How to treat vitiligo?
Vitiligo is a chronic dermatological disease in which depigmented light spots appear in some areas of the skin, especially noticeable in spring and summer against the backdrop of a tanned body.This pathological skin discoloration is associated with a lack of melanin in it.Contents:
Important facts about vitiligo
Vitiligo is not a rare disease - there are about 50 million people with this pathology in the world, and the number of cases is growing every year.Depigmented spots on the skin can appear both in representatives of the white, and in representatives of the black race.Women suffer from vitiligo much more often than men.
The first manifestations of the disease occur, usually as early as childhood or adolescence.In women, manifestation or sudden progression of the disease is possible in such critical periods of life for the body as pregnancy and menopause.
Several important facts about vitiligo:
- Vitiligo is not an infectious disease.
- In addition to cosmetic and psychological problems that arise due to dissatisfaction with their appearance, discolored blemishes do not cause any discomfort to the patients( they do not itch, they do not hurt).
- Vitiligo does not increase the risk of developing skin cancer and poses no other health hazard.
Why does vitiligo appear?
Vitiligo is a poorly understood disease, the true causes of its development are not known to science. However, there are numerous, but not completely tested, hypotheses regarding the mechanisms of skin depigmentation. In accordance with them, lead to the emergence of vitiligo can:
- Autoimmune processes.Disorders from the autonomic nervous system. .
- Mental traumas.
- Insufficiency of enzymes involved in the synthesis of melanin( in particular tyrosinase).In addition, there are a number of factors that increase the risk of developing vitiligo:
- Endocrine disorders.
- Hereditary predisposition( quite often vitiligo develops in several family members).
- Diseases of the digestive system( especially the liver and bile ducts).
- Permanent skin trauma.
- Working with chemicals.
- Radioactive irradiation.
What examinations do I need to pass?
Since scientists often call vitiligo "the skin marker of internal diseases", the patient should carefully examine the before treating this ailment. Doctors recommend special attention to the liver, thyroid gland, nervous system.Adequate treatment of diseases of these organs, if any, will lead to an improvement in the skin condition in most cases.
The list of recommended tests for vitiligo, except for the examination of a dermatologist, includes: general and biochemical blood tests;
- Consultations of therapist, endocrinologist, neurologist, gastroenterologist, immunologist( it is impossible to exclude the autoimmune nature of vitiligo development);
- US of internal organs( necessarily liver, gall bladder, thyroid gland);
- a hormonal profile study, an immunogram, other tests and diagnostic procedures that may be required depending on the symptoms and diseases identified.
After receiving the results of such extensive doctors will be able to more accurately determine the leading etiological factors in the development of vitiligo and choose the most appropriate set of therapeutic measures.
Methods for the treatment of vitiligo
It should be noted immediately that a complete recovery with vitiligo is a rarity, but with the help of modern methods of treatment it is possible to prevent the appearance of new depigmented spots and reduce the sizes of those already available. And this will be much easier if the disease is not released.Therefore, it is advisable to seek help when the first areas of depigmentation appear.The "younger" the spot, the more likely it is that there are melanocytes in it that can synthesize melanin.
In addition, it is necessary to tune in to the fact that the treatment of vitiligo is a long process, requiring the patient certain efforts:
- Proper skin care.It should be protected by special means from the sun's rays, so that there is no strong contrast between the normal and depigmented areas of the body.
- Complete nutrition, providing the body with essential amino acids, minerals and vitamins.
- Refuse all bad habits, as to provoke the appearance of new spots can any negative factor.
As for methods of treating vitiligo, there are several of them in the arsenal of modern dermatology:
- Hardware treatment.
- Medication therapy( including hormonal therapy).
Most often these methods are used in a complex, which allows to affect several factors contributing to the emergence of vitiligo.
Surgical treatment, consisting of melanocyte transplantation into depigmented foci, is rarely performed in practice due to the high probability of side effects.
In the treatment of vitiligo, the following medicines are used:
- Glucocorticosteroid hormones that are prescribed to the patients inside, externally( in the form of cream applications) and for the impaling of depigmented foci.
- Preparations of vitamins A, E, C and group B.
