Vitiligo causes white patches on your skin. It can also affect your eyes,
mouth, and nose. It occurs when the cells that give your skin its color are
destroyed. No one knows what destroys them. It is more common in people with
autoimmune diseases, and it might run in families. It usually starts before age
40.
Medical therapies
The use of medical treatment is mostly useful in focal vitiligo, and has the dual aim of arresting disease progression and inducing repigmentation in the white lesions.
Topical creams
First line treatment for localized vitiligo consists of topical creams containing either corticosteroids or calcineurine inhibitors.
Topical corticosteroid
Creams of low, medium or high potency are often used first, having been in use for several decades. They are easy to use, and help moderately to restore some pigment, especially when applied in the early stages and for focal vitiligo. They are estimated to have a 50-75% success rate in vitiligo.
They probably act as immunomodulators. Their disadvantages include non-uniform effectiveness, prolonged treatment time, they may cause the epidermis to atrophy leading to skin shrinkage and the appearance of purplish-red striae, when used over a long period.
Other side effects may be due to systemic absorption, and include glaucoma, tolerance and suppression of the hypothalamo-pituitary axis, as well as Cushing’s syndrome and growth retardation in infants and children.
Topical calcineurin inhibitors
Such as tacrolimus or pimecrolimus are another class of compounds used to treat childhood vitiligo, in particular. They have fewer associated side effects but are as effective as corticosteroids. They bind to the immunophilin binding protein and so inhibit dephosphorylation and activation of the nuclear factor of activated T cells induced by calcineurin, in turn preventing cytokine production and T cell proliferation.
The cytokines inhibited include TNF-alpha and IFN-gamma, which are increased in vitiligo patients. Tacrolimus also promotes the proliferation of melanocytes and melanoblasts. Side effects include a burning sensation, short-lived pruritus and erythema.
Calcipotriol
A synthetic analog of vitamin D3 used to treat psoriasis. It has been used in vitiligo because of its known ability to induce hyperpigmentation around the psoriatic lesion. Its mechanism is not known, though it may act upon the 1,25-dihydroxy vitamin D3 receptors or affect intracellular calcium metabolism; another possibility is immunomodulation of T lymphocytes, inhibiting the destruction of melanocytes.
The combination of calcipotriol with steroids has been successful in causing repigmentation after corticosteroid failure, and this was a stable and relatively faster process. It is applied once or twice a day. Side effects include a burning sensation and skin irritation, both transient.
Systemic corticosteroids
These have been used to arrest the spread of depigmentation and also induce repigmentation, having been successful in arresting disease progression in almost 90% of treated patients. It was used as oral mini-pulses in patients with fast or extensive spread of lesions. Its systemic side effects are of concern, however, as it can cause Cushing’s syndrome, glaucoma and diabetes mellitus, among other metabolic disorders.
Light methods
Light therapy is based on the finding that certain wavelengths of ultraviolet light powerfully induce melanin synthesis leading to repigmentation. Sunlight contains a broad band of ultraviolet rays, which may result in the production of excessive pigment and diffuse darkening of the skin, depending on how much exposure took place.
The mechanism is two-fold: melanin is synthesized and packaged into melanosomes, a process called neo-melanogenesis, and melanocytes migrate into the light-exposed area of depigmented skin.
At the same time, ultraviolet light also brings about two effects specifically helpful in vitiligo:
It suppresses autoimmune activity by inducing T-regulatory (suppressor) cell activity, by upregulating the release of the cytokine IL-10 which stimulates the differentiation and activation of T-regulatory cells.
Systemic immune responses may also occur with narrowband ultraviolet B.
At the same time, ultraviolet A can cause the release of several growth factors like basic fibroblast growth factor (bFGF), which may possibly induce melanocyte re-growth. These may be responsible for the increase in the number of residual melanocytes after ultraviolet irradiation. Narrowband light is being studied for its efficacy in inducing repigmentation but avoiding other side effects.
Excimer laser
Excimer laser therapy has also been used for the same purpose. This is used to provide targeted phototherapy at a wavelength of 308 nm, whereas nbUVB has a wavelength of 312 nm, and thus spare normal skin.
It has been reported to produce up to 50% repigmentation, especially over the face. Side effects include hyperpigmentation around the lesions, skin burns, and folliculitis. It has also been combined with pimecrolimus, to produce a significantly better result.
New Treatment for vitiligo 2017
UM-D treatment is a suit of treatment newly researched by Beijing CASU TCM Vitiligo Hospital to specific to treat stubborn vitiligo, is a diagnosis and treatment system, it perfectly combined traditional Chinese medicine with western medicine along with some large scale medical equipment, it also use Chinese medicated bath, gas bath, water therapy, electroacupuncture, silicon light, carbon light, eximer laser, NB-UVB, patent Chinese medicines, western medicines and other treatments, it absorbed the essence of both traditional Chinese medicine and western medicine.
UM-D treatment not only pay attention to the color restore of vitiligo, it take the advance measures to help doctor to to diagnose their immunity to see if their immune system disorder, lack of trace elements, the melanocyte condition, all kinds of antigens' condition, their skin, blood, internal organs. our treatment treat vitiligo both emphasize the inside and outside without side effects, this treatment praised by the patients from home and abroad.
Can UM-D Cure Vitiligo
UM-D Treatment holds that control the spread of vitiligo as it first step not the restore of color, because we need to cure the causes of vitiligo not only the symptoms, not like some external use medicines irritate the skin and force it change the color, later it will relapsed again. But our the UM-D treatment take this into consideration, the second the step is restore the color, the third steps is the consolidation treatment, it will decrease the relapse rate of vitiligo.vitiligo is a curable disease, but it need the confidence and patience of vitiligo patient.
