Vitiligo is an autoimmune skin disorder in which the immune system attacks melanocytes, causing a loss of pigment to the skin. Around 70 million people are affected by vitiligo. While there is no treatment that can 100% cure vitiligo, treatments exist to restore pigment or limit the spread of vitiligo. Treatments can vary depending on location and size of the area affected by vitiligo. Some areas will respond better to treatments than other areas.
There are different categories of treatment:
● Topical Treatments
○ Include creams and steroids
○ “It works by modulating (reducing) the immune response (where applied), allowing the melanocytes to once again grow and flourish” (GVF)
○ Corticosteroids are used for patients recently diagnosed
○ Calcineurin inhibitors like Protopic block calcineurin, a protein that is linked to the immune response. Calcineurin inhibitors tend to be effective around the face and neck.
● Phototherapy Treatment
○ The main goal of phototherapy treatment is to restore pigment.
○ The area of vitiligo is exposed to UV light for a certain amount of time 2-3 times a week
■ Treatment plan can vary
○ ADA reports that phototherapy is “good for restoring color to face and necK” as those areas tend to be the most responsive
○ Sunlight exposure might have to be reduced.
● Oral Treatment
○ Corticosteroids
○ Oral steroids
■ Monitored as they have varying side effects
■ Helps stabilize vitiligo
■ Combined with other treatment methods
○ Oral antioxidants
■ help stabilize vitiligo as melanocytes are often damaged by oxidative stress, so antioxidants can help minimize it
■ Combined with other treatment methods
● Surgical Treatments
○ Restore color/pigment,but it may not work for everyone, especially for those whose vitiligo is still growing
○ Skin Graft
■ The doctor will take skin from an area of the body not affected by vitiligo and put that on the area affected by vitiligo
○ Cell Transplant
■ Instead of using skin, the doctor takes health melanocytes and applies it to the area of vitiligo that’s usually been lasered off
There are other existing treatments such as depigmentation. It’s a permanent methods used with widespread vitiligo that lightens the rest of the skin to match that of vitiligo.
New research is being done on JAK inhibitors. JAK inhibitors reduce inflammation found in vitiligo and other skin disorders. Ruxolitinib was the first FDA drug approved that restores lost pigment. It also works faster. ECELL is a therapy that “[uses] the patient’s healthy cells to stimulate lasting repigmentation in stable vitiligo, the regenerative medicine company Avita Medical announced” (UCI Health). Dr. Anand Ganesan and his team at UC Irvine study these new, emerging treatments. He also researches how immune systems interact with the cells in areas affected by vitiligo.
Dr. Andrew White from Cornell explored UVB irradiation to repigment the skin. An earlier study investigated how UVB caused melanocytes to move from hair follicles to the skin. His team discovered the prostaglandin (a group of molecules linked to tissue damage and recovery) and the role of prostaglandin in mice led to a higher migration rate of melanocytes. So, there is potential in combining UVB with prostaglandin, which already exists as a gel cream.
For those with vitiligo, explore new treatments with a doctor, find support, and practice skin safety. Additionally, camouflage makeup or regular makeup is an option to hide the areas affected by vitiligo.
While finding treatments (and a possible cure) seem challenging, doctors and researchers have made a ton of progress, yet there is still alot left to explore
Sources:
https://www.aad.org/public/diseases/a-z/vitiligo-treatment#:~:text=Treatment%20cannot%20cure %20vitiligo.,many%20patients%20have%20maintenance%20treatments. https://www.mayoclinic.org/diseases-conditions/vitiligo/diagnosis-treatment/drc-2035591 https://www.ucihealth.org/blog/2023/06/vitiligo-breakthroughs
https://www.umassmed.edu/vitiligo/blog/blog-posts1/2015/12/surgical-treatment-and-maybe-eve n-a-cure-for-vitiligo/
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