Vitiligo. Causes, symptoms, treatment of vitiligo

Vitiligo is a pigmented abnormality. This disease contributes to the destruction of colored skin cells - melanocytes, instead of which white spots appear on the affected area of \u200b\u200bthe skin. The disease is characterized by the appearance of small depigmented spots that tend to grow in size and merge.

In some cases, the number of such spots reaches several dozen. The hairline on the affected skin also lends itself to discoloration. The disease can manifest itself at any age, regardless of the sex of the person. This disease is characterized by different localization and a rather long, usually progressive course. The process is often exacerbated after trips to sunny resorts.

What it is?

Vitiligo is a pigmentation disorder, expressed in the disappearance of the melanin pigment in certain areas of the skin. The disease occurs on the skin, presumably as a result of the action of certain medicinal and chemical substances, neuro-trophic, neuroendocrine and autoimmune factors of melanogenesis, as well as after inflammatory and necrotic processes on the skin.

A predisposition to vitiligo can be inherited. The nature of the disease is not fully understood.

Statistics

This is a common skin pathology. The number of patients reaches 0.5-8% of the world's population, which is about 40 million people. Vitiligo appears more often at a young age: 50% of patients are people 10-30 years old. The onset of the disease in people over 40 is rare. The rise in incidence is noted in the spring and summer months, when the skin is more exposed to sunlight.

Causes of occurrence

It is interesting to consider the fact that this pathology is not congenital; white spots have to be treated after exposure to not only external, but also internal factors. Race is not particularly important, however, the disease is more often diagnosed in patients with dark skin.

The following reasons can provoke the development of the disease:

1. Heredity.
2. Endocrine and hormonal disorders.
3. Exposure to chemicals that can be used in the production of low-quality cosmetics.
4. Prolonged exposure to the sun.
5. The use of certain pharmaceuticals.
6. Digestive system pathologies.
7. The presence of autoimmune processes in the body, in which antibodies tend to infect healthy cells instead of pathological ones.
8. Various injuries to the skin, burns - inflammatory reactions with an autoimmune component are triggered in the affected areas, most often it is the cells that produce the pigment that react in this way.

The development of vitiligo can begin completely unnoticed by a person. Sometimes it is preceded by a slight itching, increased sensitivity of the skin, a tingling sensation, "goose bumps". Each speck that appears has clear outlines, more often such spots with smooth or scalloped edges have a rounded shape. In addition to the white color, no skin changes are observed, there is no peeling or atrophy.

With the further development of pathology, the spots begin to merge, increase in size, and be observed on any part of the body. Lack of pigmentation is not the only symptom of the disease; sometimes skin irritation is observed.

Classification

Vitiligo, depending on the location of the spots, are divided into three main types:

• localized form: spots are located in certain places;
• generalized form (most common form): spots are located all over the body;
• universal form (less common): almost complete loss of pigment (more than 80% of the body area).

In turn, the main types are subdivided into subgroups. The generalized form includes acrofacial vitiligo (only the face and limbs), vulgar vitiligo (spots are scattered over the body symmetrically), mixed vitiligo (a combination of different types). The localized form includes focal vitiligo (there are spots on 1-2 sites), segmental vitiligo (spots are located on one side of the body), mucous vitiligo (spots are only on the mucous membranes).

There is also a division according to the type of spots:

• blue spot - spots have a bluish tint;
• inflamed spot - the border of the spot is inflamed and raised;
• tricolor spot - there is a moderately pigmented zone between healthy skin and the spot;
• four-color spot - in addition to the three colors, a zone of strong pigmentation appears around the spot.

The course of the pathological process with vitiligo is divided into types:

• stable appearance: a white spot appears and remains unchanged for a long time;
• progressive appearance: there is a constant progress of the depigmentation process, sometimes it happens quickly, sometimes it happens slowly;
• unstable appearance: some spots disappear, while others enlarge.

What are the symptoms of the disease?

The main manifestation of the disease is white spots on the body. The foci of the disease can occur at any age, often in children and adolescents, can form on all areas of the skin. The places where the skin is most injured are at the greatest risk of the appearance of depigmented areas - spots appear on the legs, knees, hands, elbows.

1. In the foci of vitiligo, sweating is disturbed, the skin becomes unable to respond normally to cold and heat. Hair on the whitened areas of the body in many patients also discolored. Individual spots can disappear spontaneously even without treatment, but with the progression of the disease, foci of depigmentation can form at the sites of recent injuries, friction or pressure on the skin.
2. The initial stage of vitiligo is very weak. It is characterized by minor foci of depigmentation - small spots that look like a noticeable but not particularly prominent cosmetic defect that can be easily masked with clothing. Gradually, the light spots on the skin enlarge and coalesce to form large areas of milky white.

Vitiligo does not cause any disturbing symptoms, it is not contagious, but it is difficult to cure it. Vitiligo is perceived by patients as a serious aesthetic defect, therefore, the disease can cause severe psychological discomfort. After sunburn, colorless areas become very visible, the affected areas of the skin are very sensitive to ultraviolet light and quickly "burn".

What does vitiligo look like: photo

The photo below shows how the disease manifests itself in humans in the initial and other stages.

Diagnostics

Vitiligo spots at first glance can be confused with spots that occur with lichen or syphilis. However, the latter two diseases are characterized by other symptoms besides skin discoloration. So, with syphilis, specific lesions of the mucous membrane are observed, and with deprivation, the surface of the spots peels off.

Vitiligo can be most accurately identified by shining a Wood lamp on the spots. Under it, the affected areas will be highlighted in blue-white, and areas where the pigment has just begun to disappear will become visible. When visiting a dermatologist, it is better to insist on this particular diagnostic method.

How is Vitiligo Treated?

If the area of \u200b\u200bthe lesion of vitiligo is no more than 20% of the body, first of all, topical glucocorticosteroid agents in the form of creams and ointments are prescribed for treatment.

• methylprednisolone aceponate (Advantan and analogues);
• alklometezone dipropionate (afloderm and analogs);
• betamethasone dipropionate (actiderm and analogues).

There are several schemes for the use of these drugs, the doctor chooses the optimal scheme based on the test results, the area of \u200b\u200bthe lesion, the patient's age and other factors. If no visible effect is observed within 4-6 months, drugs of the second stage are prescribed - topical calcineurin inhibitors:

• tacrolimus, ointment of varying concentration;
• pimecrolimus cream.

It is worth considering that despite the successful studies (2013), the diagnosis of vitiligo is still not officially included in the indications for use.

How can you get rid of vitiligo?

New methods in the treatment of this disease:

1. Skin whitening. This is an attempt to even out the tone of the affected areas and healthy skin. Today, the most popular means for this procedure are injections of eloquin, hydroquinone (2-4%) and its monobenzyl ether (Monobenzone) externally. All drugs are quite aggressive and have a lot of side effects, so they cannot be considered a panacea for solving the problem of depigmentation. In addition, the price tags on them bite very much (an injection of eloquin costs about 50 thousand rubles), and the clarification occurs in sections, therefore, almost constant use of drugs is required.
2. Laser therapy. This is the elimination of areas of depigmentation with narrow-beam radiation with a wavelength of 308 nm. In this case, the mechanism of action is almost similar to phototherapy. At the same time, the greatest efficiency is achieved in persons with local forms of the disease and the duration of the pathological process no more than five years. The duration of the action of radiation in one session is seconds. Other names for this method are excimer laser or Ratokderm. Read more about contraindications and indications for laser therapy.
3. Melagenin plus. It is an alcoholic extract from the human placenta produced by Cuba. The drug has been on the market under the name Melagenin since 1998, and has an average efficacy against localized forms of the disease.
4. Melanocyte transplantation. This is the introduction of pigment cells taken from healthy areas of the patient's skin into his problem skin.
5. Vaccine development. In 2013, scientists from the University of Chicago School of Medicine tested a protein vaccine in a series of experiments on mice that suppressed the autoimmune response that leads to vitiligo. However, to this day, no information has been received about the completion of work on the vaccine.

