmentation process, however, it is important to note that prolonged or excessive exposure to UV radiation can increase the risk of skin cancer, which underscores the importance of close medical supervision and adherence to prescribed treatment protocols.

Immunotherapy for vitiligo

In cases where topical methods and phototherapy are insufficient, the doctor may consider treatments that target the underlying immune processes leading to vitiligo.

• Oral corticosteroids, such as prednisone can help  prevent immune attack on melanocytes which may slow or stop the progression of vitiligo, however, they should usually be used sparingly and in measured doses due to the risk of side effects.
• Immunosuppressive medications, such as methotrexate and azathioprine, are potential treatment options for more widespread or treatment-resistant vitiligo.

Such medications require careful monitoring and management of potential side effects, which emphasizes the importance of working closely with a qualified physician;

احجز استشارتك في مركز الجلدية والتجميل At Al Mousa Specialist Hospital

What is the surgical treatment for vitiligo?

In cases where other treatments have not been successful or in cases where vitiligo is limited to certain areas, health care providers may consider surgical interventions as a way to restore skin tone.

The surgery aims to unify skin tone and restore its natural color.

• Skin Grafting:  This process involves moving healthy, normally-colored skin from an area of ​​the body to the depigmented lesions.
• Blister Grafting: The doctor creates blisters, or so-called skin bullae, on the pigmented skin using a pulling or suction technique.
• Cellular transplantation (melanocytes and keratinocytes): In this specialized procedure, a small sample of the patient's healthy skin is taken, the melanocytes are separated and then transplanted into the non-pigmented areas, which promotes the growth of these cells over the following days (about 4 weeks) and improves the condition of vitiligo.

While surgical interventions can be effective in restoring pigmentation, they are usually reserved for individuals with stable, non-progressive vitiligo and may not be suitable for all patients due to the risk of scarring or uneven pigmentation.

Are there cosmetic solutions for vitiligo?

For some people with vitiligo, the immediate cosmetic effect of the condition can be highly desirable.

Camouflage cosmetics can be used to blend and obscure the appearance of vitiligo spots, providing a more even and natural skin tone.

Creams and cosmetics available in pharmacies may also be used to temporarily tan the affected areas, which helps reduce the contrast between the pigmented and non-pigmented areas.

ما أسرع طريقة لعلاج البهاق؟

Studies indicate that The quickest way to treat vitiligo is using phototherapy That is, through narrow-band ultraviolet light (NB-UVB) treatment. 

This treatment involves exposing the affected skin to specific wavelengths of UVB light, which helps stimulate melanin production and repigmentation of the skin.

The treatment of vitiligo has undergone a remarkable transformation, with the introduction of cutting-edge treatments, advances in diagnostic tools, and a deeper understanding of the underlying mechanisms that drive this autoimmune condition.

Frequently asked questions

What is the forbidden food for vitiligo patients?

It is recommended to avoid foods that may weaken immunity or stimulate oxidation, such as very acidic foods such as lemon and orange, seafood, foods rich in gluten, as well as processed foods, canned foods, and excess sugars.

How do I differentiate between vitiligo and white spots?

Vitiligo is characterized by bright, smooth white spots, often without scales, that spread gradually, while other white spots are often less white and accompanied by itching or scaling. The final diagnosis of vitiligo treatment requires a dermatologist and an ultraviolet examination.

How does vitiligo begin to appear?

Vitiligo often begins with the appearance of a small white spot on the skin, especially on the hands, face, or around the mouth and eyes. These spots may enlarge slowly and spread without pain or itching. Some patients also notice a loss of hair color in the same affected areas.

Sources and references

Vitiligo – mayo clinic

Vitiligo Treatment – nhs