Vitiligo
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Vitiligo is a long-term problem in which patches of skin lose their colour.
Vitiligo is a long-term problem in which patches of skin lose their colour. It can affect people of any age, gender, or ethnic group. When you have vitiligo, the cells that are responsible for your skin colour are destroyed. These cells, called melanocytes, no longer produce skin pigment, called melanin. Once the cells no longer produce melanin, areas of your skin will lose colour or turn white.
Areas of white patch can develop anywhere on your body, including:
- sun-exposed areas like the hands, feet, arms, and face
- inside the mouth or other mucus membranes.
- nostrils.
- genitals.
- back of the eye.
- within the hearing system of the ear.
Your hair may also turn grey or white if the areas involved have hair. Vitiligo can start at any age, but usually appears before age 30.
It's difficult to predict how vitiligo will progress. Sometimes the patches stop forming without treatment and occasionally, the skin gets its colour back.
Vitiligo has no cure. But treatment might stop or slow the discolouring process and return some colour to your skin.
Vitiligo may be related to:
- A disorder of the immune system (autoimmune condition)
- Family history (heredity)
- A trigger event, such as stress, severe sunburn or skin trauma, such as contact with a chemical
Depending on the type of vitiligo you have, it may affect:
- Nearly all skin surfaces. With this type, called universal vitiligo, the discoloration affects nearly all skin surfaces.
- Many parts of the body. With this most common type, called generalized vitiligo, the discoloured patches often progress similarly on corresponding body parts (symmetrically).
- Only one side or part of the body. This type, called segmental vitiligo, tends to occur at a younger age, progress for a year or two, then stop.
- One or only a few areas of the body. This type is called localized(focal) vitiligo.
- The face and hands. With this type, called acrofacial vitiligo, the affected skin is on the face and hands, and around body openings, such as the eyes, nose and ears.
Myths associated with vitiligo/white patch
- It's a myth that Vitiligo is contagious and can spread.
- It's a myth that Vitiligo is a punishment for past karma.
- It's a myth that Vitiligo is caused by some food
- It's a myth that Vitiligo patients are inferior to others physically or mentally
- It's a myth that Vitiligo vanishes/heals by itself.
- It's a myth that Sun damage causes vitiligo.
- It's a myth that Vitiligo is untreatableand is related to other skin diseases such as skin cancer, leprosy, and albinism.
Vitiligo is more of a social and psychological distress to the patients and their immediate family members.
Treatment of vitiligo
The types of treatments include medical, surgical, or a combination of both. But not all treatments work for everyone and some may cause unwanted side effects.
Dr Amit Agarwal will recommend you the suitable option for the treatment of vitiligo on the basis of-
- the severity of your condition
- the location and size of your patches
- how many patches you have
- how widespread the patches are
- how you respond to treatment
Medical treatment
You'll usually need at least three months of treatment before you can see its effects. Medical treatments include:
Topical creams: Some creams, including corticosteroids, can help return colour to white patches in the initial stages. Others help to slow the growth. Side effects can include:
- skin shrinkage
- thinning
- excess hair growth
- skin irritation
Oral medications: Some medications like steroids and certain antibiotics may be effective in treating vitiligo.
Psoralen and ultraviolet A (PUVA) therapy: This treatment combination requires you to take psoralen as a pill or apply it to your skin as a cream. Then Dr Amit Agarwal exposes you to UVA light to activate the drugs which help restore colour to your skin. Afterwards, you'll need to minimize sun exposure and wear protective sunglasses. PUVA does have side effects that can include:
- sunburn
- nausea
- itching
- hyperpigmentation
Depigmentation: Dr Amit Agarwal may recommend depigmentation if more than 50 percent of your body is affected and you want to balance your skin. This often is a solution when treatments to return pigment to your skin have failed. Depigmentation focuses on fading the rest of the skin to match the areas that have lost color. It can take up to two years for treatment to be effective. You'll apply a medication like monobenzone. The biggest side effect of depigmentation is inflammation. This treatment tends to be permanent, and you'll be extra sensitive to sunlight.
