Vitiligo: causes and treatment in adults.

Dermatovenerologist (1 KO, 1/35)

Kintaev

Azamat Samuratovich

7 years experience

Dermatovenerologist

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Vitiligo is a pathology characterized by discoloration of the epidermis. Light spots (usually irregular, random shapes) appear on the skin, which remain that way forever and do not restore their color. The darker the skin, the more noticeable the effect.

Vitiligo is localized anywhere - on the arms, legs, torso, face, scalp and even in the mouth. Moreover, it is impossible to predict the localization - the color of the skin is lost without any logic.

Causes and main manifestations

At the moment, medicine does not know 100% what the causes of vitiligo are. But there is an understanding of how this process occurs. Special melanocyte cells and the amount of melanin in them are responsible for the color of our skin. When such cells begin to die, areas of the skin are provided.

The factors that trigger this process are still in question. But doctors suggest that the following points contribute to this:

autoimmune problems. It is assumed that for some reason melanin is destroyed by the protective cells of the body’s own;
genetic factor. Vitiligo syndrome is often observed in children and grandchildren of those people who suffered from this pathology;
serious stress that can cause absolutely any malfunction in the body;
severe effects on the skin, such as contact with harsh chemicals or sunburn.

Often it is not possible to establish the cause of the manifestation, but doctors try to at least exclude some factors so that there are no other problems in the body.

Factors contributing to the development of vitiligo

The exact causes of vitiligo are still not understood. However, a number of observations have shown that most often the disease occurs after severe stress and nervous shock. Autoimmune diseases can also be the cause, and deviations in the functioning of the endocrine system, inflammation of the thyroid gland and adrenal cortex can also play a role. Sometimes there is a hereditary factor, but it is not at all necessary that if one of the parents had vitiligo spots, the child will inherit them. General recommendations for avoiding vitiligo spots are simple - maintain a healthy lifestyle, eat right, consume the required amount of vitamins and minerals, take sunbathing, harden yourself (to strengthen the immune system), avoid stress and nervous shock.

How the disease begins and progresses: clinical manifestations

Most often, the first signs of the disease appear before the age of 20. Moreover, the disease vitiligo immediately begins in those places that have more contact with the sun - on the arms, face, legs.

The spots can be located symmetrically, covering large areas of the body, but they can appear only on one side of the body or cover a relatively small area. It is not uncommon for the spots to progress for a relatively short time (a year or two) and then stop growing. At the onset of vitiligo, it is very difficult to say how much tissue will be affected and whether it will stop at a certain level. Most often, there are cases when the spots gradually grow and cover more and more skin.

Treatment of vitiligo in Moscow

Faced with such a problem, the patient, of course, is interested in how to cure vitiligo. Let us clarify right away that there are no 100% effective methods. Some treatment options can significantly slow down the process of tissue lightening - but there is always a risk that it will start again. It is easiest to achieve results in the early stages of the disease.

Now there are drugs for the treatment of vitiligo, but their effectiveness is not very high, so doctors prefer an integrated approach. Depending on the specific situation, vitiligo is treated using:

some hormonal drugs. Usually they choose softer and more gentle ones;
glucocorticoid creams. Under no circumstances should you prescribe such drugs yourself - they have serious side effects if used incorrectly;
ointments for vitiligo with pimecrolimus or tacrolimus. They are prescribed for minor skin lesions and are often combined with phototherapy;
PUVA therapy. It involves the use of drugs based on psoralen, as well as UV rays. The therapy is long-term, it usually lasts for six months to a year and is repeated several times a week.

Since vitiligo in humans gives an undesirable aesthetic effect, if the spots are not too pronounced, the skin color is evened out using healthy areas - they are lightened, which makes the spots less noticeable.

Drastic methods of treating vitiligo include skin transplantation, which is not recommended by doctors, since instead of an aesthetic problem, you can get the risk of serious complications.

How to cure vitiligo (dog) forever

They say that, despite taking various droppers, there is no cure. Why? My most important advice: be treated only by an experienced dermatologist, do not self-medicate, do not look for miracle cures, do not follow the recommendations of friends and patients with vitiligo, or pharmacy employees. The treatment for each patient is individual; a dermatologist will select it for you; there is no single template for everyone.

