Vitiligo Treatment In Delhi

Vitiligo Surgeries

Vitiligo is a skin ailment in which little white patches appear on a person's skin as it loses colour. Patches can form anywhere on the body, although they commonly appear on the hands, arms, and face.

Causes of Vitiligo

A combination of these aforementioned factors can be the cause behind vitiligo.

Symptoms of Vitiligo

The following are some of the most prevalent vitiligo symptoms.

• Skin discolouration occurs in patches. Small patches known as macules that are 5 mm or smaller in size begin to emerge at first. Patches are macules that are greater than 5 mm in diameter.
• The patch may begin to form in open areas such as hands, feet, eyelids and lips. They can also occur in other body parts, like arms, legs, face, lips or genitals.
• Pigment loss can also result in white hair on brows, eyelashes, scalp, beard or patches.
• A person may notice a loss of colour in the inner lining of their mouth, genitals, or nose.

What are the different types of Vitiligo?

There are two primary types of Vitiligo:

• Non-segmental vitiligo, often known as bilateral vitiligo: This is a condition present in most individuals. In this case, the white patches on a person's body begin to appear on both sides of the body. Hands, eyes, and places that experience a lot of friction on a daily basis, such as the genitals, are commonly affected. Non-segmental vitiligo progresses slowly over time, changing colours as a person ages.
• Segmental vitiligo or unilateral vitiligo: Segmental vitiligo typically begins in young people and advances slowly for a year or two. Segmental vitiligo affects only one region or side of the body. The person may also notice a loss and change in the colour of their eyelashes.

The doctors further divide these two categories into subtypes, to characterise pigment loss:

• Focal vitiligo: The macules are limited to a tiny focal spot and do not spread to other parts of the body. In cases with focal vitiligo, the patches may be limited to one location for 1 to 2 years.
• Mucosal vitiligo is a condition that affects the inner mucosal membranes of the mouth, nose, and genital region. A person with mucosal vitiligo will notice a loss of colour and the inside lining of these places.
• Trichrome vitiligo: it is a condition that starts with a colourless patch of skin in the centre and gradual pigmentation. Surrounding the colourless patch is the area of slight pigmentation and followed by normal skin colour.
• Universal vitiligo: This is a rare disorder in which 80 per cent of the body loses colour.
• Lip tip vitiligo: this is a condition where the white patches of vitiligo are visible around the lips, certain distal parts of fingers and the toes and on the penile tip. Sometimes, the patches can be seen between the eyes.
• Vitiligo around the eyes: The loss of pigment around the eyes can cause the formation of white patches around the eyes and between the eyes. If it develops in symmetrical patches then it is also known as bilateral vitiligo.
• Penile vitiligo: the formation of white patches that can occur around the penis, glans in men and can be disturbing for the person.
• Acral vitiligo: acral vitiligo is a form of vitiligo that is classified under generalised vitiligo. This form of vitiligo is seen as lesions start appearing on the extremities of the body like the genitals and the mouth. Oral and genital lesions are also commonly seen in acral vitiligo. The lesions can transition and cause generalised vitiligo.

Vitiligo treatment In Delhi

The therapy of vitiligo begins with a diagnosis. The spots on the skin can be seen simply by looking at them, but a wood lamp can also help diagnose them. Wood lamps emit ultraviolet light onto the skin, which can aid in determining the quantity of pigment lost. The treatment strategy involves a combination of different therapies and medications. A repigmentation therapy includes stopping the spread of white patches and preventing the formation of new leucoderma spots as well as restoring the skin's colour and hair colour is the main focus of treatment. A depigmentation therapy involves the removal of pigmentation from the surrounding skin.

The following are some of the most prevalent treatments:

• Repigmentation therapy: Repigmentation therapy focuses on stopping the spread of vitiligo and preventing new patches from coming whereas inducing new pigmentation and colour in patches, it includes medical therapy in form of creams and tablets aiming to stop inflammation and well as modulating the immunity to reduce the autoimmune process and activity. Treatment also focuses on melanocyte stimulation to induce pigmentation as well as controlling the autoimmune process to arrest the spread of the disease.
• Immunomodulators assist in reducing immune system activity against melanocytes and thereby treat vitiligo. These medications are helpful for both localised disease and widespread patches.
• Light therapy: Light therapy generally involves utilising ultraviolet light. Light therapy involves the treatment of the patches present in smaller areas on the face, hands, neck, and arms with Handheld UV lamps and a whole-body chamber for widespread disease. The treatment improves the appearance and aids in the reduction of the patches as well as helps to stabilise the disease.
• Psoralen is a plant-based substance that is commonly used with light treatment. A combination of these two treatments helps in restoring colour to the skin's light spots and give it a more uniform look.
• Sunscreen to avoid tanning: Using a decent sunscreen with an SPF of 30 or higher can help prevent tanning and lessen the contrast between the skin patches and the rest of the skin.
• Depigmentation therapy: Depigmentation therapy often employs medicine and treatment to lighten the colour of the surrounding skin, minimising the appearance of white patches. The discoloured region normally blends in with the rest of the skin. The length of this therapy might be nine months or more in order for the desired results to occur. This treatment is done for those with vitiligo patches on the almost entire body with few spared patches.
• Surgery is a common option when the condition is stabilised and complete repigmentation is not achieved with medications or light therapy. Normal skin provides donor cells and tissue that may be removed and utilised as grafts throughout the surgery. The skin transplant contains healthy melanocytes capable of producing melanin. These grafts are placed in affected areas so that the new skin grafts may begin generating melanocyte pigment and help balance the skin tone. The repigmentation achieved by surgery is permanently provided that the disease is stable.