The Australian drug Sceness, registered in Europe for the treatment of erythropoietic protoporphyria, also represents a prospect for the elimination of depigmentation in vitiligo.

Phototherapy

Phototherapy - treatment with light of a certain wavelength - for vitiligo is used in the form of selective phototherapy, PUVA therapy, narrow-wave UVB phototherapy at a wavelength of 311 nm. Selective phototherapy is the least effective, PUVA therapy (taking psoralens photosensitizers by mouth followed by irradiation of the skin with UVA rays) is much more effective than selective phototherapy, however, the toxic effects manifested by nausea, vomiting, headache, dizziness, as well as the risk of skin cancer with long-term use limit the use of PUVA therapy in the treatment of vitiligo.

Narrowwave 311 nm UVB phototherapy is comparable in effectiveness to PUVA therapy (restoration of pigmentation in more than 75% of the area of \u200b\u200bvitiligo foci in 70% of patients), however, it is devoid of toxic side effects and, moreover, is approved for use in the treatment of children. The most noticeable therapeutic effect is observed in the presence of foci in the face, neck, trunk and proximal extremities. When localized on the fingers and toes, the effect is less pronounced. In addition, lesions that arose no more than 2-5 years ago respond better to treatment.

Phototherapy, namely narrow-wave 311 nm UVB phototherapy, is currently considered one of the most affordable and effective treatments for vitiligo. The method is quite safe, and this is important for long-term use. To achieve a good effect, it takes from 30 to 100 procedures, with a frequency of 2-3 times a week.

Surgical intervention

In 20% of cases, conservative treatment of vitiligo does not give the desired result, then the question of surgery is considered. Surgical treatment consists in the transplantation of one's own healthy melanocytes into lesions devoid of pigment. After the operation, new melanocytes are formed in the deep layers of the epidermis. The pigmentation restoration process takes several months.

Indications for surgical treatment of vitiligo

1. The lesions are located on open areas of the body (face, neck, décolleté, arms). They are a significant cosmetic defect and disrupt the patient's psychological status.
2. Lack of result from local and systemic therapy for 12 months.
3. The disease is in remission. For 1-2 years, new spots do not appear, and existing ones do not grow.

There are several methods of surgical treatment for vitiligo

1. Epidermis transplant. The affected areas of the skin are excised. In their place, an autograft prepared by the PUVA method is placed (a flap of the epidermis from a healthy area of \u200b\u200bthe body).
2. Minitransplants. Areas of healthy skin less than 1 mm in size are transplanted into depigmented foci.
3. Transplantation of cultured or uncultured melanocytes. Individual cells that produce pigment are implanted into the skin.

Side effects of surgical treatment can be:

1. The appearance of scars;
2. Uneven pigmentation;
3. Rejection of transplanted areas of the epidermis;

Contraindications:

1. Tendency to scarring;
2. Intolerance to UFO and laser therapy.

How to mask vitiligo spots?

The desire to hide white spots on the face and body is a completely natural desire of people suffering from vitiligo. Therefore, while treatment is being carried out, you can use the following methods:

• A method such as dermabrasion can help mask vitiligo. In this case, the skin is processed in layers, and the depth of penetration depends on the form of the disease, the age of the spots, etc.
• Using a self-tanner. If you perform this procedure in a salon, the color will turn out to be more even and it will last longer. In addition, it can be problematic to independently choose a shade and apply it to the body. Unlike cosmetics, self-tanning is convenient to use on the hands and feet, as it does not stain clothes.
• Using green walnut peels. To do this, grind it with a blender and leave for 2 hours. The mixture should then turn brown. The juice from the peel must be squeezed out and applied with a cotton pad to the spots, which will contribute to their staining. One of the advantages of this product is that it does not leave marks on clothes.
• The use of cosmetics. This is the most affordable and easiest way to make stains less visible. At the same time, apply foundation and other matting agents correctly. First, the skin must be smoothed to its natural color, and only after that it is necessary to start matting. In addition, you can use a permanent tattoo, which will be more resistant and will not wear off when in contact with clothing or water.

However, when using these products, it is important not to forget about the rules for caring for the affected skin. Do not injure her again or expose her to allergens. It is important not to wear too tight clothes and shoes, avoid rubbing stains, if there is a need to use a razor, then you should be as careful as possible. Jewelry should not leave visible marks on the neck and fingers. It is necessary to limit the time spent both in the sun and in the cold. After all, tanning most often provokes the formation of new spots.

Dermatological diseases are considered the most common. One of them belongs to the rare and intractable - Vitiligo. This pathology does not pose a threat to life, but it brings psychological discomfort. Dermatologists claim that the disease appears due to the development of some other serious pathologies.

The name of this disease comes from the Latin words "vitilum" and "igo", which means "unclean disease". Vitiligo is a benign skin pathology that manifests itself in discoloration of certain areas of the skin. It belongs to chronic diseases.

Pathology occurs as a result of functional blockage or loss of activity of pigment cells - melanocytes.

The disease is rarely diagnosed - in 1% of the world's population. Most often, vitiligo develops in women under the age of 18.

In medicine, pathology has a second name - leukoderma. It can produce large or small spots that do not cause physical discomfort to the patient. Pathology can go away on its own and appear during spring or autumn. The recurrent course of vitiligo complicates the implementation of therapeutic measures due to emotional exhaustion of people.

Vitiligo types

The pathology of the skin has several types. The main division is considered to be of type A and B.

1. Type A, or NSV, manifests itself in the form of spots of any shape that do not affect the functioning of the sympathetic part of the nervous system, that is, does not reduce the activity of organs and energy costs. It is believed that this form of pathology occurs against the background of autoimmune diseases.

This pathology manifests itself on both sides relative to the center line of the body and often has symmetry. With the growth of spots without pigment, vitiligo becomes unstable and may have periods of relapse or regression.

2. Type B, or SV, characterized by a change in the pigmentation of skin areas in the direction of the location of nerve fibers and nodes. It is believed that the pathology is associated with disorders in the work of the sympathetic nervous system.

This type of vitiligo can present with one large patch or several uncolored segments on one half of the body. Type B is diagnosed in 70% of cases in people under the age of 20.

After some time, the pathology becomes stable without improvement periods. The edge of the spots may be uneven. Along with this disease, partial graying of a strand of hair on the head, eyelashes or eyebrows is possible.

Vitiligo also differs in the spread of spots. There are 2 types of pathology, which are divided into additional subtypes:

3. Localized.

With this form of the disease, spots are found in certain parts of the body.

This type of vitiligo includes:

• focal form, in which the depigmented areas are close to each other;
• a mucous form in which spots appear only on the mucous walls;
• segmented form, which manifests itself in several spots located on one part of the body.

4. Extensive.

This disease is the most common. Spots with this form are located on the surface of all skin integuments. The main feature of extensive vitiligo is the size of the spots and the area of \u200b\u200bdepigmentation.

This pathology has several subtypes:

• acrofascial, in which spots form on the face or hands;
• vulgar, in which depigmented areas appear chaotically throughout the body;
• segmented, which is characterized by one large spot on one of the body parts;
• mixed type, which can combine several subtypes of extensive vitiligo at once.

5. Universal.

Such vitiligo is the rarest. With this type, pigmentation is lost by almost 80% of the entire surface of the epidermis.

Vitiligo, the causes and treatment of which are associated with the autonomic nervous system, are also distinguished by the color of pigmentation. It is believed that different staining appears with disorders in certain parts of the nervous system.

Exist:

1. tricolor pathology with a blurred color border;
2. four-color pathology characterized by a bright and clear color border;
3. blue pathology, which has a pale blue color in the middle of the spot;
4. inflamed pathology, in which the contour rises above the entire surface of the skin.

