Many patients with white patches are diagnosed with a skin pigment disorder known as Vitiligo. A person having Vitiligo may show discolouration of skin at many different locations including face, body, armpits, legs and even eyes and insides of the mouth. With dark skinned people, the white blotches are much more noticeable.
Vitiligo affects around a million cases per year in India. Usually, the blotches occur on both sides of the body and can affect any part that has skin pigment(melanin). It is seen that white patches occur on areas exposed to the sun. The severity and rate of pigment loss vary from person to person and cannot be predicted. On noticing white patches on the body or face, a medical diagnosis can help in determining the cause as Vitiligo and present treatment options available for the patient.
Treatment Options for Vitiligo Patients
Patients opt for coping strategies by hiding the white patches using clothing or cosmetic products, and even creams, tablets and phototherapy. But when nothing works, a surgical treatment may be considered as an option for patients with stable Vitiligo.
Surgical techniques for treating Vitiligo
The goal of Vitiligo surgery is to restore complete tone and pigment of the skin that matches the surrounding skin. But there are certain factors that must be confirmed before opting for surgical procedures:
The factors are:
- Patient’s age
- Vitiligo Stability
- Size and location of the patch
- Surgical procedure and grafting site
Different types of Vitiligo Surgery
All surgical methods aim to transfer melanocytes (pigment-producing cells) from normal skin to the skin affected with white patches.
Skin grafting is also a common technique in which the normal skin is surgically transplanted to the affected area, causing the new skin grafts to produce skin colouring pigments.
The surgical procedure is only performed on patients with a stable vitiligo that has not increased for at least six months.
Skin grafting is highly popular as it shows a success rate of 80 to 90% in patients.
The two main categories of Surgical treatment for vitiligo are Grafting of melanocyte-rich tissue (tissue grafting) and Grafting of melanocyte cells (cellular grafting).
The Grafting of melanocyte-rich tissue is performed by these three techniques
- Miniature punch grafting (MPG)
- Suction blister grafting
- Split thickness skin grafting
The grafting of melanocyte cells is performed by these techniques
- Autologous non cultured epidermal cell suspensions
- Cultured melanocyte suspensions
The Melanocyte transplants procedure involves melanocytes and keratinocytes in the top layer of dermal tissue removed surgically under local anesthesia and grown in a culture for one day. The grown tissue is then placed on the vitiligo patches
The therapy shows best results for stable vitiligo with large white patches as the pigment cells restore the skin color and tone.
The Melanocyte transplant surgery has a success rate of 95% in patients and is considered one of the best options for Vitiligo surgical treatment.