Vitiligo

What is Vitiligo?

Vitiligo is a skin condition caused by progressive depigmentation; it presents as white patches on the skin. The texture of the depigmented skin is not altered and the condition is not painful, although the affected skin may be much more sensitive to the sun.

Vitiligo affects both sides of the body equally, often symmetrically, and the borders of the white patches are irregular but well-defined. White patches may appear gradually or suddenly. Vitiligo is not uncommon, affecting between one-half and one percent of the population. While not serious medically, it can cause emotional distress for the sufferer because of how it makes the skin look.

What Parts of the Body Can Be Affected by Vitiligo?

Although vitiligo can affect any part of the body, this skin pigmentation is usually on the:

Face
Elbows
Knees
Hands
Feet
Genitals
Upper thighs

When vitiligo affects the scalp, the hair growing on the patch is white. It can also affect the chin or eyelid, in which case the lashes or beard become white.

Causes of Vitiligo

Vitiligo appears to be an autoimmune disorder in which immune cells attack melanocytes, the cells that produce pigment. We do not know yet why this happens. This skin pigmentation runs in some families; can appear at any age; affects both sexes equally; and affects people of every skin color. There is also some correlation between vitiligo and three other autoimmune diseases: pernicious anemia, hyperthyroidism and Addison’s disease.

Diagnosing Vitiligo

In most cases, a physical examination can diagnose vitiligo, but, in some cases, we will use an ultraviolet light called Wood’s light. Wood’s light provides a definitive diagnosis because it illuminates only skin affected by vitiligo. At times, we take a skin biopsy to make sure the depigmentation does not have another cause. If another medical issue is suspected, blood tests may be administered to check the patient’s levels of various hormones, especially thyroid hormone, and of vitamin B12.

Skin Pigmentation Treatment

Vitiligo is a very difficult disorder to treat. In most cases, patients just live with it, using sunblock to protect white patches from sunburn and/or makeup to camouflage them. Although we used to believe that melanin was the only agent protecting the body from sun damage, vitiligo has shown that that is not the case. Some patients suffer severe sunburn on patches and others do not. In all cases, however, it is important for patients to use sunblock.

There are several treatments for skin pigmentation with varying degrees of success. They include the following:

Phototherapy (medical exposure to ultraviolet light)
Topical drugs (to increase skin sensitivity to light)
Topical corticosteroids
Autologous skin grafts from pigmented areas
Medical tattooing (micropigmentation)
Topical immunosuppressants

Other treatments are being used experimentally. One involves the transplantation of melanocytes grown from a patient’s healthy cells to the area affected with vitiligo.

Laser Therapy for Vitiligo

Dr. Callender uses the Excimer Laser as an effective, safe, and convenient treatment for vitiligo. Clinical studies have shown that patients have received greater repigmentation in two to four weeks than with any other therapy or treatment. This treatment targets only patches of skin with vitiligo and limits exposure to healthy skin. These laser treatments are painless and only take a few minutes, twice a week, for multiple weeks.

How does the Excimer Laser Work?

The Excimer Laser creates a concentrated, yet painless, beam of ultraviolet light that is delivered to vitiligo patches. This is done through a handpiece that rests directly on the skin. By targeting these patches, the laser stimulates repigmentation with limited exposure to healthy skin.

Vitiligo laser treatment candidates

This laser treatment is good for patients of all ages and ethnic backgrounds. It is ideal for patients with vitiligo in localized areas, including the face, neck and torso. Areas such as the underarm are also easily treated due to the laser’s aiming beam and adjustable handpiece. The Excimer Laser can effectively treat stubborn areas that have not responded to other treatments.

What to expect during laser vitiligo treatment

The treatment will take place in Dr. Callender’s office. She will determine what dosage is best for the patient. The laser handpiece will be placed directly on the vitiligo patch. Patients will hear a gentle hum and see a blue colored light from the handpiece. The treatment only takes a few minutes.

No preparation is required prior to treatment. The patient should ensure that the area is clean, dry, and free of any makeup, lotions, creams, or SPF protection.

The amount of sessions will depend upon the extent and degree of depigmentation, and location of the patches. Most patients will need fewer than 30 sessions.

Advantages of the Excimer Laser

Unlike most treatments that have low efficacy or significant side effects, the laser effectively repigments with a small number of treatments in a relatively short period of time. Compared to UVB or PUVA booths that may 6 months to a year of sessions, many excimer laser patients have fewer than 30 sessions. The total UV radiation is also lower than alternative methods. Treatments are fast and no pharmaceuticals are necessary.

Excimer Laser Therapy Side Effects

The side effects of laser therapy are minimal. Most patients report no side effects. Side effects may include mild and short-lived redness of the treatment area. More serious, but rare, side effects include short-lived blistering and hyper-pigmentation.

Schedule a Consultation

If you suffer from Vitiligo and would like to seek treatment, call (301) 249-0970 or fill out an online form to schedule a consultation with Dr. Valerie Callender. Our practice serves Glenn Dale, MD and the surrounding areas.

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