Medical therapies
The use of medical treatment is mostly useful in focal vitiligo, and has the dual aim of arresting disease progression and inducing repigmentation in the white lesions.
Topical creams
First line treatment for localized vitiligo consists of topical creams containing either corticosteroids or calcineurine inhibitors.
Topical corticosteroid
Creams of low, medium or high potency are often used first, having been in use for several decades. They are easy to use, and help moderately to restore some pigment, especially when applied in the early stages and for focal vitiligo. They are estimated to have a 50-75% success rate in vitiligo.
They probably act as immunomodulators. Their disadvantages include non-uniform effectiveness, prolonged treatment time, they may cause the epidermis to atrophy leading to skin shrinkage and the appearance of purplish-red striae, when used over a long period.
Other side effects may be due to systemic absorption, and include glaucoma, tolerance and suppression of the hypothalamo-pituitary axis, as well as Cushing’s syndrome and growth retardation in infants and children.
Topical calcineurin inhibitors
Such as tacrolimus or pimecrolimus are another class of compounds used to treat childhood vitiligo, in particular. They have fewer associated side effects but are as effective as corticosteroids. They bind to the immunophilin binding protein and so inhibit dephosphorylation and activation of the nuclear factor of activated T cells induced by calcineurin, in turn preventing cytokine production and T cell proliferation.
The cytokines inhibited include TNF-alpha and IFN-gamma, which are increased in vitiligo patients. Tacrolimus also promotes the proliferation of melanocytes and melanoblasts. Side effects include a burning sensation, short-lived pruritus and erythema.
Calcipotriol
A synthetic analog of vitamin D3 used to treat psoriasis. It has been used in vitiligo because of its known ability to induce hyperpigmentation around the psoriatic lesion. Its mechanism is not known, though it may act upon the 1,25-dihydroxy vitamin D3 receptors or affect intracellular calcium metabolism; another possibility is immunomodulation of T lymphocytes, inhibiting the destruction of melanocytes.
The combination of calcipotriol with steroids has been successful in causing repigmentation after corticosteroid failure, and this was a stable and relatively faster process. It is applied once or twice a day. Side effects include a burning sensation and skin irritation, both transient.
Systemic corticosteroids
These have been used to arrest the spread of depigmentation and also induce repigmentation, having been successful in arresting disease progression in almost 90% of treated patients. It was used as oral mini-pulses in patients with fast or extensive spread of lesions. Its systemic side effects are of concern, however, as it can cause Cushing’s syndrome, glaucoma and diabetes mellitus, among other metabolic disorders.
Light methods
Light therapy is based on the finding that certain wavelengths of ultraviolet light powerfully induce melanin synthesis leading to repigmentation. Sunlight contains a broad band of ultraviolet rays, which may result in the production of excessive pigment and diffuse darkening of the skin, depending on how much exposure took place.
The mechanism is two-fold: melanin is synthesized and packaged into melanosomes, a process called neo-melanogenesis, and melanocytes migrate into the light-exposed area of depigmented skin.
At the same time, ultraviolet light also brings about two effects specifically helpful in vitiligo:
It suppresses autoimmune activity by inducing T-regulatory (suppressor) cell activity, by upregulating the release of the cytokine IL-10 which stimulates the differentiation and activation of T-regulatory cells.
Systemic immune responses may also occur with narrowband ultraviolet B.
At the same time, ultraviolet A can cause the release of several growth factors like basic fibroblast growth factor (bFGF), which may possibly induce melanocyte re-growth. These may be responsible for the increase in the number of residual melanocytes after ultraviolet irradiation. Narrowband light is being studied for its efficacy in inducing repigmentation but avoiding other side effects.
Excimer laser
Excimer laser therapy has also been used for the same purpose. This is used to provide targeted phototherapy at a wavelength of 308 nm, whereas nbUVB has a wavelength of 312 nm, and thus spare normal skin.
It has been reported to produce up to 50% repigmentation, especially over the face. Side effects include hyperpigmentation around the lesions, skin burns, and folliculitis. It has also been combined with pimecrolimus, to produce a significantly better result.
New Treatment for vitiligo 2017
UM-D treatment is a suit of treatment newly researched by Beijing CASU TCM Vitiligo Hospital to specific to treat stubborn vitiligo, is a diagnosis and treatment system, it perfectly combined traditional Chinese medicine with western medicine along with some large scale medical equipment, it also use Chinese medicated bath, gas bath, water therapy, electroacupuncture, silicon light, carbon light, eximer laser, NB-UVB, patent Chinese medicines, western medicines and other treatments, it absorbed the essence of both traditional Chinese medicine and western medicine.
UM-D treatment not only pay attention to the color restore of vitiligo, it take the advance measures to help doctor to to diagnose their immunity to see if their immune system disorder, lack of trace elements, the melanocyte condition, all kinds of antigens' condition, their skin, blood, internal organs. our treatment treat vitiligo both emphasize the inside and outside without side effects, this treatment praised by the patients from home and abroad.
Can UM-D Cure Vitiligo
UM-D Treatment holds that control the spread of vitiligo as it first step not the restore of color, because we need to cure the causes of vitiligo not only the symptoms, not like some external use medicines irritate the skin and force it change the color, later it will relapsed again. But our the UM-D treatment take this into consideration, the second the step is restore the color, the third steps is the consolidation treatment, it will decrease the relapse rate of vitiligo.vitiligo is a curable disease, but it need the confidence and patience of vitiligo patient.
