5 TYPES OF BLACK SPOTS ON FACE

WHAT ARE VARIOUS TYPES OF BLACK SPOTS ON FACE?

Black spots on face can be either types:

1.Freckles: Scattered multiple tiny brown to dark brown flat spots. They occur mainly due to sun exposure in fair individuals. Genetic predisposition also play a very important role in there occurrence. They mainly occur in fair individuals.

Freckles 

2. DPN: Dermatosis Papulosa Nigra : Scattered multiple tiny, slightly raised above skin surface. They mainly occur in darker races. 

DPN: Before After 

3. Moles: Can vary in size from 0.5 mm to 5 mm. Occurrence is usually without any cause. They is no reason behind their occurrence. 

Moles : Before After 

4. Sebborhoeic Keratosis: Black spot raised above skin surface, rough and irregular to touch. Sun exposure and ageing the main causative factors. Thus, seen in older age groups.

5. Lentigens: Jet black, well defined flat black spots.

All are harmless skin conditions. People seek removal only for cosmetic concerns.

WHY ARE BLACK SPOTS FORMED FORMED?

Black spots are formed because of either of the following reasons:

  1. Sun exposure
  2. Ageing and Passing years
  3. Genetic tendency to get them
  4. They may occur without any cause in many

HOW CAN THEY BE TREATED?

Single session of laser can cure them. Either Co2 ablative laser or radiofrequency would do. Both ablate the spots with precise heat. Very large moles may require surgical excision. 

Swelling and redness seen immediately after black spot ablation with laser. 

CAN’T CREAMS AND PILLS REMOVE BLACK SPOTS?

No, because creams don’t penetrate deep enough into skin to remove them. Neither are they that strong to ablate a black lesion. Also when creams and lotion are used to burn something on skin, we cannot control their penetration into skin. Lasers are controlled, thus a better option.  

IS IT SAFE TO REMOVE BLACK SPOTS WITH LASER?

Yes, absolutely provided done by a dermatologist using high quality laser.

IS IT PAINFUL?

No, since done after application of numbing creams.

WILL BLACK SPOTS ONCE REMOVED RECUR?

The ones removed won’t recur but the new ones can come,since causative factor can’t be removed. But the new ones come at very slowspeed. It’s not that one got black spots removed and within a month new onescame. New ones takes 1 to 3 years to come.

IS THERE ANY POST TREATMENT HEALING TIME?

Yes, immediately after the treatment there is redness and swelling, which goes off in one to two hours. Black crusts are formed at the points where laser is given next morning. They fall off own it’s own in 4 to 5 day’s time. Leaving behind clear skin.

CAN ONE DO ANYTHING TO PREVENT RECURRENCE ?

Nobody can stop ageing. Sun protection can help up to a certain extent to prevent new ones from coming. 

CONCLUSION: Black spots on face can be of various types. Single session laser would help you get rid of them. Creams and pills don’t cure them.

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SKIN TAGS: CAUSES AND TREATMENT

WHAT ARE SKIN TAGS?
Small skin colored extensions seen usually on skin folds like underarms, neck, eyelids etc. 
These are harmless, people seek removal mainly because of they cosmetically don’t look good.

SKIN TAGS REMOVED WITH LASER

WHY DO THEY APPEAR?
S
kin tags primarily appear due to ageing. It’s commonly seen in people after forties. Other causative factor is to constant friction at skin folds. Diabetes, obesity and genetic predisposition are other factors. At times constant friction caused by heavy chains around neck too add as additive causative factors. 


WHO CAN GET THEM?
Anyone can get them after forties. People with diabetes, overweight and genetic predisposition are more prone to have them at early ages of life.


HOW TO GET THEM REMOVED?
Co2 ablative laser or radiofrequency ablation would remove them effectively and safely.

SKIN TAGS ON EYELIDS


HOW MANY SESSIONS ARE REQUIRED?

Single session would suffice to remove the skin tags. It may take around ten minutes to an hour to remove them completely. Time involved depends upon the number of skin tags.

 
IS IT PAINFUL?
Since done after application of local anesthesia,procedure is pretty comfortable.