Discussions during a vitiligo correction surgery consultation should include
- Any past medical condition or surgeries.
- Any present illness, drug allergies and medical treatments.
- Any on-going supplements
- Where on your body did it first start?
- Does anyone in your family have vitiligo?
- Alcohol, tobacco and drug use
A candidate opting for vitiligo correction surgery should fill up these criteria for better results
- Individuals who have stable white patch from 1 year areideal for the surgery.
- You should be a non-smoker and if you are a smoker, you should compulsorily stop smoking before at least two weeks before the planned surgery.
- You should not have any uncontrolled chronic illness or medical condition.
- You should be conscious towards improving your looks.
Dr Amit Agarwal's focus duringvitiligo correction surgery consultation
- Examine your overall health, and risk factors
- Discuss the options for your surgery
- Take photographs
- Risk and complications associated with surgery
- Outcome of surgery
Questions to be asked with Dr Amit Agarwal about vitiligo correction surgery
- Are you a good candidate for the procedure?
- How and where will you perform the surgery?
- What are the risks and complications related to the surgery?
- How long will be my recovery period?
- How long do I have to stay at the centre?
Preparations to be done for the surgery
- You should be physically healthy.
- You should stop smoking if you are a smoker before at least two weeks prior to the surgery.
- Get the tests done prescribed by Dr Amit Agarwal.
- Avoid taking anti-inflammatory drugs and herbal supplements as they aggravate bleeding.
- Admission will be done on the same day at the centre.
- Written consent form will be signed explaining the procedure after the admission.
- Compression garment measurement should be given for post-surgical use
- Meeting with the anaesthetist for Pre-Anaesthesia Check-up (PAC) before the surgery. All pre surgical work up investigations should be shown to the operating surgeon and the anaesthetist, and we will evaluate your fitness for the surgery. You will be given date for the surgery only after you are declared fit for the procedure.
- Nil per oral for minimum of 5-6 hours before the planned procedure.
Vitiligo correction surgery procedure includes
Surgical options are available when medications and light therapy don't work. Dr Amit Agarwal can recommend surgical options if you have had no new or worsening white patches in the last 12 months, and your vitiligo wasn't caused by sun damage.
The types of surgery include:
Ultra thin Skin grafting - Dr Amit Agarwal removes healthy, pigmented skin and transfers it to depigmented areas. Risks of skin grafting include infection, scarring, or failure to re-pigment.
Blister grafting - Skin grafting using blisters is another option that has less risks. For this procedure, Dr Amit Agarwal will create blisters on your unaffected skin and transfer the top of the blister to another area. Possible risks include scarring, a cobblestone appearance and failure of the area to recolour. And the skin damage caused by suctioning may trigger another patch of vitiligo .
Melanocyte transfer: Dr Amit Agarwal harvests a very small chunk of skin from the uninvolved area. He then separates the cells responsible for pigment, melanocytes and isolate then. Then, the cells are transplanted to the depigmented areas of skin.
Micropigmentation: Dr Amit Agarwal will tattoo pigment into your skin. This is best for the lip area, but it may be hard to match your skin's colour.
Even if you are undergoing medical treatment for vitiligo, the results can be slow. So, you may want to incorporate the following:
Sunscreen: Reducing sun expose can help keep your skin even. Tanning will add contrast to your skin, making affected areas more visible. The higher the SPF, the more protection you receive. It is important to use sunscreen as areas without pigmentation are susceptible to sunburns and sun damage.
Cosmetics: Makeup or self-tanning lotions can help even out your skin tone. You may prefer self-tanning lotions because the effect lasts longer, even with washing.
Recovery after the surgery
After the surgery, dressings are applied to the surgical area, and you are made to wear a compression garment to reduce swelling. You should give your body 3-6 months' time for evaluation of best results.
- In the days following surgery, there will be pain which can be subsided by the pain killers given by Dr Amit Agarwal.
- You will be made to walk 6 hours post-surgery or the very following day, depending on your will and wish and the area operated upon.
