Dermatology >>>> Vitiligo - to treat or mask?

Vitiligo - to treat or mask?

Vitiligo is a type of skin dyschromia (lack of pigmentation). Although vitiligo is called a skin disease, it can rather be classified as a skin cosmetic defect. Milky patches appear on the skin, which can take up large areas over time. Vitiligo does not cause any physical suffering, but it strains the nervous system of people with this disease very much, since it spoils the appearance and complicates social adaptation.

The causes of the disease lie in the absence of melanocytes, cells responsible for skin color, and are associated with an acquired or congenital disorder of melanin synthesis. Prolonged exposure to the sun aggravates the contrast of depigmented spots with tanned areas of the skin.

Scientists have long been trying to link the processes occurring in the body of people suffering from vitiligo with the mechanism of this disease. At the moment, the prerequisites for the development of vitiligo are considered to be metabolic disorders in the body, psychoemotional disorders due to stress, chronic diseases of the digestive system, abnormalities in the liver, thyroid gland, heredity and much more. There is also an opinion that under certain unfavorable conditions, immune cells damage melanocytes, which leads to focal depigmentation. That is, we are talking about the autoimmune nature of the disease, the so-called autosensitization.

Treatment of vitiligo is aimed at correcting endocrine processes, treating chronic diseases of the gastrointestinal tract, and also requires creating comfortable conditions for the nervous system (avoiding stressful situations, developing stress resistance). A diet high in B vitamins, zinc, copper, iron is required.

Photochemotherapy with UV-A is used according to indications (called PUVA - therapy): photosensitizing drugs (trioxisalene, methoxalen or bergapten) are taken internally, followed by photo-irradiation for several minutes (time is selected individually). Or the same drugs by mouth plus a sun bath (the procedure is called general photochemotherapy or photochemotherapy with sun exposure). Photochemotherapy is a difficult thing, it has many side effects and is not shown to everyone, but is even contraindicated for many. The goal of photochemotherapy is to prevent the formation of new discolored skin areas.

For minor skin lesions, skin transplantation surgery on these areas is possible:

autoplasty flaps (transplantation of the native or cultured layer of the epidermis);

transplantation of cultured cells of autologous keratinocytes and melanocytes (used in the case of the formation of stable, unchanging spots);

There are a number of cosmetic procedures that improve the appearance of a person suffering from vitiligo: tattooing, concealers, sunscreens, skin discoloration.

Vitiligo tattooing.

The use of tattoos for vitiligo is rather decorative in nature and is possible when small areas of the skin are affected. A pattern is applied to the discolored area or the color is shaded to match the color of the skin, thus masking the defect.

Concealing cosmetics for vitiligo.

Concealers for vitiligo can be divided into groups:

Self-tanners and similar self-tanners (Nyce Legs, L'Oréal Nutribronze, Viticolor);
Foundation (Flori Roberts "Dermablend", IGN "Vitadye", Max Factor "Lasting", Lydia О 'Leary "Covermark", Owen Laboratories "Dy-o-Derm")

In both cases, cosmetics are applied in a very thin layer, the excess is removed.

Sunscreens for vitiligo.

Sunscreen cosmetics for vitiligo are designed, on the one hand, to prevent exposure to ultraviolet radiation on areas of the skin unprotected by melanin (in order to avoid burns), and on the other hand, to protect normal skin areas from sunburn, so that sharp contrasts of skin color do not occur. Sunscreens should have an SPF of 15 to 100.

Discoloration of the skin with vitiligo.

There is a drug monobenzone in the form of a cream, which causes irreversible depigmentation processes. Discoloration is carried out within a year, the effect is visible after 2 or 3 months. Monobenzone has side effects to consider: allergic dermatitis, contact dermatitis, skin inflammation, dry skin, itching. After discoloration, the skin needs mandatory protection from ultraviolet radiation. It is better to use products that contain zinc oxide or titanium dioxide.