This division into types and subtypes helps to better navigate the use of effective therapy and to develop an individual course of taking medications.

Stages and degrees of vitiligo

Vitiligo has 4 stages of development:

1. Onset of the disease.

It is characterized by the appearance of several small spots. They have a slight degree of depigmentation, but form a bright outline at the border.

The decrease in the number and activity of melanocytes occurs smoothly. At first the patches are beige or milky in color, but over time they become almost white. They can also form new lesions or coalesce into large areas.

With timely treatment for medical help, pathology at this stage can be completely eliminated.

2. Developing.

Over time, unpainted areas of the skin grow. New foci of depigmentation may appear around. This stage can be transient or gradual.

With the rapid development of the disease in 6-14 days, the area and the number of spots increase by 2-4 times. With a gradual course of pathology, neoplasms grow slowly.

Vitiligo at this stage is difficult to treat.

3. Stable.

The spots that appeared earlier stop growing, do not change color or appearance. This stage can appear at any time if therapy is effective. But it has a chronic form in 95% of cases.

4. Recovery.

This stage is characterized by the disappearance of depigmentation foci. The spots may be completely pigmented or less visible. This stage is achieved only after complex treatment of vitiligo, but it is not a sign of complete cure, since spots can appear on other areas of the skin.

Vitiligo, the causes and treatment of which depend on the degree of damage to the pigment centers, can have different degrees of severity. Remission rarely occurs, and in 70% of such cases it is associated with an active immune response and the compensatory ability of the body in childhood under 3 years of age.

During this period, any form of pathology is equated to a mild degree, when the spots do not have a bright contrast with the main skin tone due to the presence of sufficient melanin and vitamin D for staining.

Adults and children after 4 years of age often experience moderate to severe vitiligo. They differ in the size of the depigmented areas and the area of \u200b\u200bthe lesion. A universal and extensive type of vitiligo belongs to the severe degree of pathology. The rest of the disease is usually classified as moderate.

Vitiligo symptoms

The destruction of melanocytes and a decrease in the concentration of the pigment melanin form discolored areas on the skin. This cutaneous manifestation is considered the most basic symptom of a developing pathology, but there are additional specific symptoms of the disease, which allow you to quickly diagnose:

Rarely enough, other obvious symptoms may also appear:

• violation of the process of salivation or increased sweating;
• the occurrence of allergic reactions to ultraviolet radiation;
• lack of reaction of the outer layers of the epidermis to stimuli;
• baldness in the area of \u200b\u200bdepigmentation;
• increased light sensitivity of the eyes;
• dermatitis;
• thickening of some areas of the skin;
• indigestion;
• enlargement and soreness of the liver.

The causes of vitiligo

Vitiligo, the causes and treatment of which are complicated by the presence of psychological problems, are often referred to as chronic diseases. This course of pathology can persist for many years or throughout life. Vitiligo remains a poorly understood anomaly of the skin, but specialists were able to establish several reasons for the development of depigmentation.

1. Heredity.

Scientists have found that the risk of vitiligo increases if relatives suffer from this anomaly. Experiments also confirmed the connection of a certain human genotype with the development of depigmentation. In 73%, vitiligo is diagnosed in brown-eyed or dark-skinned people.

2. Nervous disorders.

There is an opinion that pathology develops, like psoriasis, due to dysfunction of some parts of the autonomic nervous system.

Regular stress can be the cause of vitiligo, early gray hair and other diseases associated with the production of melanin. Treatment should start with a stress fence.

Stressful situations, tension and instability of the psycho-emotional background slow down the work of the parasympathetic and sympathetic nervous systems, blocking important metabolic processes in the cells. This situation can lead to disruption of melanin production and depigmentation of areas of the skin.

3. Strong medications.

The use of aggressive agents for the treatment of severe pathologies can affect the color of the skin. Such changes can cause the appearance of individual discolored spots on the skin, which disappear after the completion of the therapeutic course.

4. Hormonal imbalance.

Disorders in the work of the adrenal glands, pituitary gland or thyroid gland cause the appearance of not only age spots, but also vitiligo. This is due to an imbalance of important chemicals that stimulate the production of pigments and collagen compounds necessary to protect the skin.

5. Poisoning by chemicals.

Melanin is a compound with weak chemical bonds. During work or frequent contact with caustic substances, it breaks down, and the production of this pigment stops.

The most dangerous substances include:

• phenol and its derivatives;
• pyrocatechol and its isomers;
• polymeric compounds with an acrylic group;
• formalin;
• hydrofluoric acid.

6. Skin diseases and injuries.

Vitiligo often begins to form in areas of skin lesions. Areas with burns, scars and wounds are at risk. Pigmentation is often impaired after prolonged sun exposure. This is due to the inflammation of several layers of the epidermis at once and the death of melanin-producing cells.

7. Autoimmune diseases.

This factor has a number of proofs.

People with vitiligo also have one or more autoimmune pathologies:

• lupus;
• psoriasis;
• leukemia;
• rheumatoid arthritis;
• diabetes;
• juvenile arthritis.

Melanocytes are part of the immune system, they protect the skin from environmental influences. With insufficient strength of the immune response, the pigment is not produced in sufficient quantities, which leads to discoloration of some areas of the skin.

9. Diseases of the digestive system.

The production of melanin requires energy and a certain amount of essential enzymes and nutrients. Disturbances in the work of the digestive organs reduce the absorption of these compounds, which leads to a decrease in the concentration of pigment.

Diagnosis of vitiligo

Vitiligo, the causes and treatment of which are formed by specialists on the basis of the general clinical picture, is rather difficult to diagnose.

To confirm the pathology, it is necessary to visit a dermatologist and conduct a number of studies:

The most effective methods for diagnosing vitiligo are MRI and all types of blood tests.

All the necessary tests can be passed in a comprehensive manner in almost any clinic:

Medical institution name	Average cost for a set of studies, rubles
Alternative clinic	2100
New medicine	3250
European Medical Center	2840
He Clinic	3400
Invitro, laboratory	2600
Hemotest, laboratory	3100

When to see a doctor

Vitiligo is considered a disease that is not dangerous for life and health, but when depigmented skin areas appear, it is necessary to undergo an examination as early as possible. Timely diagnosis and treatment of pathology increases the likelihood of remission or inhibition of its further development. If vitiligo is suspected, an initial examination by a dermatologist is required.

• neurologist;
• neurobiologist;
• a surgeon;
• immunologist;
• psychiatrist;
• allergist.

Vitiligo prevention

There are no specific measures that help avoid leukoderma. Many factors affecting the skin do not depend on the person.

• apply sunscreen to open areas before going out into the sun at any time of the year;
• reduce the frequency of contact with aggressive substances and use personal protective equipment when working with them;
• do not be in the sun for more than 30 minutes;
• use only high-quality and proven cosmetics;
• do not take medications without first consulting a doctor;
• take vitamins A, C and B in courses;
• increase your intake of foods containing copper, zinc and iron.

Vitiligo treatment methods

Modern medicine offers several treatments for skin depigmentation. In addition to medicines, new innovative methods have appeared. The choice of treatment regimen depends on the stage of the disease and the area of \u200b\u200bskin lesions.