Ideal Candidate for Vitiligo surgery

An ideal candidate for vitiligo surgery is a person :

• Who has had stable vitiligo for the past year
• has not seen the formation of a new white patch in a year
• there has been no extensive loss of pigmentation in recent time
• is overall healthy

At Dr Shankila’s skin and hair clinic, we use a variety of approaches and procedures during vitiligo surgery.

• Skin grafting is a process in which a skin graft is removed from a healthy coloured part of the skin and implanted into the area of discolouration. This is usually done for people who have small or medium sized vitiligo spots. Skin grafting techniques is a safe and effective way of inducing repigmentation.
• Autologous mini punch grafting: autologous mini punch grafting is a common and effective surgery for vitiligo. This is generally utilised for acral vitiligo where the spread is around the palms, fingers and nipples. The surgery involves punching out small skin punches and then transplanting them to the holes created on the white patches. This area is dressed and left to heal. The minipunched skin takes up and helps to restore the lost melanocytes and restore skin color.
• Split thickness skin graft surgery: this surgery involves transplanting a graft of skin onto the white patches. The skin over the white patches is removed prior to the transplant by dermabrasion followed by transplanting healthy skin on the area. It helps to induce colour match and color take up, giving the colour back to white patches and inducing repigmentation.
• Smash grafting: smash grafting procedure is a type of tissue grafting surgery utilised for vitiligo treatment. The graft is taken from the healthy skin site and smashed before being transplanted onto the recipient site. This surgery is prescribed in cases of patients suffering from segmental and focal vitiligo. It helps to achieve better colour match and texture match with the recipient site.
• Suction Blister grafting: Blister grafting is a procedure that involves the formation of tiny blisters on healthy pigmented skin. The use of suction therapy accomplishes this. The top part of the blisters is implanted onto the discoloured skin. When the blisters heal, it helps restore the colour to the region that has lost its pigment. It works very well for lip vitiligo and focal vitiligo patches on the face and body with good results.
• Cultured Melanocyte cell transplantation: A cultured melanocyte cell suspension transplant treatment involves making a suspension of melanocytes which are pigment-producing cells from a skin graft. It is then followed by keeping the cells in a nutrient medium for culturing. Once the cells grow in number these are ready for transplantation and placement in the affected area. The procedure can show its result in 4 to 6 weeks. This procedure is also known as a melanocyte cultured transplant and is ideal for most cases as it helps cover a larger area with very less grafts.
• Non cultured Melanocyte cell transplantation procedure: This is an advanced procedure for the treatment of vitiligo. The procedure majorly involves four steps:
  • Skin graft extraction: first, the doctor extracts the skin graft from a suitable location that contains healthy, unaffected skin.
  • Preparation: the graft is kept in a petri dish containing trypsin which helps in cell separation and separates the melanocytes from other epidermal cells thereby making a suspension rich in melanocytes.
  • Preparing the recipient site with dermabrasion: Dermabrasion is done on the recipient site to prepare it for the transplant.
  • Transfer: The doctor transfers the harvested melanocyte rich cell suspension to the recipient site followed by a dressing that helps in graft take up and repigmentation on white patches.
• FUE hair transplant: the main reason for the failure of repigmentation is lack of melanocytes or stem cells at the site of vitiligo. Repigmentation is particularly different at acral parts and pressure points which lack hair follicles. FUE hair transplant works on principle of reintroducing the pig
• A camouflage treatment: a camouflage treatment Generally entails concealing the appearance of patches. The most temporary solution for camouflage in vitiligo is the use of dyes cosmetics like foundation and tanning products.

The temporary solution for camouflaging the vitiligo includes the following:

• Hair colours to cover up grey hair.
• Makeup to conceal the patches.
• concealer to hide patches.

The more permanent solutions for the treatment of vitiligo include

• Micro-pigmentation or Medical tattooing is a procedure that can help reduce the appearance of the patches by tattooing it with a colour similar to that of the skin. Micropigmentation can also be very helpful for the treatment of Lip patches, areola, patches around the nipples and hands especially when instant results are desired.

Aftercare of the vitiligo surgery

After vitiligo surgery, it is critical to take adequate care of the donor and recipient sites in order to ensure a healthy recovery. The following are some of the most common directions that you must follow:

• Avoid going out in the sun as much as possible. The sun can interfere with therapy, healing, and even the overall health of the skin.
• Wear high-quality sunscreen with an SPF of 30 or higher.
• It is critical to keep the surgical site clean after the surgery.
• If you notice any symptoms such as itching, redness, or swelling, these are signs of an infection and you should not ignore them; instead, call your healthcare provider and your doctor for treatment.

Why choose Dr Shankila Mittal for the best Vitiligo / Leucoderma treatment?

Vitiligo is a challenging ailment. It has an emotional and physical impact on a person, and there is a lot of social shame associated with vitiligo. Getting the correct treatment and care may be tough, and it requires a dermatologist who is both well-trained in the profession and has expertise in treating diverse types of skin.
Dr Shankila Mittal is a dermatologist with extensive experience in vitiligo treatment. Dr Shankila is the leading and best dermatologist in Delhi for vitiligo treatment, with years of expertise and many qualifications and awards. She is well versed with all types of vitiligo treatments and surgeries and has been treating patients with excellent results. Dr Shankila Mittal’s Skin and Hair Clinic offers broad and comprehensive vitiligo treatment with a wide range of facilities. She provides one of the most risk-free and complication-free vitiligo surgeries available with great results.
Make an appointment with Dr Shankila Mittal right now for all your skin and hair related problems.

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