Treatment of Vitiligo

There is still no completely developed cure, and patients experience cosmetic and psychological stress. Above all, it is important to understand the disease and recognize that treatment may take a long time.

Treatment can be broadly divided into topical agents (ointments), oral medications, phototherapy and excimer laser, and surgical treatments such as epidermal grafting.

1. Topical agents

1. Steroids

If the lesions are few, topical steroids can be effective and may be used together with other treatments. When overused, side effects such as thinning and redness of the skin can occur, so they should be applied with consideration of the location and size of the lesions and the duration of treatment.

2. Tacrolimus, pimecrolimus

These are non-steroidal immunomodulators. Their advantage is that they do not have the side effects associated with steroids. However, treatment effectiveness may vary from person to person, so they are selected and used carefully along with steroid ointments.

2. Oral medications

1. Steroids

If vitiligo is in its early stage or spreads rapidly, short-term use can be expected to produce good results without side effects.

2. Vitamins and antioxidants

There are research findings suggesting that antioxidants such as folic acid and tocopherol may be helpful, so they are sometimes taken as an adjunct to treatment.

3. Phototherapy

1. Photochemotherapy (PUVA)

This method involves taking or applying a photosensitizer in advance and then receiving phototherapy. Because these steps are inconvenient, and because a newer phototherapy method, narrow-band phototherapy, has been introduced, it is no longer used except in some special cases.

2. Narrow-band UVB therapy

This method involves narrow-band phototherapy two to three times a week. It can be used safely in children and pregnant women, and because it is highly effective, it is one of the basic treatments for vitiligo. The treatment period varies from person to person.

3. Targeted phototherapy

This method uses a 308 nm excimer laser. Its advantage is that it can target only the areas affected by vitiligo. It is one of the preferred treatments, especially when vitiligo is on the face. However, if it is widespread over large areas of the body, treatment is difficult, so narrow-band phototherapy is used in such cases.

4. Surgical treatment

Surgical treatment can be attempted for lesions that do not respond to medication or phototherapy and are no longer spreading. Methods include grafting normal skin itself or separating or culturing cells from the skin and then grafting them.

Frequently asked questions about vitiligo

1. What precautions should patients with vitiligo take in daily life?

1. Ultraviolet rays

Because patients with vitiligo lack melanin pigment in the affected areas, they are more likely to get sunburned, so exposed areas such as the hands and face should be protected from sunlight by using sunscreen and similar measures. Otherwise, even brief exposure to sunlight can cause burns. After a burn, if it acts as skin irritation or damage, vitiligo can spread to normal skin, so extra caution is needed, especially in summer.

2. Irritation

When patients with vitiligo are exposed to severe irritation or suffer an injury, new vitiligo tends to develop at the injured site or existing symptoms tend to worsen. Therefore, care should be taken in daily life to avoid irritation or injury to the skin. Habits such as vigorously scrubbing the skin should be stopped, and wounds should be looked after carefully.

3. Stress

Because stress can trigger or worsen lesions, it is important to keep both mind and body at ease.

2. Is vitiligo hereditary?

Among young patients with vitiligo, some worry that it may be inherited and therefore avoid marriage, or hesitate to have children even if they do marry. Reports of vitiligo among family members or relatives of patients with vitiligo vary widely, from 6.05% to 38%. According to a domestic study of more than 1,000 patients, the family history rate was 12.2%. Based on these trends, it is true that vitiligo has some genetic component.

3. Does pregnancy worsen vitiligo?

The relationship between pregnancy and vitiligo is not yet clearly understood. In some cases, pregnancy or childbirth causes vitiligo to spread to other areas or become larger; in other cases, it improves during pregnancy and worsens after childbirth; and in still other cases, there is no relation at all.

Considering that most autoimmune diseases tend to worsen after childbirth, vitiligo, which is also a type of autoimmune disease, is thought to have a relatively high chance of worsening during pregnancy and after childbirth.

So far, we have explained the treatment methods for vitiligo.

In the next part, we will look at chest pain.

Source: Korea Disease Control and Prevention Agency National Health Information Portal