Vitiligo affects around 1% of the population and is more visible in darker races.
It is important to follow these steps:
1. See a dermatologist:
-to confirm the diagnosis.
-to classify the vitiligo: extent and distribution.
-to ascertain its behavior (stable for 6 months or evolving?)
-to follow an algorythm of treatment (see below). Monitor improvement
-to evaluate how psychologically impairing the condition is?
2. Follow an algorithm:
-start with mometasone furoate to apply twice a day for 6 months
-after 6months, if there is no improvement, combine with tacrolimus
-if no improvement try NBUVB, PUVA or Multiclear (UVA and UVB); it must be done 2-3 times a week for 4 months. If no time, try photoxic agents like meladinine to stimulate melanogenesis.
-if no improvement try cellular grafting or punch grafting combined or not with NBUVB.
-Janus Kinase (JAK) inhibitors are showing promising results but are not yet approved for Vitiligo (time of the publication)
3. Follow some precautions
-avoid trauma as patients can develop new lesions (Koebner phnomenon)
-if wishing to camouflage the lesions, self tanning agents like dihydroxyacetone may be tried.
-If very extensive, total depigmentation can be better using monobenzyl ether of hydroquinone or para-substituted phenols. However, this must be carefully considered with a dermatologist after evaluation of possible outcome.
This advice is for informational purposes only and does not replace therapeutic judgement done by a skin doctor.
Source of information: here