- Copper sulphate( inside and outside by electrophoresis), as well as products containing zinc, iron, sulfur.In vitiligo patients, a deficiency of these chemicals is observed in the body.
- Photosensitizing preparations followed by skin irradiation( artificial ultraviolet sources can be used, as well as natural sunlight).The photosensitizers include Beroxan, Ammifurin, Psoralen, etc. Medicines of this group in combination with ultraviolet stimulate melanogenesis.Appoint photosensitizers inside and outwardly.
- Immunomodulating drugs - Immunal, T-activin.
- Psychotropic, tonic and restorative means.These drugs stabilize the activity of the nervous system and increase the body's resistance.
In addition to vitiligo, it is possible to use special therapeutic cosmetic products that regulate skin pigmentation.However, they should not be used as a basis for therapy.
Hardware treatment of vitiligo
There are two hardware methods for treating vitiligo:
- PUVA therapy.
- Irradiation with helium-neon laser.
PUVA-therapy provides for the use of furocoumarins( photosensitizing agents) and exposure to the skin of ultraviolet rays with a wavelength of 320-390 nm.This method has another name - photochemotherapy.The effectiveness of this technique is due to the fact that UV irradiation stimulates skin melanocytes to produce melanin, and also contributes to the release into the blood of growth factors that cause the growth of new populations of pigment cells.
The guarantee of effectiveness and safety of PUVA therapy is a correctly selected dose of a photosensitizing drug and duration of irradiation( the so-called erythematous dose).The number and duration of treatment courses also matters( repeated therapy is necessary to maintain the results already achieved).
The following contraindications may become an obstacle to using PUVA therapy:
- of cancerous tumors;
- increased sensitivity of the body to irradiation;
- diseases of the blood, heart, liver, kidney, stomach;
- age under 5 and older than 60 years.
Irradiation with helium-neon laser is a newer technique for treating vitiligo.It is based on the use of external photosensitizers and subsequent exposure to the skin of laser beams( the effect is similar to that of PUVA therapy).The course of such treatment usually includes 15-20 sessions for 3-5 minutes.
New treatments for vitiligo
In 2014, scientists at the Detroit clinic published information on the positive results of a clinical study of a new method of treating vitiligo, which allows the skin pigmentation to be effectively restored.The essence of this method is the use of narrow-band phototherapy with special ultraviolet rays in combination with the appointment of a patient Afamelanotida, which is implanted to the patient under the skin( the implant is not larger than a rice seed).This drug actively induces skin pigmentation.
Studies on the safety and efficacy of this method for vitiligo are still ongoing.
Some medicinal plants can also be successfully used in the treatment of vitiligo because of their high content of phytocoumarins( photosensitizing substances). In particular, folk physicians recommend patients to rub into the depigmented areas of the skin the following herbal remedies:
- Juice or tincture of parsnip fruit.
- Juice of red chili pepper.
- Infusion of duckweed marsh.
- Fresh strawberry juice.
Inside the broths of medicinal plants:
- St. John's Wort.
- Nettle-shaped nettle.
- Spring primrose.
In addition, depigmented areas on the body can be masked with the help of rhubarb juice, alcohol tincture of walnut partitions.These products color the skin in a brownish color.
Vitiligo diet is no less important than the main treatment. The patient's diet should provide the body with all the necessary nutrients( vitamins, copper, zinc, iron, tyrosine, which is a precursor of melanin). The sources of these substances are the following products:
- cod liver;
- fish and seafood;
- lean meat;
- dairy products( milk, cottage cheese, hard cheese);
- porridge( especially buckwheat);
- all leafy vegetables;
- fresh fruit and berries;
- extra virgin olive oil.
It is not recommended to use( or at least try not to abuse them) the following products:
- greasy food;
- smoked meat, pickled vegetables, spicy and spicy dishes;
- beef meat;
- flour products, baking;
- sauces( horseradish, ketchup, mustard, etc.);
- chocolate, cocoa, strong tea and coffee.
You can not transfer and make the digestive organs work "for wear".It is best to eat food a little, but 6-7 times a day.Dishes should preferably be steamed or in the oven.From drinks to patients with vitiligo, green tea, fresh juices without sugar, non-carbonated mineral water will be useful.
Zubkova Olga Sergeevna, medical reviewer, epidemiologist doctor