- You can start exercising after four weeks post-surgery.
- Pressure garment is a must wear for the next 3 months without gap or fail for almost 24 hours a day.
- You can return to work depending on your will power and the type of work required and the area involved between 2-3 weeks
- You can return to your normal lifestyle after 2-3 weeks of surgery.
There will be some specific instructions given to you by Dr Amit Agarwal which includes:
- How to take care of the surgical site.
- About the follow up dates.
- How to take the medications or application of creams. There are not many medications though.
Risk and complications post-surgery
Before going for the surgery, you should always understand the risks and potential complications related to surgery. Vitiligo correction surgery usually gives desired results but there can be some risks involved which include:
- Risks related to anaesthesia. General Anaesthesia is relatively very safe in this era and time zone and the chances are very rare to land up in any complication. Team at Kayakriti Plastic Surgery and Dental Centre has two very competent Anaesthetists and world class workstation and equipments to make your surgical journey as safe as possible.
- Infection
- If you have a poor blood supply, the healing will be poor.
- Sometimes irregular take of graft or loss of grafted skin is seen.
- Sometimes change in skin sensation is noticed.
- Reactivation of vitiligo is always a possibility. That's why patches which are stable for around 1 year should be operated upon.
- Irregular pigmentation of the surgical area.
- Bleeding or haematoma formation under the transplanted skin.
- There will be faintly visible scars present along the grafted skin margin which might hypertrophy only if you are prone for it.
- Possibility of revision surgery if the results do not meet your expectations.
These are the risks and possible complication which should be discussed by you with Dr Amit Agarwal before the procedure.
Do's and Don'ts
- You should not get into surgery if you are having any chronic illness and should not hide it with your doctor.
- You should always wear the pressure garment after the surgery if required as it reduces swelling and improves your contour.
- You should consult Dr Amit Agarwal immediately if you have any complication.
Self care approach in vitiligo
The change in your appearance caused by vitiligo might make you feel stressed, self-conscious or sad. These self-care approaches can help you cope with vitiligo:
- Make a good connection - connect with a dermatologist/ plastic surgeon who specializes in the care of skin.
- Learn about your condition. Find out as much as you can about vitiligo and your treatment options so that you can help decide what steps to take.
- Communicate your feelings. Let your doctor know if you're feeling depressed.
- Talk with others and Confide in loved ones. Seek understanding and support from your family and friends.
Frequently Asked Questions
Vitiligo is not painful. However, you can get painful sunburns on the lighter patches of skin. It is important to protect yourself against the sun with measures like using sunscreen, staying out of the sun during the hours that it is strongest, and wearing protective clothing. Some people with vitiligo have reported having itchy skin sometimes, including before the depigmentation starts.
Vitiligo is not necessarily inherited. However, about 30% of people who have vitiligo do have at least one close relative who also has vitiligo.
Signs and symptoms of vitiligo include the following
- Patches of skin lose color. This can include the eyes and/or the mucous membranes in your mouth or nose.
- Patches of hair on your head or face turn prematurely gray or white.
Quitting smoking is a perfect solution even without surgery as it involves many health risks, but it's totally up to your wish that you want to quit or not. But you should surely stop smoking at least 2 weeks before the surgery.
Segmental or focal: White patches tend to be smaller and appear in one or a few areas. When vitiligo appears in a focal or segmental pattern, it tends to stay in one area one side of the body. Many times it continues for a year or so, then stops. It also progresses slower than generalized vitiligo.
Non-segmental or generalized: Widespread white patches appear symmetrically on both sides of the body. This is the most common pattern and can affect pigment cells anywhere on the body. If often starts and stops many times over the course of a person's lifetime. There's no way to determine when, if, or how fast patches will develop.
Vitiligo Images
Indivisual results may vary from person to person.
These pictures are shown for the purpose of education only.
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Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
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Frequently Asked Questions
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
Kayakriti Plastic Surgery & Dental Center
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
Phone No. +919695940009, +919695940006
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