ARE THERE ANY SIDE EFFECTS?
None provided done by an expert using a good quality equipment.


WILL THEY LEAVE ANY MARKS?

No, if done by an expert’s hand. They don’t leave marks because of their superficial origin in skin. 

WHAT ARE THE POST INSTRUCTIONS AFTER REMOVAL WITH LASER?

An antibiotic cream needs to be applied twice daily at the site from where skin tags have been removed for a week. Person can immediately resume normal life post procedure. 


WON’T ORAL PILLS OR CREAMS WORK?

No, only laser would do the job.

WILL THEY RECUR?

The ones that are removed won’t recur. But new onescan occur since we are not removing the cause of occurrence. New ones come veryslowly, so a person would remain tag free for a long time.

ANY HOME REMEDIES TO REMOVE SKIN TAGS AT HOME ?

People do visit us after having tried home remedies. Some apply a harsh chemical , some tie a hair at base. By doing at home you are risking yourself at two things : infection and scars. What’s the point of removing skin tags and ending up with scars. 

Lasers are very precise. They cut the skin up to a depth we want them to. also heat from lasers kill microbs. thus chances of leaving scars or infection are minimal. 

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BOILS: CAUSE AND TREATMENT

WHAT IS A BOIL?

Infection of the hair follicle in the skin is called folliculitis. In common language it’s called boil. When few adjacent folliculitis blends, it gives rise to a larger boil medically it’s called furuncle.

                                  Boils

 CAUSES OF BOIL

Through impaired skin barrier, a cut or an abrasion microorganism enters the skin. It proliferates in oil gland lying next to hair. Microorganism releases substances which give rise to swelling and pain.

Most common causative bacteria is: Staph Aureus. It’s a part of normal flora on skin. Though it’s majorly present around nasal nares and anus.

At times, fungus too can cause folliculitis. It mainly affects back. Then it’s called pityriasis folliculitis.

Though it can affect any part of body, butts, pubic region and axillae are commonly afflicted. People with low immunity, diabetics, malnourished, alcoholics etc. are more prone.

                            Folliculitis

WHAT IS THE TREATMENT FOR BOILS:

  1. Hot fomentation i.e. cotton swabs soaked in warm water placed over lesion several times a day.
  2. Topical antibiotics like soframucin, mupirocin etc. prescribed by doctor.
  3. Oral antibiotics may also be required at times.
  4. If boil is deep within skin, a surgical drainage is advised.
  5. Application of mupirocin ointment at nasal nares and anus region twice a day for first five days of every month for six months would eliminate the hidden source of Staph. Aureus infection. By doing so chances of recurrences are reduced.
  6. Maintain general hygiene, by changing clothes twice a day, bathing twice a day with antibiotic soaps containing triclosan eg: Soapex.
  7. In case, dermatologist suspects, folliculitis to be of fungal origin, a course of topical and oral antifungal is advised.
                          Carbuncle

If a boil is ignored, infection may penetrate deep into skin. It can also spread through blood to entire body causing septicemia.  Long lasting follicilitis and carbuncle may leave scars and marks too. Thus, it’s important to seek medical advice well on time.

 

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SKIN FUNGAL INFECTION : CAUSES TREATMENT

 

Fungus proliferates in moist and damp environment. Thus, most commonly affected sites are under breast, groins and underarms. Sweat accumulates here and ventilation is least. Both these factors provide an excellent breeding ground for fungus to proliferate.

General advice for prevention of skin fungus infection;

  1. Wear loose cotton clothes. Thick fabrics especially denim are made for countries under snow for most of the year i.e. USA and Europe. Wearing them in hot and humid countries like India would lead fungus proliferation. Since they don’t allow skin to be well ventilated. Also, adds to sweat production. That again facilitates fungus proliferation.

 

  1. Keep the skin dry especially over groin region. Use tissue paper to pat dry after using the washroom. If one let the region wet, it invites fungus growth.

 

  1. Never ever use steroid based cream to cure skin fungus infection. Betnovate, Candid B, Quardiderm etc. all contains steroids. They do cure your fungus infection initially, but the moment you stop using them, disease flare up like never before. Also the fungus then becomes resistant to anti fungal treatments.