Here is a review from the mother of one of my little patients, three-year-old Ravil, who developed white spots on the external genitalia, around the anus. “We are satisfied with L.V. Belova. We heard about it from people who were cured and came from afar. The doctor examined Ravil very carefully, the tests were ready on the same day. Ravil was found to have worms and lamblia. Lyubov Vladimirovna prescribed treatment at home on the same day, wrote and explained everything in detail. We stayed in Tashkent for only one day. Then they called several times and talked about Ravil. The spots have completely disappeared. We spent very little money on medicine. We were very lucky with the doctor. Just miracles! Sincerely, Nailya Nuriyeva, Termez.”

Vitiligo treatment is carried out individually, taking into account the results of the examination, concomitant diseases, age, and tolerance. Dermatologist in Tashkent Lyubov Vladimirovna Belova will help you in the treatment of vitiligo!

Self-medication: does it work?

Home remedies are not a treatment, but rather a prevention of vitiligo. To keep your skin in good condition and protect it from unnecessary stress, we recommend:

use remedies against the harmful effects of the sun. These are creams with SPF, which are available for both the body and face. It is recommended to apply such creams in a sufficient (thick) layer, and also to constantly renew them if required by the instructions;
choose safe self-tanning products – at the moment these are formulations with dihydroxyacetone;
strengthen the immune system, monitor the quality of tests. If necessary, take courses of vitamins (on the recommendation of an endocrinologist);
monitor your psychological state. Since psychosomatics for vitiligo is considered one of the probable causes, it is necessary to take care of your peace of mind and comfort.

It is believed that the condition of the skin is improved by decoctions and compresses (for example, from radish seeds), as well as tinctures for internal use - based on chamomile, St. John's wort, oregano and other herbs. It is important to understand that all these remedies will not help stop the disease or reverse it. These are auxiliary options for maintaining immunity. But be careful: natural remedies also have side effects and can cause allergies.

Vitiligo - causes, symptoms, signs, diagnosis, treatment of pathology, photo

If one or more white spots appear on the skin, then you need to go to an appointment with a dermatologist. He will examine the skin using a specialized lamp and determine the nature of depigmentation. If necessary, material will be collected to clarify the diagnosis. These procedures are important because it is necessary to be able to distinguish vitiligo from other skin diseases.

As for therapy, despite the medical cases of complete and spontaneous healing from vitiligo, there is a high risk that the disease will progress without appropriate treatment. Due to the fact that pathology is often accompanied by concomitant diseases, it is important to correctly use drugs from various groups.

Treatment with glucocorticoids (drugs aimed at suppressing autoimmune processes and allergic reactions) is indicated for:

Localized form of the disease. In this case, it is advisable to use ointments. To begin with, drugs with average activity are prescribed. Among them are hydrocortisone butyrate, Esperson, Alcomethasone, Fluorocort, Triacort and others. The course must last at least 3 months. If no effect is observed, then ointments with higher activity are indicated. Among them are Elokom, Cutivate, Sinalar, Dermovate, Beloderm and others. These products cannot be used without interruption for more than 8 weeks. The course will need to be repeated after 1 to 4 months.
Generalized form of the disease.
However, in this case, the use of drugs in tablet form is indicated. Since when taking glucocorticoids orally there is a high risk of developing diabetes mellitus and Iceno-Wushing syndrome, it is necessary to use pulse therapy in parallel, and take the drugs themselves intermittently. Among this group of drugs used to treat the generalized form of vitiligo, Triamcinolone, Dexamethasone, Prednidosolone, Methylprednidosolone can be distinguished. Since ultraviolet lamps are often used to treat vitiligo, doctors prescribe photosensitizing drugs to patients. They increase the sensitivity of melanocytes to ultraviolet radiation.

Among plant furocoumarins we can distinguish:

Containing bergapten and xanthoxin Beroxan;
Containing one xanthoxin Puvalene, Oksoralen, Lamadin, Methoxalen;
Containing imperatonin and xanthoxin Meladinin;
Containing xanthoxin, bergapten and isopimpinellin Ammifurni;
Psoberan isolated from figs;
Psoralen, isolated from psoralea.

In addition, there are such products as Elidel and Protopic. They are most often prescribed for the treatment of psoriasis and various dermatitis. But in some cases they are effective in the fight against vitiligo. They are used externally and have an anti-inflammatory effect, suppressing T-lymphocytes and inhibiting the body's immune response. Their action is in some way similar to the effect that can be achieved using glucocorticoids.

Elidel and Protopic can be used in both adults and children. However, the concentration of the active substance in ointments will vary (for children - 0.03%, for adults 0.1%). Treatment should be a course and, depending on the stage and form of the disease, can last from three to six months. The advantage of these agents is that they are not absorbed into the blood, having a local effect.