Medications

All funds are prescribed by a specialist depending on the form of pathology:

Vitiligo type	Drug name	Release form and method of administration	Dosage	Course	Average price, rub.
Localized	Triacort			10 days	118
	Laticort	Topical cream or ointment	Apply in a thin layer up to 3 times a day	21 day	130
	Esperon	Ointment for external use		14 days	350
	Ftorocort	Ointment for external use	No more than 15 g per day. Apply in a thin layer up to 3 times a day	10 days	218
	Elokom	Ointment for external use	Apply in a thin layer once a day	Determined by a specialist	79
	Dermovate	Ointment for external use	The maximum daily dosage is 7 g. It is applied in a thin layer up to 2 times a day.	Determined by a specialist	465
	Kutiveit	Ointment for external use	Apply in a thin layer up to 2 times a day	14 days	302
Extensive	Triamcinolone		The maximum daily dose is 20 mg.	Up to 4 weeks	4000
	Dexamethasone	Oral tablets	The maximum daily dose is 15 mg.	Up to 3 months	35
	Prednisone	Oral tablets	Calculated by a specialist	Up to 30 days	16,5
	Elidel		Apply in a thin layer up to 2 times a day	Determined by a specialist	888
	Protopicus	Cream for external use	Calculated by a specialist	Up to 12 weeks	648

Regardless of the type of vitiligo, an appointment is also prescribed:

• vitamin and mineral complexes;
• folic acid;
• copper sulfate;
• sulfur;
• zinc oxide;
• iron preparations;
• immunomodulators;
• digestive enzymes.

Traditional methods

The causes of vitiligo are characterized as a secondary disease, that is, it must be treated comprehensively. Together with medicines, it is recommended to use folk remedies.

1. Oil for St. John's wort.

To prepare this product, you must purchase at a pharmacy or collect the flowers of the plant and place in a glass container. St. John's wort should be tamped tightly and occupy almost the entire free volume. Then you need to pour vegetable oil into the container.

Among the most effective for combating skin diseases are:

The mixture should be left for 2 weeks in a sunny place and shaken periodically. Then squeeze out the oil well, pour it back into the container and add a new portion of St. John's wort flowers. The aging period remains - 2 weeks. This step must be repeated up to 5 times.

The finished oil is taken orally in 1 tsp. up to 3 times a day. It is also applied to depigmented areas 2 times a day. The duration of treatment depends on the patient's condition.

2. Honey duckweed.

This plant contains a large amount of iodine and bromine salts; it is actively used to treat vitiligo. To prepare a remedy, you must mix the marsh duckweed with honey in a 1: 1 ratio. The remedy is taken 3 times a day for 2-3 years.

3. Black pepper.

This remedy is considered the most effective, since pepper contains a lot of piperine, a compound that stimulates the work of melanocytes. It must be mixed with soda in equal parts and rubbed into discolored foci. Stop using the product only after the formation of a new pigment.

Other methods

For the treatment of leukoderma, there are new, but quite effective methods.

These include:

1. Laser therapy.

With the help of a special device, the depigmented zones are exposed to a point or local effect with a special radiation, which consists of folding oscillatory and wave processes. The therapeutic effect is obtained by suppressing T-lymphocytes, which destroy melanocytes, by a laser beam.

The minimum course of laser therapy is 3 sessions. The method is suitable for segmental, vulgar and focal types of vitiligo.

2. Whitening procedures.

This method helps to slightly correct the color of depigmented skin in several tones.

The effect is achieved by injecting drugs under the skin:

• Hydroquinone;
• Monobenzene;
• Eloquin.

The procedures are effective, but they must be done regularly.

3. Surgical methods.

These methods are radical, but they are most effective.

There are 2 types of operations:

1. Donor melanocyte transplant, when there is a quantitative transplantation of pigments from a healthy person to a patient. This method can be complicated by the rejection of donor tissues and suppuration of depigmented areas. It is used for the universal type of vitiligo and lesions that occupy more than 70% of the skin.
2. Transplant of your own melanocytes, when pigments are transplanted from normal skin to discolored skin. The risk of cell rejection is reduced with this method, but it does not disappear completely.

The radical method also does not guarantee the absence of secondary vitiligo.

4. Plasmolifting.

A certain amount of venous blood is drawn from the patient. It is placed in a centrifuge, where plasma is separated from the blood. This substance is injected into the depigmented areas, which stimulates the production of melanin. This method is more effective than ultraviolet therapy, but has a short-term effect.

5. PUV-procedures.

The depigmented areas are irradiated with ultraviolet light.

To achieve the maximum effect, photosensitizing drugs are used:

• Peroxane;
• Melanidin;
• Beroxan;
• Lamadin;
• Psoberan.

6. Application of Melagenin.

This agent stimulates the production of melanin and fixes it in the skin cells. It is applied topically to discolored areas for several months.

Possible complications

It is believed that vitiligo does not threaten the life of patients, but pathology can lead to the development of some health problems and worsen the quality of life.

Since depigmented areas are devoid of natural protection, if untreated, they can develop:

Development is also possible:

• diabetes mellitus;
• avitaminosis;
• myopia;
• skin cancer;
• pneumonia;
• pathologies of the endocrine system.

On the part of the nervous system, depression, photophobia and complexes can occur. A cosmetic skin defect such as vitiligo must be treated in combination. In medical practice, there are cases of complete recovery from pathology. This can be achieved by identifying its root cause and adequate timely therapy.

In order to avoid psychological instability, it is recommended to hide depigmented areas in open areas of the body with the help of masking cosmetics.

Article design: Vladimir the Great

Vitiligo video

Elena Malysheva will tell you about vitiligo:

Vitiligo - a chronic disease in which white spots appear on the skin, prone to growth and fusion. In addition to the skin, hair, retina and meninges can be affected. Patients do not experience pain, itching or other unpleasant sensations, however, defects in appearance significantly disrupt the psychological state.

In limited areas of the skin, the production of melanin, the pigment responsible for the color of the skin and hair, stops. As a result, milky white spots appear in this place. The loss of pigment can occur quickly, over several hours, or slowly, over several months.

Vitiligo causes. The development of the disease is associated with a deficiency of zinc and copper in the body, exposure to heavy metals and other toxins, infectious diseases, trauma, neuroses, depression, hormonal imbalance (diabetes mellitus, thyroid pathology). But the leading role is played by heredity. For example, singer Michael Jackson, who suffered from vitiligo, passed the disease on to his eldest son.

Statistics. Vitiligo is a common skin pathology. The number of patients reaches 0.5-8% of the world's population, which is about 40 million people. Vitiligo appears more often at a young age: 50% of patients are people 10-30 years old. The onset of the disease in people over 40 is rare. The rise in incidence is noted in the spring and summer months, when the skin is more exposed to sunlight.

In general, men and women get sick equally often. But women often turn to European doctors for skin depigmentation, and men to Asian doctors.

History. From Latin "vitiligo" is translated as "vicious disease". Ancient healers mistakenly associated its appearance with syphilis and other sexually transmitted infections. In the Middle Ages, white spots on the skin were considered a manifestation of the most dangerous infectious disease - leprosy (leprosy). And only in the middle of the nineteenth century vitiligo was isolated as a separate disease and it was proved that it is not contagious.

There is no effective treatment to ensure that vitiligo is eliminated. About 20% of people fail to achieve sustained improvement with medication. However, in 7% of patients, spontaneous healing occurs.

What determines skin color?

Leather - a complex organ that covers the human body. Its color depends on the functioning of specific cells - melanocytessecreting pigment melanin.

Skin structure

• Epidermis - the outer layer, which is formed by the stratified keratinizing epithelium. In it, in turn, there are 2 main functional layers:
  • Growth (basal) layer - active processes of cell division take place in it, ensuring the regeneration and renewal of the epidermis. Melanocytes are located precisely in the basal layer.
  • Stratum corneum - consists of dead keratinized cells. Performs a protective function.
• Dermis - the skin itself, separated from the epidermis by the basement membrane. Functions: provides support and nutrition for the epidermis, provides local immunity. There are 2 layers in the dermis:
  • Papillary - is represented by loose fibrous connective tissue, which contains immune cells (basophils, macrophages and T-lymphocytes) and capillary loops.
  • Mesh - consists of dense fibrous connective tissue that performs a supporting function.

