Therapies for Vitiligo

Vitiligo is a disease of the skin where the body attacks its own color cells. It usually begins symmetrically on the face or extremities, and can progress to involve large portions of skin. Areas of trauma, such as the feet, hands or knees are often the first to be affected. There are therapies that can help. The earlier treatment is started, the better the chances of success. Vitamin therapy, combination anti-inflammatory/irritant therapies, PUVA (psoralen plus UVA light) and most recently, narrow-band UVB, LIGHT BOX. (DONE @ THE OFFICE) are some of the available therapies. However, realistic expectations are necessary. Full repigmentation may not be achieved. Cosmetic coverage and sunscreens to protect the lighter skin while undergoing therapy are both practical and necessary, for both men and women. All the options will be discussed and the best plan for your particular case will be set.

Vitamin Therapy

  • ADULTS: FOLIC ACID 5MG DAILY (OVER THE COUNTER)

  • ASCORBIC ACID 500MG 2 TABLETS OR CAPSULES WITH BREAKFAST (OVER THE COUNTER)

  • VITAMIN B12 INJECTION 1000MCG/CC 1CC IM EVERY 2 WEEKS (DONE @ THE OFFICE)
    Injection is preferable to oral because it is presented to the body in a more active form

  • ASPIRIN 81MG #1 AT DINNER (OVER THE COUNTER)

  • DEXAMETHASONE 4MG WITH BREAKFASTON SATURDAY AND SUNDAY

  • CHILDREN: FOLIC ACID 2MG WITH BREAKFAST

  • ASCORBIC ACID 500MG 2 CHEWABLE TABLETS OR CAPSULES WITH BREAKFAST DEXAMETHASONE 0.25MG WITH DINNER ON SATURDAY AND SUNDAY

Results may first be seen in about 3 months, but this is a LONG-TERM therapy. It may take up to 3 years for complete repigmentation.

Therapies

Clobetasol cream: (a pea-sized amount, 2 or more peas as needed to cover the area with no left-over cream) rubbed in well to involved areas only, twice daily (breakfast and dinner) for 2 weeks, then stop for 2 weeks. Do not apply to unaffected skin, groin, underarm, or under breast unless directed to do so by Dr. Resnik. Repeat for 2 months (a total of 4 weeks of therapy). Clobetasol is a strong cortisone cream, and if used improperly, may cause thinning of the skin and new blood vessel formation. Please follow the directions explicitly.

Protopic Ointment: (a pea-sized amount, 2 or more peas as needed to cover the area with no left-over cream) rubbed in well to involved areas only twice daily (breakfast and dinner)

Heliocare: this oral sun protectant can help protect the involved skin, while possibly decreasing inflammation. 1 capsule taken daily

Pseudocatalase cream: apply twice a day to entire affected skin surface.

  • Only a small amount is needed to cover the area; increasing the frequency and/or amount will not necessarily bring about better results.

  • Allow the Pseudocatalase cream to vanish into the skin and be completely dry before applying any other topical agents. (A full instruction sheet will be given to you for this therapy)

Narrow Band Ultraviolet B (NB-UVB) Light Therapy: this in-office treatment light source does not hurt or sting. At least 30 sessions done 3 times a week are needed to adequately assess possible success. Sunburn is the worst side-effect that may be experienced. Protopic ointment application is enhanced when used in conjunction with this therapy. Insurance companies may reimburse this therapy.

Levia Light Therapy: this Narrow Band Ultraviolet B (NB-UVB) light source is a home treatment and does not hurt or sting. It is most appropriate for small isolated areas. At least 30 sessions done 3 times a week are needed to adequately assess possible success. Sunburn is the worst side-effect that may be experienced. Protopic ointment application is enhanced when used in conjunction with this therapy. Insurance companies may reimburse this therapy.

PUVA Light Therapy: psoralens cream is applied to the involved areas 2 hours before sun exposure. At least 15 sessions done 3 times a week are needed to adequately assess possible success. Sunburn and blistering may occur.

Minigraft Surgery: this in-office procedure is done under local numbing. Small punches of normal skin are taken from the buttock or lateral thigh and placed in tiny holes made in the involved skin. A test procedure is recommended to assess potential success. Light therapy helps repigmentation move more quickly.

 

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