 

  1. Complete the anti fungal course prescribed by a dermatologist. People get a major relief in the problem after two weeks of treatment. Thus, they stop the treatment. Even though the doctor would have prescribed it for a month. One got relief because 80 percent of the fungus has been killed. What one need to remember is that 20 percent is still left. If one stop the medicine half way this 20 percent would proliferate to become 100 percent. Thus it’s very important to complete the course and stop medicine only after a dermatologist’s advice.
tinea corporis
  1. Anti fungal medicines. Combination of oral tablets and creams would be prescribed by the dermatologist. Like Terbinafine, Itraconazole, Grisofulvin etc. Never resort to self medication. It can do more harm than good.

 

  1. Antifungal soaps containing ketaconazole too are advised for a month.

 

  1. Potassium permagnate , a pinch should b put in a mug full of water. Pour this over your body as the last rinse. No need to put normal water after this. This too is helpful as an adjuvant therapy when don for a month.

 

Fungus is infection has become so rampant in India. That it should be declared as an epidemic. People are suffering from it since last 4 to 8 years continuously at stretch. Major reason behind this is misuse of steroids. Steroid creams are easily available over the counter. People use steroid based cream without dermatologist advice on local chemist or friends’s suggestion. Thus , stop doing this. Talk to your dermatologist and take proper treatment.

 

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                                                            SKIN ALLERGY  OR ECZEMA

 

Allergy is common term we all know about. Allergy can affect many organ like eye, lungs etc. we would be talking about skin allergy in this blog. Intolerability of the skin to a certain substance is called allergy. Medically, we call skin allergy as eczema. Its notorious for being recurrent. But we can always nip the bud at the root and keep recurrences to minimum by having the right knowledge about the disease.  Knowing as to how and why eczema happens is the first step towards treatment.

 

HOW DOES ALLERGY  or ECZEMA LOOK LIKE?

Allergy may have various manifestations:

It may appear as red raised patches with white scales or as group of tiny water bubbles on red background. Bacterial infection may ensue on scratched skin and lead to development of pus. Itching is the hallmark of eczema.

Rashes can occur on any part of the body, not necessarily at the point of contact of allergen. They may either slowly spread to involve the entire body or may remain restricted to a certain body parts.

Microscopically, following things happen at the eczematous rash:

Blood vessels get dilated: giving rise to redness.

Fluid oozes out of blood vessels giving rise to swelling.

White blood cells from blood release certain substances giving rise to itching.

 

 

WHAT COULD BE THE CAUSE OF ALLERGY?

One can be allergic to anything under the sun including sun.  Any food item, any cosmetic, anything in the air, your pet, cement being blown in from the house etc. can trigger allergic response in the body.

The triggering substance can cause rashes after coming in direct contact with skin. Else after ingestion or inhalation too the triggering substance can cause skin rashes.

 

WHAT ARE THE TYPES OF ALLERGY?

There are two types of allergy:

Acute eczema: Skin developing allergy to a particular substance after very first exposure. Rashes are usually restricted to point of contact and develop within few hours of coming in contact with new substance.

Chronic eczema: Skin rashes slowly developing after years of exposure to certain substances.

Allergic attack my happen after the very first contact or after years of exposure to a particular substance. So when your doctor says you are allergic to your lipstick, it doesn’t matter you have been using it safely since years.

It’s like at times you hate a certain person instantly and at times you may start hating the person years later initially having loved them.

 

HOW DOES SKIN DEVELOP ALLERGY?

 

  1. Disrupted skin barrier: Skin protective barrier gets disrupted due to continuous exposure to harsh soaps containing SLS. Thus, allergens find easy access into body.
  2. The immune system overreacts: once the allergen enters body, it’s the duty of the immune system to throw the foreign substances out. But if, immune system over reacts, allergy and red rashes appear.

Allergic attack my happen after the very first contact or after years of exposure to a particular substance. So when your doctor says you are allergic to your lipstick, it doesn’t matter you have been using it safely since years.

 

WHAT IS THE TREATMENT?