Cellular composition of the epidermis

• Keratinocytes or epithelial cells (85%) - cells that form the basis of the skin epithelium.
• Langerhans cells (10-15%) - cells that receive information about antigens (viruses, bacteria). They interact with lymphocytes and other immune cells to activate local skin immunity.
• Merkel cells (2-3%) - are responsible for the sensitivity of the skin, provide the sense of touch.
• Melanocytes (up to 10%) - cells with large dark nuclei and a large number of processes located in the thickness of the basal layer. Skin pigment - melanin is produced and matured in specific organelles - melanosomes.

Through the processes, the pigment is transported to the surrounding keratinocytes. Each melanocyte provides pigment for about 10 surrounding cells.

Melanin production process

Melanin is formed in melanocytes from amino acids - tyrosine, which enters the body with food and is synthesized in the liver from phenylalanine. This process takes place with the participation of a copper-containing enzyme - tyrosinase, a substance that converts tyrosine to melanin, as well as zinc and oxygen.

Melanin is formed in several stages:

1. Melanocytes receive chemical signals from surrounding cells and produce an enzyme called tyrosinase.
2. An enzyme converts tyrosine into melanin. Pigment grains ripen in rounded "containers" of melanosomes.
3. Melanin is transported along the processes of melanocytes to surrounding cells and absorbed by them. The degree of saturation of keratinocytes with pigment depends on the race, individual characteristics of the organism, the degree of sunlight.

Disruption of the functioning of melanocytes or their death leads to a decrease in the amount of melanin in the cells of the epidermis and the development of vitiligo.

Vitiligo causes

Modern medicine has not established the exact cause of the appearance of white spots on the skin. However, it is known that the production of enzymes DOPA-oxidase and tyrosinase associated with the formation of melanin is impaired in patients.

Possible mechanisms for the development of vitiligo:

• Self-destruction theory after infections or as a result of exposure to toxins, melanocytes are reborn. They produce toxic products that damage cell walls.


• Autoimmune theory - due to a defect in immunity, melanin is destroyed by immune cells. They perceive the pigment as a foreign organism and attack it.


• Biochemical disorders - free radicals (hydrogen peroxide) accumulate in the skin. In this regard, the production of an enzyme - catalase, is reduced, designed to neutralize them. Free radicals damage melanocytes and lead to skin discoloration.


• Genetic theory... In 2007, British scientists managed to identify the NALP1 vitiligo gene, which is inherited. People who have this gene develop vitiligo.

The causes of vitiligo and pathology that increase the likelihood of illness

• Genetic predisposition... Vitiligo is transmitted from parents to children as a dominant trait. This means that if one of the parents is sick, then the probability that the children will develop the same pathology is 50%. Even if vitiligo has arisen under the influence of trauma or other reasons, the disease is fixed at the genetic level and is further transmitted to descendants.
• Endocrine gland disorders:
  • thyroid gland
  • liver
  • pancreas
  • ovaries
  • pituitary-adrenal system
  A malfunction of the endocrine glands leads to a disruption in the formation of enzymes in melanocytes.
• Nervous system disorders:
  • strong emotional turmoil
  After mental trauma, neuro-endocrine changes occur and the innervation of certain areas of the skin is disrupted. Melanocytes do not receive neurochemical commands to produce melanin.
• Skin damage
  • burns, including sunburn;
  • scars formed after injuries;
  • microtrauma arising from rubbing the seams of clothes, jewelry.
  If the skin is damaged, the basal layer of the epidermis is injured, in which melanocytes are located. In some cases, cells are not restored. In immune pathology, damaged melanocytes can be attacked and destroyed by immune cells.
• Diseases of the gastrointestinal tract
  • intestinal invasions;
  • maldsorption syndrome.
  Diseases of the digestive system cause a change in the chemical composition of the blood and a deficiency of enzymes in cells. Malabsorption leads to a lack of magnesium, manganese, copper and zinc, which are necessary for the formation of pigment.
• Skin exposure to chemicals
  • poor quality cosmetics;
  • formaldehyde;
  • phenol and phenol-containing reagents used in the production of paints, rubber, cables;
  • other chemically aggressive substances.
  Work in hazardous work is one of the most common causes of vitiligo. Chemicals attack cells in the epidermis and disrupt their functioning. In this case, a change of job can lead to spontaneous self-healing.
• Decreased immunity
  • operations;
  • excessive physical activity and sports.

Factors that reduce immunity can provoke the appearance of foci of vitiligo, especially in people with a genetic tendency.

Vitiligo symptoms (photo)

Symptom	Mechanism of occurrence	Manifestations	A photo
Disease start - single spot	In melanocytes, melanin synthesis decreases or completely stops.	The first symptom is a spot on the surface of the skin or mucous membranes. It can be rounded or with "ragged" edges. The stain will fade gradually or over several hours.
Hyperpigmentation around the lesion	An inflammatory process develops around the focus, which is accompanied by increased melanin synthesis.	The spot is surrounded by a rim that is darker than healthy skin. This symptom distinguishes vitiligo from other skin discoloration conditions.
The tendency of stains to grow and merge	Peripheral growth of foci is associated with the involvement of new melanocytes in the process.	White spots increase in size and merge with each other. The growth rate of foci depends on the individual characteristics of the organism.
Localization - any area of \u200b\u200bthe skin or mucous membranes, except for the feet and soles	The skin on the palms and feet does not contain melanin, so spots do not appear on these areas.	Mostly spots are formed on the flexion and extensor surfaces of the limbs, on the face, in the armpits on the buttocks, around scars and in places of permanent skin trauma.
Symmetrical defeat	For unknown reasons, the spots are located symmetrically on the body.	In most cases, the spots on the right and left sides of the body are identical.
Discoloration of hair in the affected area.	In the affected area, the hair follicles lose melanin.	The vellus hair and scalp are discolored inside the focus. Early gray hair is found in 30% of patients.
Reticular vitiligo	Many small foci of depigmentation are formed, located close to each other.	On the skin of the genitals, inner thighs and on the chest, there are dotted foci of discoloration located in gray.

Diagnosis of the cause of vitiligo

Vitiligo is diagnosed and treated by a dermatologist. The diagnosis of "vitiligo" sometimes causes difficulties for physicians, since its symptoms are similar to fungal infection, lichen coloration, depigmented nevus, partial albinism.

Poll.During the collection of anamnesis, the doctor finds out:

• whether any of the relatives have the same clinical symptoms, is there a hereditary predisposition to vitiligo;
• does the patient suffer from autoimmune diseases that often accompany vitiligo (especially Hashimoto's thyroiditis);
• when the disease started and how quickly it progressed;
• whether there was an exacerbation over the past 6 months - growth and the appearance of new foci;
• features of acquiring a tan. This information is essential when prescribing phototherapy.

Inspection.The doctor identifies the external diagnostic criteria for vitiligo to distinguish it from other diseases.

• Symmetrical arrangement of spots. In only 10% of cases, one side of the body is affected. Rashes can be located along the nerve or its plexuses.
• The lesions are round, in 10-15% they may have an irregular shape or be punctate.
• The rash may present as single small patches or lead to complete depigmentation of the skin.
• The skin on the lesions does not flake, is not covered with crusts or erosion. The exceptions are cases when a secondary infection joins.
• Hair located on spots loses its color, discoloration.
• There are spots around moles.
• The lesions are surrounded by a ring of hyperpigmentation. The dark rim is highly visible after exposure to medical ultraviolet light or sun exposure.
• In the universal form, when a large surface area of \u200b\u200bthe body is affected, areas of healthy skin have a falling edge.
• Often depigmented areas appear in places of constant friction with a shirt collar, for hours, with a belt.

Wood lamp

A Wood's lamp or black light lamp emits ultraviolet A rays and is used to diagnose skin conditions. The lamp is made of dark glass and has a faint glow.

Wood's lamp is used to detect foci of depigmentation in areas of the skin where the sun's rays do not fall: under the hair, in the armpits, on the genitals. The light of the lamp is brightly reflected from the spots, which makes it possible to see their number, shape and color transitions. The foci of the disease are bluish-white in color.