Systemic therapy is aimed at eliminating hormonal imbalances, lifting patients out of depression, and eliminating mental and other diseases of the nervous system, which are often triggers in the development of vitiligo. It is important that the patient replenishes the deficiency of microelements and vitamins. Therefore, he is indicated for the use of complexes containing ascorbic acid and copper. Your doctor may also prescribe antioxidants and immunomodulators.

Medicine does not stand still and methods for treating vitiligo are constantly being improved. New ways to combat the disease include:

Treatment using laser or laser therapy. In this case, the affected areas of the skin are exposed to radiation having a certain wavelength. This method is similar to phototherapy. The greatest effect can be achieved in the treatment of local forms of the disease (for patients with segmental, focal and vulgar forms), when the patient has suffered from vitiligo for no more than five years. There is no need to spend a long time under the laser; the initial procedures only take a few seconds.
Skin whitening helps make spots less noticeable. At the same time, its tone is evened out. For this purpose, various injections are used, the most popular are Eloquin, Monobenzone and Hydroquinone. But before deciding on such procedures, it is worth learning more about the presence of contraindications, since each of these drugs is very aggressive and has certain side effects. In addition, the drugs are expensive and will need to be administered regularly.
Surgical intervention (melanocytic transplantation). If vitiligo does not affect large areas of the skin, then you can resort to surgery and autologous transplantation. But this method is fraught with complications in the form of rejection and suppuration of the transplanted area. In addition, no doctor can guarantee a stable and long-lasting effect.
Transfer of a person’s own pigment cells (melanocytes) from undamaged areas of the skin to the problem area.
The use of Melagenin plus is an alcoholic extract isolated from human placenta. The drug is most effective if the patient suffers from a localized form of the disease.
Sceness drug. In the future, a drug developed in Austria called Sceness may be used to treat vitiligo. It is currently used for the treatment of erythropoietic protoporphyria.

In addition, scientists are not abandoning attempts to develop a vaccine that can eliminate the autoimmune reaction that leads to the development of the disease.

In addition, increasing evidence indicates that combination treatment, when surgical treatment is complemented by several non-surgical methods, is most effective.

Also, in rare cases, the doctor is able to detect a connection between vitiligo and an external or internal factor. By eliminating them, you can stop the pathological process. In particular, by ridding the patient of helminthic infestation or stopping contact with a certain chemical.

As for recommendations regarding the patient’s diet, he needs to include foods fortified with copper in his diet. Among these: seafood, apples, tomatoes, cabbage. In addition, it is worth including rice, oats and corn in your diet, as they contain zinc.

Treatment of vitiligo with folk remedies

Before using folk remedies for vitiligo, be sure to consult your doctor!

St. John's wort oil for vitiligo.

St. John's wort oil stimulates melanocytes to produce melanin, which is actually responsible for skin pigmentation. To prepare it, you need to fill a small glass jar with St. John's wort flowers, lightly crush them in the jar so that about 5 cm remains to the edge of the neck. Next, fill the flowers with refined sunflower oil, filling the remaining empty space with it, and place the jar with the mixture in the sun for 2 weeks , stirring it periodically. After 2 weeks, you need to squeeze out the oil, add a new portion of St. John's wort flowers to it, and again put the jar with the mixture in the sun for 2 weeks. This procedure must be done 6 or more times until the oil becomes red-brown and thick, which will indicate its high concentration. St. John's wort oil is used externally as an ointment for vitiligo, sore throat, flu, muscle strain, radiculitis, osteochondrosis, cuts, burns, neuralgia and tumors. It is also effective for gastrointestinal diseases if taken orally, 1 teaspoon before meals.

Black cumin oil for vitiligo.

It has not only photosensitizing properties, but also a general strengthening effect and helps with fatigue. Before external use, the skin should be lubricated with vinegar, then black cumin oil should be applied and rubbed into it. Next, you need to walk down the street for about 30 minutes and take a sunbath. You can take it orally 2 times a day, 1 teaspoon diluted in 100 ml of water.

Duckweed for vitiligo.

It helps due to the iodine and bromine salts it contains. Used as a tincture. To prepare a tincture of duckweed, thoroughly rinse the required amount of duckweed under running water, then place it in a dark glass container and fill it with vodka (or alcohol diluted with water), in the proportion of 1 teaspoon of duckweed per 50 ml of vodka. Next, set aside the infusion product in a dark place at room temperature for a week. Then strain the product and take the prepared duckweed infusion, 15-20 drops diluted in a quarter glass of water, 3 times a day.