 

  1. 1. Treatment primarily consists of finding the trigger and avoiding it.
  2. Avoid using harsh soaps for they disrupt the skin barrier. So stop using all soaps containing SLS like – Dettol, Lux, Lifeboy etc. Use Dove instead which is SLS free.
  3. Moisturizing the skin with moisturizer containing oats and ceramides is of prime importance as it helps heal the disrupted skin barrier. And at the same time it hydrates the skin.
  4. Flax seed oil: Apply flax seed oil just before bathing. They would lock in the skin natural oil and moisturizer and won’t allow soap to rip it off while bathing. Plus it contains essential fatty acids which heal the disrupted skin barrier.
flax seed oil
  1. For the current allergic episode visit a dermatologist who would prescribe you steroid based creams for few days. Oral steroids may also be needed in case of very severe reaction.

 

By:

Dr. Anvika Mittal

9999 747 717

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WARTS : CAUSES, TREATMENT, PREVENTION

WARTS

                                                               

WHAT ARE WARTS? HOW DOES ONE GET WARTS?

Tiny discrete rough skin outgrowths are called warts. They are caused by inoculation of papilloma virus in skin, through any cut and abrasion.

WHAT IS THE SOURCE OF INFECTION?

Source of infection can be the direct contact with the infected person, or through use of infected substances like towels, razors etc. People who get shaving from outside are one ones usually infected.

WHY DO THEY NEED TO BE REMOVED?

Once virus enters the skin, it leads to formation of localized skin outgrowths called warts. Slowly it spreads to nearby skin giving rise to newer lesions. Thus, treatment becomes mandatory.  Also warts are contagious i.e. can spread to other people. Also they don’t look good.

WHERE ON BODY CAN THEY APPEAR?

They can appear virtually in any part of the body –hands, palms, under the nails, scalp, eyebrows etc.

When they appear in ano – genital region, the source of spread is mostly sexual contact with the person having these lesions in the similar area. Thus, if a child presents with warts in anal region, possibility of sexual abuse has to be ruled out.

WHAT ARE THE TREATMENT OPTIONS?

Creams: In case warts are really thin and flat, creams containing, imiquimod, retinoic acid or salicylic acid would help. A derrmatologist would prescribe them for home use.  Application of trichloroacetic acid TCA, or podophyllin would help too. Both these medicines are strictly not for self use. One has to get it done at dermatologist’s clinic.

Thicker lesions won’t respond to creams. They need to be physically destroyed either by heat (lasers and radiofrequency devices) or by cold (nitrogen spray at – 172 degree Celsius is given to warts to destroy them. It also called cryotherapy).

HOW DOES LASER HELP IN TREATING WARTS?

Laser treats warts by burning it off. Since done after local anesthesia it doesn’t pain.  No there won’t be any pain after anesthesia affect wanes off. No scars would be left behind. Person can immediately return to work post treatment. A course of oral and local antibiotics is prescribed post treatment .

WARTS TREATMENT WITH LASER

HOW DOES CRYOTHERAPY WORK?

Cryotherapy involves killing the warts through freezing by exposing them to -172 degree Celsius nitrogen spray. Disadvantage is that it’s little painful and requires repeated sessions at a week’s interval.  It may take 3 to 6 sessions. Both the treatment has no side effects provided done by a qualified doctor.

ANY ORAL MEDICINES FOR WARTS?

Whether doctor chooses to treat by cream or with destructive procedures, zinc supplements are prescribed to be taken on daily basis for two to three months, which not only would aid in killing virus but also help prevent recurrences.

WHAT SHALL ONE DO TO PREVENT RECURRENCE OF WARTS?

Taking oral zinc supplements is one way to prevent recurrences of warts.

By the time one approaches the doctor to treat the warts, some virus would have already spread to the nearby skin. It might give rise to new lesions sometime after the removal of initial lesions. Get the new warts removed the moment they come. Thereby,  not giving them time to spread to nearby skin. Thus, slowly virus would be slowly out of the body.

SUMMARY: Warts are viral infection of the skin which can be cured by destroying them with laser or cryotherapy.