Skin biopsy

Research is rare. The scalpel is used to scrape off the epidermal layer in the center of the focus and on the periphery. Microscopy of a sample in vitiligo patients reveals:

• complete or partial absence of melanocytes
• altered collagen fibers
• a large number of melanosomes in the rim surrounding the lesion

Vitiligo treatment

Vitiligo treatment is aimed at curbing the progression of the disease, reducing its cosmetic manifestations and restoring melanin production.

It is believed that vitiligo cannot be cured with one drug or method - an integrated approach is needed.

Therefore, the treatment of vitiligo includes several areas:

• topical treatments (ointments, creams and lotions)
• general treatment with systemic drugs
• physiotherapy procedures
• treatment of diseases of the gastrointestinal tract and other pathologies that provoke vitiligo
• taking vitamin preparations (A, E, B1, B2, C, PP, D), taking minerals, especially copper and zinc
• elimination of provoking factors (friction, pollution)

Ointments and creams for the treatment of vitiligo

Group of drugs	Representatives	The mechanism of therapeutic action	Mode of application
Corticosteroids	Prednisone Betamethasone Diprospan	Hormone therapy reduces the immune attack and promotes pigment repair.	The funds are applied to the depigmented areas with a thin layer 1-3 times a day for 3 months. The use of corticosteroids around the eyes is not recommended.
Calcineurin inhibitors	Protopicus Elidel	Suppress the attack of the immune system on melanocytes. Reduces signs of inflammation and allergies.	Apply in a thin layer to the affected skin 1-2 times a day. The ointment is gently rubbed in until completely absorbed. Duration of treatment is not more than 6 weeks.
Photosensitizers	Melaginin Melaginin Plus Psoralen	Strengthen the absorption of ultraviolet rays by the skin, restore skin pigmentation.	The drugs are applied to the foci of the disease and rubbed gently 1-3 times a day. After application, it is desirable to expose the skin to low-power radiation (solar or UV lamp). The course of treatment is 3 months.
A comprehensive approach to the treatment and care of skin with vitiligo	Vitix gel	Restores the balance of free radicals. Stops the development of the disease and causes skin repagmentation.
	Vitix tablets	Food supplement that increases the effectiveness of Vitix gel therapy in the treatment and care of skin affected by vitiligo.
	Gel-corrector Viticolor	Camouflages depigmented skin areas.

Signs of improvement with topical treatment of vitiligo become noticeable after 2-6 weeks:

• spots are reduced in size. At the same time, their edges become uneven, scalloped.
• the lesions change their color, evenly darken
• dark blotches appear inside the spots - foci of melanin production around the hair follicles

Cosmetic preparations for vitiligo

Cosmetics for vitiligo helps to make the manifestations of the disease less noticeable.

• Artificial tanning products - milk, lotion, cream based on dihydroxyacetone. The product is gently rubbed into clean, dry skin in a circular motion. It contains dyes that help to achieve a tanned skin effect.
• Whitening lotions eliminate excessive pigmentation around the foci of the disease. Some companies (Covermark, Dermablend) have developed products taking into account the characteristics of the skin of people with vitiligo.
• Photoprotective means with UPF protection index 15-25 protects depigmented skin from direct sunlight and prevents burns on the affected areas. They must be applied to open areas of the body just before going outside.

Systemic therapy for vitiligo

Taking drugs by mouth is prescribed with the rapid progression of the disease and the ineffectiveness of local treatment for 6 months. To reduce the immune attack on melanin, use:

• systemic corticosteroids: Prednisolone, Betamethasone, Diprospan;
• immunosuppressants: Levamisole, Cyclosporin A, Cyclophosphamide, Isoprinosine.

The dosage and duration of therapy is determined individually. Treatment should be carried out under the supervision of a physician, as these drugs have a number of side effects.

Physiotherapy for the treatment of vitiligo.

Ultraviolet irradiation (phototherapy)

For the treatment of vitiligo, ultraviolet B is used - medium wavelengths. Irradiation is carried out according to a general (whole body) or local technique, when they affect exclusively the affected areas. Sometimes, to enhance the effect, photosensitizing agents are applied to the skin: Melaginin, Psoralen.

The sessions are held 2 times a week for 5-10 minutes. The course of treatment takes about a year.

PUVA therapy

PUVA therapy is a method of treatment that includes long-spectrum ultraviolet irradiation in the A-band together with photosensitizers. These drugs increase the sensitivity of the skin to ultraviolet light, and therefore improve the production of melanin. With PUVA therapy, the following are used: Methoxaralen, Trioxaralen, Ammoidin, Meladinin, Lamadin, Puvalen, Oxoralen. Medicines are taken with meals 2-3 hours before the procedure.

The whole body or the affected areas are irradiated for 5-30 minutes. The procedure is carried out every other day. To achieve significant results, 100-200 sessions are required.

Laser therapy

The laser affects the remaining melanocytes and activates their work. Laser therapy improves metabolic processes in the skin and promotes the production of enzymes responsible for the formation of melanin. Irradiation is carried out with two types of lasers:

• red length - wavelength 0.67 μm
• infrared - wavelength 0.89 μm

The procedure is carried out in the biocontrol mode. The radiation is modulated by the patient's pulse and respiration rate. The duration of one procedure is up to 30 minutes. The full course includes 15-20 sessions. A noticeable improvement occurs after the 6th exposure.

Proper treatment of vitiligo can slow the progression of the disease and cause the lesions to grow back. However, 60% of successfully treated patients relapse after some time (months, years).

Surgical treatment of vitiligo

In 20% of cases, conservative treatment of vitiligo does not give the desired result, then the question of surgery is considered. Surgical treatment consists in the transplantation of one's own healthy melanocytes into lesions devoid of pigment.

After the operation, new melanocytes are formed in the deep layers of the epidermis. The pigmentation restoration process takes several months.

There are several methods of surgical treatment for vitiligo

• Epidermis transplant. The affected areas of the skin are excised. In their place, an autograft prepared by the PUVA method is placed (a flap of the epidermis from a healthy area of \u200b\u200bthe body).
• Minitransplants. Areas of healthy skin less than 1 mm in size are transplanted into depigmented foci.
• Transplantation of cultured or uncultured melanocytes. Individual cells that produce pigment are implanted into the skin.

Indications for surgical treatment of vitiligo

• The lesions are located on open areas of the body (face, neck, décolleté, arms). They are a significant cosmetic defect and disrupt the patient's psychological status.
• Lack of result from local and systemic therapy for 12 months.
• The disease is in remission. For 1-2 years, new spots do not appear, and existing ones do not grow.

Contraindications:

• tendency to scarring
• intolerance to UFO and laser therapy

Side effects of surgical treatment can be:

• scarring
• uneven pigmentation
• rejection of the transplanted areas of the epidermis

Prevention of vitiligo.

Prevention of vitiligo is especially relevant for people with a hereditary predisposition.

Preventive measures for vitiligo:

• A balanced, nutritious diet rich in vitamins, zinc and copper. Nutritionists recommend consuming regularly:
  • milk products
  • sea \u200b\u200bfish, squid and shrimp
  • liver, rabbit and chicken meat
  • buckwheat and legumes
  • bran, seeds, nuts
  • citrus fruits, apples, figs
  • parsley, spinach, celery.
• Herbal remedies help to normalize the activity of melanocytes. Among them:
  • tincture of mountain arnica
  • rosehip decoction
  • decoction of nettle leaves.
• Avoid prolonged exposure to the sun and tanning beds. Use sunscreen before going outside.
• Avoid rubbing the skin with clothing, jewelry, washcloths, back of a chair, exercise equipment.
• Use hypoallergenic cosmetics for sensitive skin.
• Avoid skin contact with chemically active substances.
• If possible, avoid stressful situations, hypothermia, infectious diseases and other factors that reduce immunity.

For people with vitiligo, these tips will help prevent worsening of the disease.

