VItiligo FAQ

Vitiligo mostly being an auto-immune disorder in which pigment cell destruction takes place, Most of the patients experience itching before developing a white patch (vitiligo lesions are preceded with itching which is considered to be a bad sign).

The first symptom that initially appears is a scattered white patch or a de-pigmented area over the skin in response to a trauma, injury, burns, and scalds or over the pressure points or without any obvious reason. This is commonly found on exposed areas. For example: after getting traumatic injury due to fall which is more common among children, after healing of the wound it may lead to the development of white patch. This speaks the underlying susceptibility towards vitiligo known as active koebner’s phenomenon. Hairs over the vitiligo lesions may be altered which is known as leucotrichia.

The role of H2O2 accumulation is defined as oxidative stress. To date, there is ample evidence that Vitiligo affects the entire epidermis. Convincing the data support the participation of Keratinocytes and langarhans cells besides the loss of functioning melanocytes, various degree of cellular vacuolation and debris in all epidermal cell have been documented. Recently the vacuolation was attributed to H2O2 mediated lipid per oxidation which makes the lesion resistant.

There is undoubted genetic predisposition in causing Vitiligo. Approximately 13% percent patients do have an affected relative but the mode of inheritance is not fully understood. However, it is considered to be a multi-factorial.

As Vitiligo is an autoimmune disorder. The best evidence of auto immunity in Vitiligo is its clinical association with other autoimmune disorders like Thyroid disorders most commonly hypothyroidism, psoriasis, pernicious anemia, Halonaevi, Addison’s disease, alopecia areata and atopic dermatitis, scleroderma and hyper parathyriodism etc.

Certain food articles like sea food along with the milk products, excess use of broiler chicken and egg, pickles are considered to be a source of aggravation of disease- This is a hypothesis. A balanced non vegetarian / vegetarian diet consist of mutton, organic chicken, vegetables, chapatti, rice, sprouts, non citrus fruits is considered to be a good balanced diet.

Vitiligo is a complex metabolic disorder characterized by loss of pigmentation which is polygenic in nature and mostly regarded as social stigma, the course of vitiligo with or without treatment is unpredictable. The magnitude of the problem can be highlighted with the fact that the patients of vitiligo are denied of matrimonial alliance, denied of first line jobs which needs public interaction leading to social isolation.

Many patients with vitiligo may feel depressed and start lacking confidence especially when the lesions are on exposed areas and always eager to re-gain their lost pigmentation.

The course of the disease is unpredictable. Usually has periods of stability followed by Aggrevation. As every person has a different body condition like for some vitiligo can spread very slowly whereas for others it spreads very rapidly. This disease is a progressive in nature and over the time it usually spreads to other parts of the body. Few patients report the onset of the disease followed by periods of physical and emotional stress. However, the non-dermatomal vitiligo tends to spread faster than acrofacial and segmental vitiligo.

No. neither it is contigious nor infectious for sure.

The comprehensive treatment for Vitiligo must consist of good amount of psychological counseling, Medicinal formulations drugs to control the further spreading and to induce re-pigmentation- it can be achieved sometime only with the medical treatment and some patients needs an integrated approach where a surgical intervention can be made like melanocyte tranasplant.

Age, duration of disease, type of vitiligo, site of the lesion, extension of the lesion, distribution of the lesion, leucotrichia and the mental stress are the few factors which has influence on the treatment outcome.

Yes there is a great need for an integrated approach for complete cure of vitiligo but not always. An Integrated approach can be taken:

• Once the disease becomes stable
• When there are unyielding macules
• Need for surgical intervention
• Auto skin graft
• Micro graft /punch graft
• Melanocyte transplantation

The chances of repigmentation are excellent in non-dermatomal vitiligo, vitiligo vulgaris followed by focal vitiligo, segmental vitiligo, acro-facial vitiligo and mucosal vitiligo respectively.

Usually initial 3 months of treatment is a very good time to see the visible improvement. If disease becomes stable, the regained pigmentation mostly remain permanently.

Except acral areas and lips every site of the body has an excellent re-pigmentation chance.

Every patient of vitiligo is a new challenge to the doctor as complex disease phenomenon exists. However, based on new knowledge and new modalities both medical and surgical, not all but most of the patients may definitely expect a complete cure (to the extent of over 70% to 80% of vitiligo patients).

For the last three decades Unani compound formulations both for systemic and topical use are catering the needs of vitiligo patients in treating and inducing the cosmetically acceptable re-pigmentation. There are different treatments modalities available like formulations to overcome the resistance created because of prolong treatments, to control the further spreading of the disease, to induce the re-pigmentation. The above measures are the excellent tools not only to control the disease process and to induce the re-pigmentation but also to minimize the chances of relapse. Dr Waheed’s vitiligo and psoriasis clinic caters the need of vitiligo subjects.

Safety profile: Drugs are safe, as hepatic and renal toxicity is not reported and well tolerated even in prolong use, except sensitivity like iching, burning sensation and blistering with external application which is due to skin sensitivity will be known after few days of application. Which are being managed by proper advice.