By:

Dr. Anvika

MBBS, MD (Dermatology)

BLOG – DR ANVIKA

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HYPERHIDROSIS: CAUSE AND TREATMENT  

Hyperhidrosis mean excessive production of sweat. It may affect the entire body. Most of the times, it’s limited to palms and soles.

Not only the sweaty hand and feet embarrassing for the person but also interfere with routine activities. Writing and shaking hands can be troublesome.

Sweating can be intermittent or continuous.

When it’s intermittent, it’s often exaggerated with emotions like anxiety, stress and fear.  There is no particular reason for it occurrence.

When sweating is continues, genetic predisposition is the cause.  Onset often occurs during childhood but can happen any time. It tends to improve with age. Sweating typically stops at night.

Treatment of sweaty hands and feet:

  1. Antiperspirant creams: Creams containing 50% aluminum chlorhydroxide are advised. They are applied every night. Left overnight to be washed off next day while bathing. Regular use would help decrease sweating. It works by suspending sweat glands. Once the desired results are achieved, frequency of use is reduced to once a week. Later to once a fortnight to maintain the results.

 

  1. Iontophoresis: Invest in an iontophoresis machine. Iontophoresis machine is available on amazon. It’s a compact device with can be stored in your drawer without occupying much space. Every day hands have to be soaked for half an hour in iontophoresis device. This kills the sweat glands by electric current. Don’t worry, it’s neither painful nor does it have any side effects. Once the desired results are achieved, frequency of use is reduced to once a week. Later to once a fortnight to maintain the results.
Iontopheresis for hands and                       feet

 

 

  1. Botox for sweaty hands : Botox is the trade name for botulinum toxin. Botox when injected into palms and soles lead to decreased sweating. Single session is required This gives results lasting for up to 7 to 16 months. Procedure takes around half an hour to an hour post which person to return to work immediately. Once the desired results wanes off post few months, person can get the repeat injection. Getting the procedure repeated is never out of compulsion but always out of choice. That is, if person chooses not to repeat the procedure, there won’t be any harm.
              Botox for sweaty hands

 

  1. Sweaty hands and feet treatment at home: Add a pinch of potassium hydroxide or alum (commonly called phitkuri) in water. Soak hands for twenty minutes every day till desired results are achieved.

 

 

  1. Aurvedic treatment for sweaty hands and feet: Prepare a mixture of crushed mishri and amla powder added in equal ratio. Take a tablespoon with water every day for 6 to 8 months.

Thus, find the right dermatologist near you to get the right treatment for sweaty hands and feet.

 

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BEST SCAR REMOVAL CREAM

Before looking for best scar removal creams, know what skin actually have. And what it requires.  Skin can have either marks or scars. Marks and scars are different.

SCARS ON SKIN

Scar means a depression in skin. It’s formed due to damage up to deeps layers of skin. Damage can be caused either by pimples, trauma, surgery etc. Skin heals by a scar formation. Which is visible as a depression and change in skin texture. Microscopically the damage destroyed the collagen and replaced it with the scar tissue. Collagen is the main building block of the skin.

Scar

MARKS ON SKIN 

Marks means blackish or reddish discoloration of skin. Damage is limited to superficial layers of skin. It’s not deep.

Black Marks

MARKS TREATMENT

Marks can be treated with creams. That’s because marks involve only superficial damage to skin. Creams can penetrate up to superficial layers of skin.

Creams can’t penetrate deep. Thus, no cream can treat scars. All claims of scar removal creams like Noscar cream or Mederma  are false. Though there is one exception. Creams containing tazarotene can heal scars up to certain extent. That’s because they are very strong retinoids. Retinoids are known to stimulate skin to form new collagen. As skin forms new collagen, collagen fills the scars from beneath, decreasing their depth and visibility. Tazarotene has to be used only on dermatologist’s prescription.

SCARS TREATMENT

Scars are formed due to breakage of building blocks of skin: collagen and elastin. They involve deep damage of skin. Thus, only lasers or micro needling can help. They can penetrate deep into skin giving strong enough stimulus to form new collagen.

As new collagen forms it slowly fills scars from beneath. With time, scars look less visible.