Vitiligo is a rare autoimmune disease of the skin and subcutaneous tissue in which a person lacks the pigment melanin, which gives the dermis a healthy hue. The stains tend to spread and give the patient psychological discomfort.

The diagnosis of a patient does not cause any difficulties for dermatologists. The spots have a pronounced contrast to healthy skin and dark, uneven contours. Diagnostics is purely visual.

The disease is chronic in nature, has a sluggish progressive form. Pain, tightness, peeling, itching at the site of manifestation of the disease are absent, it is not contagious, does not pose a danger to others. Psychological discomfort and visual defect are the unpleasant sensations that the patient experiences from vitiligo. Signs of the disease can appear at an early age in a child, be congenital, the oldest patient at the time of diagnosis is 80 years old.

In the international classification according to ICD-10 vitiligo is assigned the code L80 in the section "Diseases of the skin and subcutaneous tissue".

Causes and symptoms

The causes of autoimmune skin diseases are not reliably known to medical science. It is believed that the predisposition is genetic, transmitted through the female line, but both male and female persons suffer from the disease. The mechanism of destruction of melanin cells is triggered under the influence of external, internal factors. Most patients claim that before the onset of symptoms, they experienced stress or a series of nervous shocks, suffer from diseases of the digestive tract. The reasons are called exacerbation of digestive problems, diseases of the organs of the system: stomach, liver, pancreas.

Symptoms at the initial stage of development are hardly noticeable to others. One or more white spots may appear on any part of the body. The person does not attach any importance to this. There is a chance that vitiligo will not progress.

Often the size of the spots, their number increases over time, then a person begins to sound the alarm, consult a dermatologist. It happens that spots are present on the body for years without changes, only with a strong shock do new ones appear.

Is the disease dangerous

If the spots are localized on the hands, face of the patient, they cannot go unnoticed by others. An ignorant person may be frightened, keep at a distance from the patient, assuming that the disease has a contact or airborne transmission method.

A person, noticing the reaction of other people, can feel tense, constrained. Vitiligo is not a social disease, it does not depend on the patient's lifestyle, material well-being, the determining factor is heredity, state of health, psychological comfort of a person.

Types and features of localization

The spots appear in places where the dermis is most delicate and the fatty tissue is thinner than in other parts of the body. The skin on the knees, in the popliteal region, hands, head, fingers, feet, face, armpits, groin - the location of the lymph nodes - there vitiligo in the initial stage manifests itself first of all.

The disease is classified according to the number of shades of the affected dermis, the degree of prevalence, the condition of the affected areas: sometimes they have swelling, may not respond to a decrease in temperature, and lose the function of sweating.

In terms of prevalence, dermatologists distinguish between:

• acrofascial pathology - the face and limbs are involved in the process;
• vulgar - foci are spread throughout the body;
• universal (total) pathology, when up to 80% of the patient's body is affected;
• mixed: the patient suffers from several groups of the disease.

Diagnosis of vitiligo

The patient can carry out the initial diagnosis of the disease at home using photographs on the Internet.

Laboratory tests examine biopsy material to rule out serious conditions such as cancer.

In general, the dermis loses its healthy shade due to the fact that a person's own immunity begins to recognize cells as foreign. The attack goes on melanocids, cells that produce melanin, which color the skin in its normal color.

Melanocides are destroyed by the effects of immunity, do not synthesize pigment. It is assumed that the localization of the disease is determined, in addition to internal factors, by skin injuries in depigmented areas, burns, aggressive exposure to ultraviolet radiation, and chemicals.

The peculiarity of vitiligo is that depigmentation has a strong contrast with healthy dermis. The spots are white or milky white, with uneven, scaly edges, the surface is smooth, without redness, inflammation. They are not colorful like birthmarks.

In most skin diseases, the damaged surface has peeling, the patient suffers from itching, sleep is disturbed, and scratches appear. Vitiligo has no clinical manifestations, except for visible light spots that do not hurt, but increase their area. It is not difficult to distinguish them from the manifestations of other diseases; it is impossible to confuse the symptoms.

Depigmentation in the affected areas of the body signals disturbances in the functioning of the body. You can get rid of them if you approach the treatment comprehensively.

Medicine of the 21st century offers many methods of treatment: from the use of hormonal, steroid ointments, to the lamp method, laser manipulations. Medicines are taken orally, applied to sore skin to suppress local immunity. External exposure to a laser or lamp removes the contrast between diseased and healthy parts of the body. Removing a skin defect with its limited prevalence can be done using surgical procedures. If the provoking factor persists, the disease will reappear.

Traditional medicine will also help remove unwanted skin problems. You can treat the affected areas at home with iodine, St. John's wort, sulsen, duckweed, parsnip, subject to strict adherence to the instructions of doctors. The therapeutic and cosmetic effect, under properly performed conditions, will come within six months after treatment. The spots will disappear, the contrast will decrease, and it will be more difficult to recognize the disease visually.

Prognosis and course of the disease

In the absence of adequate treatment, disorders of melanin production can become persistent and progressive. Only a doctor is able to determine the clinical picture of the disease, take into account the indications, contraindications to the use of drugs, and prescribe an effective therapy.

It takes a long time to deal with acquired autoimmune diseases, the result does not always correspond to expectations, but the sooner the patient begins treatment, the more favorable the prognosis will be. Reviews for one drug may vary. In one patient, the appearance of the skin will improve, for another this remedy will not help. Therefore, a specialist should prescribe drugs. The dosage and form of drugs for children is also prescribed strictly by the doctor.

A variety of masking agents will help the patient to look confident during treatment. It will be dangerous and undesirable to stay in the sun in summer: this will aggravate the contrast of diseased and healthy skin, the areas may turn red. Getting sick is always unpleasant, but it is important to remember that autoimmune diseases are successfully treated in the 21st century.

One of the strangest and most unexplored phenomena in medicine today is, perhaps, the disease vitiligo, which occurs when the melanin pigment, which is responsible for the color of the skin, is destroyed. This disease is referred to as immune leukoderma. With the development of this pathology, some areas of the skin become colorless, which visually manifests itself in the form of white spots. The disease can develop regardless of age and can even occur in children.

Modern science and the highest technologies are not able to give answers to some questions related to vitiligo, for example, does the disease affect the internal organs of a person and what is the mechanism of development of the disease. What causes this pathological process and whether vitiligo can be cured will be discussed in this article.

The reasons for the development of this pathology

The disease is not congenital, but occurs in the course of a person's life. Many internal and external causes affect the development of vitiligo, but dark-skinned people are more susceptible to it.

The main provoking reasons are as follows:

• the development of autoimmune processes, that is, the defeat of healthy tissues of the body with antibodies;
• genetic predisposition;
• brown eyes (it has been scientifically proven that those with dark eyes have a higher risk of developing vitiligo than people with blue or green eyes);
• violation of the functionality of the endocrine system;
• dysfunction of the endocrine system;
• injuries affecting the skin, such as burns;
• prolonged exposure to aggressive sunlight;
• long-term medication intake;
• low quality cosmetics;
• exposure to the skin of aggressive chemicals;
• gastrointestinal diseases.

Read about whether vitiligo is contagious and how it is transmitted.

In addition to treatment, patients with vitiligo may need help at a psychological level, since this pathology has a depressing effect on the patient, causing a feeling of inferiority and depression.

Treatment of this disease

There are many methods of treating this pathology, but each of them takes a long period of time and does not guarantee the effect forever. Therefore, many people simply mask spots with foundation.

At the first manifestations of this disease, it is necessary to seek help from a qualified dermatologist working in a medical facility where vitiligo is treated. At the initial visit, the specialist carefully examines the patient and, as necessary, will take biomaterial samples for additional analyzes.

If you do not start timely treatment, then the pathology begins to progress. In addition, concomitant diseases begin to appear, which significantly complicate the treatment of vitiligo.

