Vitiligo treatment can be effective. Vitiligo is a common condition in Brisbane, and affects up to 2% of the population. This skin condition causes a loss of melanin, the pigment that determines the colour of your skin. Vitiligo is more common in skin of colour and usually affects the skin around the eyes, mouth, elbows, knees, armpits and genital areas. The 20 week vitiligo challenge program uses anti-inflammatory creams and narrowband phototherapy to halt the immune attack on pigment cells and stimulates pigment cells to reproduce- this results in re-pigmenation of white patches.
- Vitiligo presents as white patches on the skin
- The most frequently affected areas are around the eyes, mouth and face
- The knees, elbows and hands may also be affected by vitligo
- Armpits and genital regions are frequently involved
- Vitligo affects all ethnic races, but predominantly affects people with darker skin types
- Treatment of vitligo is with phototherapy, and anti-inflammatory creams
- My success rate is up to 90% re-colouring
- Vitiligo on the face responds best to treatment
- Vitiligo on the hands and feet respond poorly to treatment
- Narrowband phototherapy should be continued for 20 weeks as an initial test to see if you respond to this treatment
- All phototherapy sessions are bulk billed, so this treatment has no out of pocket expense
Vitligo is an immune condition where your body attacks the pigment producing cells in your skin. These pigment cells are called melanocytes. Once under attack, these melanocytes hide in your hair follicles. Vitiligo treatment is aimed at stimulating the pigment cells to reproduce melanin.
Vitiligo can be associated with other immune conditions such as vitamin deficiencies, diabetes and thyroid disease.
Vitiligo occurs when the pigment producing cells called melanocytes disappear.
The internet is full of promised ‘vitligo cures’, ranging from tablets, thru to creams and hand held light devices. From a Specialist point of view, where vitligo is scientifically managed and skin repigmentation measured, there are only a few proven combinations that actually work-
Vitiligo treatment -summary
Anti-inflammatory creams: These include Vitamin D creams, Calcineurin inhibitors and anti-inflammatory corticosteroid creams. They all work by stopping the attack of your immune cells on pigment producing cells called melanocytes. A combination of creams works best.
Narrowband phototherapy: This is medically prescribed phototherapy using light at 311 nm. Phototherapy has to be conducted at least twice a week to stimulate melanin in vitiligo patches. (Ideally 3-4 times per week gives optimal results)
Vitamin D supplementation: A recent article published in 2014 suggests the use of Vitamin D tablets for supplementation in patients with vitiligo.
Prostagladin Inhibitors: Emerging research has shown that this group of anti-inflammatory creams can help re-pigment patches of vitligo. Creams should be combined with narrowband phototherapy.
Ginkgo biloba extract: One non- controlled study in India conducted in the early 2000s showed ginkgo supplements can help with skin repigmentation.
Vitiligo treatment using a combination of creams, and narrowband phototherapy gives the highest success rate of re-colouring your skin.
Creams are used on a nightly basis, and phototherapy should be performed 2-4 times per week.
The success rate of re-colouring patches of vitiligo is mostly dependent on the areas involved, as a guide-
- Facial vitiligo – 90% chance of re-pigmentation
- Vitiligo on chest and body- 50-75% chance of re-pigmentation
- Acral vitligo (hands and feet)- 10-20% chance of re-pigmentation
Another important clue as to whether your vitligo will respond to phototherapy and creams is the presence of hair follicles that are pigmented. The more pigment in your hair follicles, the higher the success rate.
More on the vitiligo Challenge20 program
This represents my average success rate for treating vitiligo.
Vitiligo treatment – dual therapy
Both treatments are essential for optimal success because the aim of the program is to stop your immune cells from attacking your pigment cells, and to stimulate any remaining pigment cells to re-colour the white patches of vitligo.
Anti-inflammatory creams such as Tacrolimus, Vitamin D and pulsed corticosteroids halt the immune attack.
Narrowband phototherapy stimulates the pigment cells hiding in your hair follicle to re-populate vitiligo affected skin, leading to re-pigmentation. If you have creams without phototherapy, the success rate of treating vitligo is low.
More on the vitiligo Challenge20 program
The initial vitiligo consultation cost $ 230 and is partially covered by Medicare, providing you have a valid referral from your GP.
