Can you cure vitiligo

However, the effects of treatment are not usually permanent, and it cannot always control the spread of the condition. Further treatment may not be necessary if, for example, you only have a small patch of vitiligo or your natural skin colour is very light. You may be referred to a doctor who specialises in treating skin conditions dermatologist if further treatment is needed.

Sunburn is a severe risk if you have vitiligo. You must protect your skin from the sun and do not use sunbeds. When skin is exposed to sunlight, it produces a pigment called melanin to help protect it from ultraviolet UV light. However, if you have vitiligo there is not enough melanin in your skin, so it is not protected. Always apply a sunscreen, ideally with a sun protection factor SPF of 30 or above, to protect your skin from sunburn and long-term damage.

This is particularly important if you have fair skin. If your skin is not exposed to the sun, there's an increased risk of vitamin D deficiency. Vitamin D is essential for keeping bones and teeth healthy. Sunlight is the main source of vitamin D, although a form of vitamin D is also found in some foods, such as oily fish. It might be difficult to get enough vitamin D from food and sunlight alone.

You should therefore consider taking a daily supplement containing 10 micrograms mcg of vitamin D. Skin camouflage creams can be applied to the white patches of skin. The creams are made to match your natural skin colour. The cream helps to blend the white patches with the rest of your skin, so they are not as noticeable. You need to be trained in using the camouflage creams, but the service is free although donations are welcome and some creams can be prescribed on the NHS.

Camouflage creams are waterproof and can be applied anywhere on the body. They last for up to 4 days on the body and 12 to 18 hours on the face. They can sometimes stop the spread of the white patches and may restore some of your original skin colour. A GP may prescribe a cream or an ointment, depending on what you prefer and where it will be used.

Ointments are greasier. Creams are better in your joints — for example, inside your elbows. A GP will tell you how to apply the cream or ointment to the patches and how much you should use. You usually need to apply the treatment once a day. Topical steroids are measured in a standard unit called the fingertip unit FTU. One FTU is the amount of topical steroid squeezed along an adult's fingertip. One FTU is enough to treat an area of skin twice the size of an adult's hand.

After 1 month, you'll have a follow-up appointment so the GP can check how well the treatment is working and whether you have any side effects. If the treatment is causing side effects, you may need to stop using a topical steroid. After another month or 2, the GP will check how much your vitiligo has improved. If there's no improvement, you may be referred to a dermatologist.

Long-term adverse effects include cataracts and skin cancer. Shephard and Panizzon 9 reviewed the literature regarding the carcinogenic risks of bath PUVA therapy compared with oral PUVA and found that both forms that use 8-methoxypsoralen increase the risk of nonmelanoma skin cancer in a dose-dependent manner. Topical corticosteroids are most effective on small, newly depigmented areas. It has been posited that corticosteroids are effective in treating vitiligo because they limit the amount of antimelanocyte autoantibodies produced.

Tacrolimus, a macrolide immunosuppressant that comes from the fungus Streptomyces tsukubaensis , is a novel treatment for vitiligo. The drug is approved by the US Food and Drug Administration for oral prophylaxis of rejection in kidney and liver transplant recipients. The complex formed inhibits the phosphatase calcineurin. Topical tacrolimus has been approved by the US Food and Drug Administration for the treatment of atopic dermatitis. Tacrolimus has also been used safely and effectively in immunologically based skin disorders, including psoriasis, pyoderma gangrenosum, and alopecia areata.

Systemic absorption of topical tacrolimus has been documented to be very limited in trials of topical tacrolimus for atopic dermatitis. High concentrations were seen only in children with Netherton disease, 16 which causes a permanent generalized abnormality of the stratum corneum. In patients with atopic dermatitis but without Netherton disease, systemic absorption of topical tacrolimus decreased as eczematous skin lesions resolved, and none of the drug was detected in the serum of the control patients with no skin disease.

The photocarcinogenic risk increased in a week animal study when topical tacrolimus was used in conjunction with UV irradiation. However, the manufacturing company generally recommends use of photoprotection while being treated with topical tacrolimus.

Oral tacrolimus has limited use in skin disorders because of its potentially severe adverse effects, including infections, hypertension, hyperglycemia, hyperkalemia, nephrotoxic and neurotoxic effects, and increased risk of neoplasia. Despite the good results achieved by our patients, larger studies that are double-blinded and placebo controlled or half-face studies would be helpful to prove the efficacy of topical tacrolimus in the treatment of vitiligo.

Vitiligo can be devastating for patients and at times, very difficult to treat. As the authors note, corticosteroids and phototherapy have been our mainstays of treatment. Surgical approaches to the disease are less commonly used in the United States than are these other modalities. The authors describe 3 patients who responded well to therapy with topical tacrolimus.

The presumed mechanism of action relates to the drug's immunosuppressant effects. The therapy was well tolerated in their patients. Most of the adverse effects experienced to date when treating atopic dermatitis relate to skin irritation, burning sensation and pruritus, and folliculitis. No significant blood levels have been detected, even when applying the drug to large surface areas, with the exception of children with Netherton syndrome, as reported by Allen et al 16 in the ARCHIVES.

In addition, the drug has not been found to be phototoxic, photoallergenic, or photosensitizing, which is important when treating depigmented skin. The relatively quick response and lack of adverse effects make this an exciting new option for patients with vitiligo.

Corresponding author: Nanette B. Successful Treatment of Vitiligo With 0. Arch Dermatol. Coronavirus Resource Center. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Save Preferences. Privacy Policy Terms of Use.

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