Is there a cure for vitiligo?

It is necessary to carefully approach the choice of drugs for the treatment of vitiligo. This can only be done by a doctor. Often, at the localized stage of the disease, the patient is prescribed corticosteroid drugs, which have an anti-allergenic effect and also eliminate autoimmune processes. Basically, these drugs are available in the form of creams and gels, and you can also use an ointment for vitiligo. If vitiligo has a generalized form, then pills are prescribed.
The complex of therapy includes the use of an ultraviolet lamp. In this regard, most drugs for the treatment of vitiligo have a photosensitizing effect.

The main objectives of systemic therapy are:

• stabilization of hormonal levels;
• normalization of the patient's psychological state and withdrawal from depression.

Innovative treatments for vitiligo

Laser therapy

Today there are several little-known but effective methods of getting rid of vitiligo in addition to treatment with medicines and vitamins:

• laser therapy;
• whitening of the epidermis;
• surgical intervention;
• ultraviolet irradiation.

There are currently no medications used to treat vitiligo. However, this pathology is a consequence of dysfunctions of some mechanisms of the human body and it is these disorders that need to be treated. Often the doctor prescribes vitamin therapy, which replenishes the supply of macro- and microelements. A patient suffering from vitiligo should use vitamins containing riboflavin, thiamine, ascorbic and pantothenic acids, iron, and copper salts. After each meal, take one percent drops of copper sulfate solution. There is also a high efficiency of treatment with electrophoresis for discolored spots based on a 0.5% solution of copper sulfate.

Laser therapy for vitiligo

The effect of laser radiation on the affected areas will help to eliminate problem areas. Especially effective laser therapy helps in the initial stage of the development of pathology, the signs of which have appeared in the last five days.

To completely get rid of discolored spots on the skin, it is necessary to undergo several sessions of laser therapy. The duration of the procedure increases with each session. In the first stages of treatment, the procedure lasts a few seconds.

Whitening

Whitening the upper layers of the epidermis evens out skin tone and makes blemishes less visible. The whitening procedure consists of injecting a special preparation into the skin. Before making injections, you need to consult a doctor, as they have some contraindications and a number of side effects. The whitening procedure is expensive and requires repeated sessions.

Skin transplant for vitiligo

If the disease affects small areas of the epidermis, then doctors carry out surgery - healthy skin is transplanted to the affected areas. Despite the effectiveness of this method, there are risks that the transplanted skin is rejected and suppurating. In this regard, doctors do not guarantee a 100% result from surgical intervention. Today, scientists are working on the development of a special vaccine that stops autoimmune processes.

Photochemotherapy

The method of photochemotherapy consists in the use of special drugs that increase the level of sensitivity to ultraviolet radiation. Pharmacists have developed such drugs in the form of tablets, ointments and solutions. The doctor prescribes one of these drugs to the patient and combines them with a procedure for exposing the skin to ultraviolet light. That is, the patient takes the medicine orally or applies the drug directly to the site of the disease, and after an hour or two this area of \u200b\u200bthe skin is irradiated with ultraviolet light. To get a positive effect from such treatment, you will need 3-4 procedures per week for a month. You will need several courses of photochemotherapy treatments, which are given at short intervals.

Contraindication to this method of treatment is the following:

• carrying a child;
• the presence of malignant tumors;
• the patient's age is less than 5 years old or more than 60 years old;
• the presence of diseases of the circulatory, cardiovascular, genitourinary, digestive systems.

It is worth noting that this method causes some side effects - nausea, vomiting, itching, blistering, increased pigmentation. The likelihood of developing skin cancer. However, the likelihood of a positive effect is tens of times higher than the risk of negative consequences.

To treat this pathology at home, an ultraviolet lamp 311 is used. The advantages of treating vitiligo with a 311 lamp has the following advantages:

• wide biological effect of ultraviolet radiation (the body's immune defense is activated, metabolism improves, the level of vitamin D production increases);
• does not require additional intake of photosensitizing drugs, which significantly affect the liver and kidneys;
• the likelihood of getting burns or scars is excluded;
• does not contribute to the development of cancer.

Vitiligo and the army - questions answered

Vitiligo - treatment with folk methods

Vitiligo on hands

Vitiligo can also be cured at home. Over the years, adherents of traditional medicine have collected many effective remedies. How to treat vitiligo at home? The main component in most folk remedies for vitiligo is black cumin and St. John's wort.

Method number 1 - using St. John's wort oil

To get St. John's wort oil, you need to finely chop a fresh medicinal plant and place it in a clean jar, pour it with refined sunflower or any medicinal oil (for example, sea buckthorn or almond oil) and leave in a sunny place for two to three weeks. During this time, the jar needs to be shaken from time to time. The resulting solution has little effect. To obtain a highly effective remedy, only the inflorescences of the plant must be used to prepare St. John's wort oil.

Method number 2 - using black cumin oil

This oil is used internally and externally. For external use, before using black cumin oil, the skin must be prepared - wipe it with a cloth or a sponge dipped in vinegar. After applying the oil, you must stay in the sun.

For internal intake, a teaspoon of black seed oil is added to a glass of water and drunk.

Method number 3 - using black pepper

Black pepper contains piperine - a substance that effectively removes vitiligo and gives a special smell and taste to this spice. In order for black pepper to help in the fight against this pathology, it is necessary to mix it with baking soda in equal proportions. The resulting mixture must be rubbed into colorless spots on the skin. Over time, they will disappear and the skin will return to its normal color.

Method number 4 - using the ointment "Sulsen"

You can fix discolored spots at home with Sulsen ointment. The indication for the use of this remedy is the presence of dandruff and / or hair loss. However, the ointment is also effective for skin diseases. "Sulsena" is rubbed into the affected skin and after thirty minutes washed off with warm water. The first results will be noticeable after three or four procedures.

Method number 5 - using birch tar

You can buy this product at the pharmacy. The essence of the treatment of vitiligo with birch tar is that for a month it is applied to the affected areas of the skin. Then a break is made for two weeks and the course of treatment is resumed again.

Method number 6 - using apple cider vinegar

Apple vinegar

There are two ways to treat skin discoloration with apple cider vinegar. When applied externally, they wipe the damaged areas of the skin until the effect is noticeable. To use apple cider vinegar inside, you need to prepare the following recipe: two teaspoons of bite and honey are stirred in a half full glass of water. You need to drink such a solution three times a day half an hour before meals.

Method number 9 - using walnuts

With the help of leaves and pericarp, walnuts allow you to mask colorless spots on the skin. They must be crushed and mixed in equal parts, placed in a container with dark glass and poured with vodka in a proportional ratio of 1 to 10. The container is placed in a cool and dark place for two weeks. After this time, the tincture is filtered, and then 1-2 times a day the stains are wiped with it. Before applying the tincture to the skin, a protective cream is applied to it. The course of treatment is several months.

Method number 10 - treatment of vitiligo with herbal mixture

Mix chopped sage, St. John's wort (4 tablespoons each), a string, calendula (3 tablespoons each), and oregano (2 tablespoons). Pour the resulting mixture into a thermos and pour boiling water (0.5 l). Insist for two hours, then strain and take three times a day half an hour before meals, half a glass. The course of treatment is 7-8 weeks.

Before you start treating vitiligo with folk remedies, you need to consult your doctor. If you neglect the advice of a specialist, you can aggravate the problem, since many folk remedies have contraindications or side effects.

Vitiligo treatment and vitamins

Vitamins with vitiligo are not able to independently cure this pathology. However, they can be used to enhance the effectiveness of the main therapy. To date, there is no special complex designed for patients with this diagnosis. In each individual case, doctors examine the patient and determine which vitamins are insufficient in his body.

There is a standard set of vitamins that a person with vitiligo can take. It includes B vitamins, as well as vitamins C and E (ascorbic, folic and pantothenic acids, tocopherol).