All phototherapy sessions are bulk billed with no out of pocket expenses. Cream cost approximately 50 cents per day, and can be purchased via myskinpharmacy.com.au (compounded creams).
Phototherapy is offered at Westside Laser Dermatology in Taringa, Brisbane.
Make sure you have a valid referral and ask for a HOLD FOR VITILIGO SLOT under Dr Davin Lim. Westside Dermatology contact – 3871 3437
As part of the 20 weeks Vitiligo skin repigmentation challenge, you will need at least 50 sessions of phototherapy to see if your vitiligo will respond to this treatment method.
More on the vitiligo Challenge20 program
Yes, medically prescribed narrowband phototherapy is very safe with no risk of skin cancer. The current European studies on phototherapy has shown that up to 500 lifetime treatments are safe. This means if your vitligo returns, repeat sessions are possible.
Sunlight contains a spectrum of wavelengths delivered over a long period of exposure. Some wavelengths promote skin cancer whilst others accelerate skin ageing. Narrowband phototherapy, delivered medically takes only a few seconds to minutes to perform and uses only one wavelength 311nm of UVB. This wavelength can halt the immune system from attacking pigment cells, but most importantly promotes re-pigmentation in vitiligo affected patches.
Side effects are very rare following narrowband treatment. The most common side effect is skin darkening, as the rest of your skin is treated, along with patches of vitligo. You can reduce skin darkening by applying sunscreen to areas not affected by vitligo.
Yes however the success rate is low. I have performed clinical trial over the years using several types of lasers to repigment skin affected by vitiligo. These include Fractional laser resurfacing as well as Eximer 308 laser.
For fractional laser resurfacing, only 5% of patients respond to this treatment, and this has to be used in conjunction with phototherapy. Pigmentation, if it returns is never complete, and always patchy.
308 Eximer laser is a much more effective treatment, and works on the same principle as phototherapy- namely to stimulate pigment cells to produce melanin. The advantage with Eximer laser over phototherapy is that individual spots can be treated within seconds, saving time and exposure of skin unaffected with vitiligo. The done side of Eximer laser is the cost- each treatment is over $75, and is not covered by Medicare, making this a very expensive method to repigment skin.
No. In 95% of cases this condition can be easily diagnosed.
As previously discussed, I always work in with your GP to obtain annual blood test to look for conditions such as diabetes and thyroid disease that can be associated with Vitiligo.
Vitiligo treatment -diets and supplements
Diet, vitamins and supplements can play a role in re-colouring white patches of vitiligo. There are now several scientific papers on the use of vitamins and natural remedies that can help. Vitamin D, folic acid, low acidic foods and ginko can all help
A referral from your GP is needed to see a Specialist as this will enable you to claim back a percentage of the initial consultation and all of the phototherapy sessions. Note – treatments are free as Phototherapy is under Medicare.
If you close to Taringa or are in the Western Suburbs, call Westside Laser Dermatology on 3871 3437 and make an appointment with Dr Davin Lim.
Yes! In fact if you hold a Medicare card, all phototherapy sessions are bulk billed, so no out of pocket expenses are incurred.
Anti-inflammatory creams are not expensive, and cost less than 50 cents a day!
Vitiligo Treatment & Medical Insurance
In most cases they do, however you individual circumstances may vary. Ask your Health Insurance if they cover vitiligo treatment using NARROWBAND PHOTOTHERAPY by a Dermatologist before making an appointment. Once again, if you hold a Medicare card- this treatment is fully covered.
By Dr Davin Lim
Vitligo is a very common condition, and I have at least 150 patients under my care every year. The chances of re-pigmenting white patches depends on 3 important factors, the area of vitiligo- patches on the face, chest and upper back respond best, whilst vitligo on the hands and feet/ fingers and toes have a poor response rate. Secondly, the presence of pigment within the hair follicles of vitiligo patches- repigmentation occurs from both the surrounding skin and within the hair follicle. Lastly – the commitment from the patient to undertake both phototherapy and use creams on a nightly basis. This combination treatment is the basis of the 20 week- vitiligo challenge program. Re-colouring can be seen in over 90% of cases, especially for face vitiligo.Motivation equals success.