LASER SCAR TREATMENT BEFORE AFTER

LASER TREATMENT FOR SCAR

There is variety of laser treatments for scar:

Co2 fractional laser: It destroys the old scar telling skin to replace with new collagen. There is a post treatment healing time. That is minute crusts are formed the next day. Crusts fall off own its own in next 5 to 7 days time.  Face doesn’t look presentable during this time.

Non ablative laser:  Works on the same principal as Co2 ablative laser. Difference lies in the fact that it’s a less strong stimulus. Thus requires more number of sessions as compared to co2 fractional to get similar results. Advantage is that there is no or minimum post treatment healing time. Thus, person can return to work sooner.

Fractional Microneedling: This is the latest advancement in treatment of scars. Microneedles penetrate deep into skin and release radiofrequency energy. Depth of the needle can be controlled depending upon the depth of the scars. It may vary from 0.5 mm to 3.5 mm. There is no post treatment healing time. Except for redness for few hours. Thus, person can resume work faster.

FRACTIONAL RADIOFREQUENCY

Dermaroller: Also called poor man’s laser. It’s a small device with microneedles which when run in to and fro direction over scars help heal them. It’s a less strong stimulus compared to lasers.

 

Make sure to get these treatments done by a dermatologist. Saloon and spa are not recommended. To avoid side effects of laser it’s important to get it done by a expert who has the complete knowledge.

 

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                               DARK UNDERARMS CAUSES TREATMENT AND PREVENTION

Underarms can get dark due to various causes. Finding out the causes of underarms darkening is the first step towards treatment. Various modalities are available for dark underarms treatment . Right knowledge would help make right decision.

                                                                           

  CAUSES OF DARK UNDERARMS 

  1. Direct application of deodorants and perfumes spray to skin over underarms can lead to underarms darkening. Never apply deodorants directly on skin. Spray it on clothes over waistline. Fumes anyways rise up and to spread fragrance everywhere.
  2. Never ever use hair removal creams. They kill hair  by denaturing protein. That means they are very strong chemicals which when applied on skin can trigger skin darkening. Those who are sensitive, skin darkening may happen in first use itself. In some, underarm darkening may happen after few applications.
Hair Removal Creams

3. Obesity: Yes, excessive weight gain may lead to a condition called acanthosis nigricans. Acanthosis nigricans  leads to skin thickening and darkening at skin folds like underarms, neck groin etc. Work towards  weight  reduction. Weight reduction would automatically lead to skin lightening.

Acanthosis Nigricans

 

 

  1. Excessive sweating: People who are exposed to hot and humid climate sweat a lot more in underarm region. Constant wet skin lead to skin darkening. try using sweat pads . Sweat pads are applied on inner side of  clothes at underarm region . They are disposable absorbent  sheets which are discarded after one use. Sweat pads keeps the skin dry. Thus reducing the chances of underarm darkening.

 

TREATMENT OF DARK UNDERARMS: 

  1. Keep the region dry as far as possible by either using sweat pads etc. or wiping it off with a dry tissue frequent times day.
  2. Opt for laser hair removal. No hair means no sweat accumulating in that region. Also laser itself leads to skin lightening. Get it done by a clinic using US FDA approved laser. Cheap laser is not recommended. Also a dermatologist supervision is very important to get desired results. Right energy levels delivered give results .

 

UNDERARMS LASER HAIR REMOVAL

 

UNDERARMS LASER HAIR REMOVAL                                          RESULTS

3. One can opt for few sessions of peel off peels (three sessions done at two weeks interval) done by a dermatologist. When topmost dead layers peel off the accumulated pigment also peels off along with it. thus subsequent sessions leads to skin lightening.

CHEMICAL PEELS

4. Skin lightening creams prescribed by a dermatologist containing – glycolic acid, hydroquinone and retinoids would help. Never ever use skin lightening creams without a doctor’s recommendation. For many of them contain steroids. Steroids give initial lightening but would ultimately lead to permanent skin darkening. thus using right creams is of paramount importance.

 

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VITILIGO  CAUSES AND TREATMENT

Right knowledge of vitiligo causes and treatment can allay the unnecessary fear . And also help one make right decision about the treatment.