Black pepper.

Black pepper contains a substance called piperine, which stimulates the production of melanin. To prepare a white spot remover, mix equal parts black pepper and baking soda. Rub the resulting mixture into the skin with white spots. Over time, the white areas of the skin should return to their natural healthy color.

Sulsena paste (2%).

This paste is an inexpensive remedy for dandruff and hair loss, which can be purchased at the pharmacy. It can be rubbed into the white spots of vitiligo for about 30 minutes, then rinsed. After a few uses, the stains should go away.

Birch tar for vitiligo.

Apply birch tar to white spots for a month; if the spots do not disappear completely, take a break and repeat the course of treatment. Vitiligo usually goes away in 1-2 courses. This product can be purchased at a pharmacy.

Garlic and onion.

Rub for 5-7 minutes daily, but take turns onion and garlic in places with white spots, one day garlic, the other - onion.

Walnut for vitiligo.

Place the pericarp and leaves of the walnut in a dark glass container and fill them with vodka, in a ratio of 1 part of the mixture to 10 parts of vodka. Leave the mixture to infuse in a dark place for 10 days. Then apply the prepared infusion of walnut parts externally, lubricating vitiligo-damaged areas of the skin for several months. Before use, treat healthy skin around the spots with phytoprotective cream.

Other Treatments for White Spots

Laser therapy

— treatment of vitiligo with a laser with a specific wavelength. It is used in the treatment of a local form of the disease that is not older than 5 years.

Skin whitening.

The skin tone is evened out by introducing injections into it: “Hydroquinone”, “Monobenzone”, “Eloquin”. These drugs have a number of contraindications and side effects, because are aggressive drugs, so these procedures are carried out strictly under the supervision of a doctor.

Transplantation.

The treatment method is based on the transfer of melanocytes (pigment cells) from healthy skin to problem skin.

Additional treatment for vitiligo

In combination with the above therapy, the following is used:

removing the patient from mental imbalance, depression;
normalization of hormonal levels;
additional intake of vitamins and microelements, especially emphasis is placed on ascorbic acid (vitamin C), retinol (vitamin A), tocopherol (vitamin E), B vitamins (B1, B2, B5, B9 and B12), alpha-lipoic acid, copper and zinc.
taking immunomodulators and antioxidants.
prevention of helminthic infestations.
preventing contact with various chemicals that may be the root cause of the appearance of white spots on the skin.
diet: the emphasis is on eating foods fortified with copper (cabbage, tomatoes, apples) and zinc (oats, rice, corn).

Questions and answers

We will answer the most popular questions related to the causes and treatment of vitiligo.

Can vitiligo be cured?

The doctor can give specific forecasts during the treatment process, when it becomes clear how effective the chosen regimen is. But remember that existing spots will not completely disappear and relapses are always possible.

What is vitiligo in girls?

In girls, like men, children and the elderly, vitiligo is discolored areas of the skin that appear as a result of the destruction of melanin. It is not contagious and not dangerous.

How to cure the disease forever?

Unfortunately, there is no way that would help get rid of the problem forever and “roll back” the consequences of the disease back to uniform, blemish-free skin.

Treatment

Therapy for vitiligo must be comprehensive. Treatment should include:

Glucocorticosteroids and calcipotriene. Various applications, creams, and injections into the affected areas are used.
If the skin of the face and groin area is affected, use calcineurin inhibitors (externally).
PUVA therapy method. Vitiligo spots are irradiated with UV radiation. This method has proven itself well - usually 3-5 sessions are enough for pigmentation to resume in the affected areas.
Phytotherapy. The use of various medicinal herbs, such as echinacea, duckweed and St. John's wort, has proven effective in the treatment of vitiligo. Infusions and decoctions are used both for local treatment of stains and for oral administration. However, the first result of treatment can be observed no earlier than 6 months after the start of treatment.
Protecting skin from exposure to sunlight. those areas of the skin that are affected by spots are characterized by an increased tendency to sunburn: even a short walk can cause unpredictable consequences. This is why it is so important to protect the skin under clothing and use special creams.

Important: Under no circumstances should you self-medicate! Even if the skin rashes are isolated, it is imperative to seek help from a dermatologist. Only a qualified specialist can make the correct diagnosis and prescribe appropriate treatment. The patient’s task is to visit a doctor as soon as possible in order to prevent further spread of the pathological process to other areas of the skin.