Have you been told that there is no cure for Vitiligo? Technically, that’s a true statement, but that doesn’t mean that it can’t be treated and controlled effectively. At the Dermatology & Cosmetic Laser Center, we have experience lessening the appearance of white patches with laser therapy. Using excimer lasers, we’re able to target the areas of vitiligo safely and often more effectively than alternative options such as topical creams, or traditional UVB therapy lightboxes.
What is Vitiligo?
Vitiligo appears as white patches of skin on various areas of the body as a result of pigment loss. It’s a chronic skin condition that occurs when melanocytes (the cells responsible for pigment) are destroyed. The exact cause of Vitiligo is somewhat of a mystery. Research has shown a connection of genetic, autoimmune and environmental causes of the disease. Most cases of Vitiligo appear before a person turns 40 and can even affect areas around the eye.
The severity of Vitiligo varies by individual. The condition is often more obvious on darker skinned individuals. Patients with lighter skin tones may only notice the condition during the summer months when there is more sun exposure.
Each patch of Vitiligo can have varying levels of pigment loss. Patches may appear to be different shades, often lighter in the middle with darker borders. Patients with Vitiligo may go through cycles of pigment loss where there are periods of rapid loss followed by periods of inactivity.
One of the first (and most important) steps in treating Vitiligo is to get an accurate diagnosis. Diagnosis requires a comprehensive skin examination along with a detailed health and family history.
During a health and family history questioning, we will want to know basic information such as when it started, where it started, whether it’s getting worse or remaining stable, and what (if any) treatments have been tried so far. We will then want to know if you have a history of any autoimmune disease, a family history of Vitiligo, and whether there has been any stressful events (both physical and emotional) as they can exacerbate the condition.
During the physical skin examination, we’ll be looking at every area of the skin to determine the type of Vitiligo. The white patches are often easy to see on individuals with dark skin, but for lighter-skinned individuals we may need to use a Wood lamp (essentially a black light). This light helps to see any areas of change on the skin that are not visible in traditional room lighting.
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In some cases, we may find that certain spots are caused by something other than Vitiligo, which means that we will need to come up with an alternative treatment plan. Also, a blood test or skin biopsy can be needed in rare cases where we need further clarification after the health and family history and skin examination.
Excimer Laser Therapy for Vitiligo
The Excimer laser is a new form of UVB light therapy that delivers highly selective rays, utilizing only those that are useful for treatment and eliminating those that can cause the skin to burn.
UVB therapy has been a mainstay in dermatology for many years as an effective way to treat a variety of skin conditions. While not a cure, UVB therapy can clear the skin for extended periods of time, improving quality of life for many patients.
Excimer laser treatments have many benefits including:
- Effective re-pigmentation of existing lesions
- Reduces the amount of new lesions
- Possible remission of the disease (although the duration of remission can vary)
- Treats only affected areas of vitiligo, protecting nearby healthy skin
Results from Excimer treatment
Patients can expect to have two to three laser treatments per week, scheduled at least 24 hours apart. Following treatment there can be mild to moderate skin tenderness similar to a sunburn. This is normal and a good indicator that the treatment is working as intended.
Most individuals will notice an improvement of the Vitiligo within 6-10 sessions and remission of the condition within 10-20 sessions. Areas on the scalp, hands, and feet are often the most difficult to resolve. The average remission length from Excimer laser treatment is between 3-6 months.