WHAT IS VITILIGO

 Vitiligo is a disease where Skin suddenly devolves white patches. White patches can be of any shape and size. They can either be limited to one part of body or they may be widespread. Even the hair over the affected region looses color. Disease may b e static or may be progressive that is keep spreading to involve a very large area of body. It not communicable i.e. doesn’t spread by touch. It’s asymptomatic. But has profound effect on person psyche.  

WHAT CAUSES VITILIGO

 It’s an autoimmune disease i.e. person immune system starts attacking the colour producing skin cells called melanocytes. Stress acts as triggering factor. Genetic predisposition is increases the chance of vitiligo in children. There is just increase chances of getting vitiligo in children born to parents having vitilig . It’s not that they will get it.

WHAT IS THE TREATMENT FOR VITILIGO

AIM OF VITILIGO TREATMENT:

 

To stop the progression of the disease.

To get the skin colour back

To stop the progression of the disease

An oral course of steroids and immunosuppressant  are given.  Immusupressants can be azathioprine, cyclosporine etc. This prevents or suppresses the immune system from attacking black pigment of skin. Regular monitoring of blood count, liver function test, and kidney function test are done to keep a check on side effects.

Various modalities can be adopted to get the colour back

Phototherapy :  Photoptherapy is basically concentrating UV rays towards white patches on skin. This stimulates pigments producing cells to produce more pigment. Phototherapy can be done in multiple ways.

Oral PUVA:  A medicine is given for oral consumption. After two hours patient is advised to stand in sun for 5 minutes. It’s advised when disease is wide spread and its not possible for person to visit the clinic frequently.

Bath PUVA:   A medicine is poured into bath tub. Patient is advised to be in tub for 20 minutes, so that skin absorbs the medicine. After that person can stands in UV chamber. This is advised when disease is wide spread and its convenient for patient to visit clinic on thrice a week basis.

ORAL PUVA: Two hours after taking and oral medicine person stands in UV chamber.

UV CHAMBER FOR VITILIGO

Topical PUVA: A medicine is applied on white patches and then after half n hour exposed to sun for 10 minutes. This is advised when limited number of patches are there.

Hand held UV lamps are also available for use at home. They are practical only for smaller patches.

HAND HELD UV LAMPS

Excimer laser: It releases wavelength of 308 nm . Repeated sittings are required. It’s an expensive technology. But very effective for small patches. much more effective than UV chambers

EXCIMER LASER FOR VITILIGO

Oral medicine prescribed is 8 methoxypsoralen. It’s available in tablet and lotion form.

 

In case phototherapy fails to bring the colour back then alternate methods are chosen to get the colour.

Surgery: There are various surgical modalities:

Punch grafting: Mini circular punch shaped skin is taken out from non effected area (back of ears or thighs ). Mini punches are digged out at white patches. Then punches from non effected are are put into white patches. Colour from non effected are slowly spreads to white patches, finally the complete are gets colour.

PUNCH GRAFTING FOR VITILIGO

Split skin graft: A very thin section of Skin from non affected area is taken out . The white patches abraded . i.e. top most most layer is reoved with a machine creating a raw area. The thin section of skin is applied to the affected area. Dresing don for a week . Final result is colour t the whit patches. Practical only for small white patches.

SPLIT SKIN GRAFT

Non cultured autologous melanocyte transfer:  when a wide spread area are involved then above two surgical modalities are no feasabl. In NCMCT, a small are of non effected skin is taken out . It’s processed in lab to separate the melanocytes (colour producing skin cells).

MELONOCYTE CELL TRANSFER FOR       VITILIGO

Camouflage techniques:

Artificial colour is filled into white patches. It too can be achieved either ways;

Micro pigmentation: With the help of a machine colour is filled into the superficial skin layer. Colour matching the person’s original skin colour is chosen. With the help of a machine colour is filled into the superficial skin layer. Once done, a touch up may be required after a month’s time. Colour remains for around 2 years. Henceforth once a year touch up is required.

Camouflage make up:  Special make up is available which matches one’s skin tone .It cover up the white patches. Its water resistant i.e. doesn’t come out with sweat. It needs to be applied every day.

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