What is Vitiligo?
Vitiligo simply put is discoloration of skin in patches resulting from depigmentation. The patches are most commonly seen on the face, lips, insides of the mouth, extremities and the back. Although there is no cure for Vitiligo, the goal of Vitiligo treatment is to restore complete tone and pigment of the skin that matches the surrounding skin. Different techniques like surgery, grafting, cosmetic makeup etc are used to treat and hide Vitiligo spots.
Sometimes, the Re-pigmentation treatment for Vitiligo may not show satisfactory results. The patient may develop uneven color tone on the skin and in such a situation a De-pigmentation therapy may be useful.
There are some guidelines that must be followed before opting for a Depigmentation therapy.
The patient is
- Unresponsive to therapy
- Desire for an alternate to repigmentation therapy
- A major part of the body is affected. More than 50% of body surface
- Willingness to accept that re-pigmentation is not an option anymore
Benefit of De-pigmentation Therapy
Patients may feel even more dissatisfied with their repigmentation therapy gone wrong. Patches of brown and white may be even more visible and evident to others. For the patient, cosmetic disfigurement can cause reduced quality of life. Depigmentation will evenly create a white tone throughout the skin which may help the patient restore a normal life.
How is De-pigmentation achieved?
Mononbenzyl Ether of Hydroquinone (MBEH) or Monobenzone is used for de-pigmentation of the skin. Applying a topical cream containing MBEH causes loss of melanocytes leading to de-pigmentation of the skin.
The doctor prescribes an MBEH cream to the patient which is applied to a small part of the skin, once a day for a week. This ensures the skin is not sensitive to the cream and is not causing skin irritability or complications. Afterward, it is applied, two times a day, on the desired area. Patients notice gradual dilution of skin color eventually turning white.
It is not advised to apply cream to entire body at one time. Application of monobenzone at one site usually leads to activation of Vitiligo resulting in loss of skin color at distant sites
How long does depigmentation therapy last?
The entire process of complete depigmentation lasts for a duration of 1 to 2 years. Some patients may even take up to 4 years.
Should one avoid the sun?
When exposed to the sun, a patient may experience re-pigmentation, therefore avoiding exposure to the sun is recommended. Skin with restored tone can again be treated with application of Monobenzone.
Will the color of hair and eyes change?
No. The cream does not affect melanocytes of hair and therefore will not make your hair grey. One should avoid applying the cream around eyelids which may cause loss of melanocytes in eyes.
Are there any bad effects of MBEH cream?
A common side effect of skin depigmentation therapy is irritation caused by the cream. One should first do a skin irritation test on a small part of skin for a week before starting the treatment. One can also opt for a lower concentration of the MBEH cream (5%) and gradually increase it to 20%.
What are the precautions?
- Avoid application close to the eyelids and eyes.
- Avoid application when you are going to bed
- Avoid contact of the cream with others. Avoid skin-to-skin contact with others.
- Avoid direct sunlight.
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