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When to Consider Surgery or Depigmentation for Vitiligo

Depigmentation
Depigmentation involves fading the rest of the skin on the body to match the already-white areas. For people who have vitiligo on more than 50 percent of their bodies, depigmentation may be the best treatment option. Patients apply the drug monobenzylether of hydroquinone (monobenzone or Benoquin®) twice a day to pigmented areas until they match the already-depigmented areas. Patients must avoid direct skin-to-skin contact with other people for at least two hours after applying the drug.
 
The major side effect of depigmentation therapy is inflammation (redness and swelling) of the skin. Patients may also experience:
 
  • Itching
  • Dry skin
  • Abnormal darkening of the membrane that covers the white of the eye.
 
Depigmentation is permanent and cannot be reversed. In addition, a person who undergoes depigmentation will always be abnormally sensitive to sunlight.
 

Surgical Treatment

All surgical treatments for vitiligo must be viewed as experimental because their effectiveness and side effects remain to be fully defined.
 
Surgical methods of treating vitiligo include:
 
  • Skin grafts from a person's own tissues (known as autologous skin grafts). The doctor takes skin from one area of a patient's body and attaches it to another area. This is sometimes used for people with small patches of vitiligo.

 

  • Tattooing small areas of skin.
     
Autologous Skin Grafts
In an autologous skin graft, the doctor removes skin from one area of a patient's body and attaches it to another area. This type of skin grafting is sometimes used for patients with small patches of vitiligo. The doctor removes sections of the normal, pigmented skin and places them on the depigmented areas. There are several possible complications associated with autologous skin grafting. Infections may occur at the donor or recipient sites. The recipient and donor sites may develop scarring, a cobblestone appearance, a spotty pigmentation, or may fail to repigment at all. Treatment with grafting takes time and is costly, and most people find it neither acceptable nor affordable.

Vitiligo Skin Disorder

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