If we talk about this disease as vitiligo, different authors about it you can see a lot of discrepancies. This is because the disease is poorly studied, and exact approaches for its treatment. It is characterized by the appearance on the skin white spots that tend to increase (the second name “white spot disease”). In 50% of cases start with 10 to 30 years. Any race of being, no, but in dark-skinned or tanned people the spots are more noticeable. The disease incidence of 1%.
The reasons are unknown, but doctors tend to think of autoimmune disease. Probably, who will answer exactly this question, then such a person will give the Nobel prize. Vitiligo is characterized in that kill or inhibit the function of cells – melanocytes employed, due to the pigment melanin, in the skin color. They seem to be alien in your own body. Noticed the hereditary factor in 30% of patients (severe family history, the presence of vitiligo one of the parents). If even one of them hurt “white spots”, according to the authors, the probability of this disease in the child is 10%. It is noticed that in the process of pathogenesis of important diseases of the visceral systems: thyroid, diabetes, anemia, liver disease. Sometimes first lesions appear in the projection of a suffering body.
- Focal, small spot or group of spots in a small area of the body. I must say that they have a yellowish tint.
- Segmental, one-spot or group of spots on one side of the body, that is, have more character.
- Generalized when the lesions are distributed throughout or almost throughout the skin.
Among related symptoms should be noted depigmentation of hair (graying). The spots can be statically on the body for a long time, but can increase in size, to be new spots.
Dermatologist to successfully guide differential diagnosis in conditions such as: lupus erythematosus, white versicolor, albinism, drug vitiligo, postinflammatory depigmentation. The diagnosis put on the basis of clinical findings.
Confirms the diagnosis histological examination light patches of skin, it shows a lack of melanocytes and pigmentation in the basal layer of the epidermis.
Because the exact cause of the disease is not known, there is no specific treatment, mainly symptomatic.
Treatment is difficult and consists of several stages:
- Surveyed by other specialists on everything. Because leather is a “barometer” of the internal environment of the body.
- Avoid the sun, and holidays in hot countries. In parallel, you must use sunscreen means with a protection factor of over 30 (for example DNA Intensive Shield SPF 30 from Swiss brand Valmont.) in the Sunny season.
- Restore skin pigmentation: PUVA therapy, the use of helium-neon laser, vitamin (B1, Vitamin C), copper preparations, which lacks in this disease.
- Cosmetics, masking pigmentation. The effect lasts up to 2 weeks, after which the procedure must be repeated.
- Sometimes resort to transplantation of skin, but I have a negative attitude to this methodology because the transplanted skin is uneven, rough and not the fact that everything appears new lesions vitiligo.
In this case it is important to choose the course of treatment. In doing so, we help and folk remedies. For example Echinacea tincture, increasing the number of T lymphocytes, reduced in vitiligo. Duckweed marsh, a rich spectrum of vitamins, proved to be excellent in vitiligo, used duckweed as St. John’s wort orally and topically. Treatment herbal remedies for a long period, not less than six months to achieve a tangible result. You know, in this case, I repeat: “to Each his own, your drug and treatment scheme, we select a doctor.
Until recently the disease was regarded as incurable. However, to date, tested and implemented various very effective methods of treatment. To the dermatologist it is advisable to contact the time when the first symptoms, otherwise small, blogsanity for surrounding the lesion may spread and lead to unpleasant cosmetic defects.
Local corticosteroid therapy
Local treatment with corticosteroid ointments and creams containing calcineurin inhibitors: pimecrolimus and tacrolimus. With prolonged application of corticosteroids can be very effective, however, steroid side effects (skin atrophy, the formation of telangiectasia, and the processing of the large surface area of the skin – inhibition of adrenal function, diabetes, hypertension, osteoporosis) limit their use. Calcineurin inhibitors (Pimecrolimus – Elidel) are devoid of such side effects, however, are much less effective than steroids, and are therefore used only in combination with other methods of treatment of vitiligo.
Systemic corticosteroids although it may give a very positive therapeutic effect, not widely used due to the high likelihood of development of severe systemic side effects: diabetes, hypertension, osteoporosis, suppression of adrenal function).
Laser therapy vitiligo
Laser therapy using acceptable excimer laser for treating vitiligo with a small area of the lesion. The method is very expensive. The newest development excimer laser XTRAC (USA).
Phototherapy – treatment with light of a specific wavelength is used in vitiligo in the form of selective phototherapy, PUVA therapy, uzkogorlovoy UV-b phototherapy at a wavelength of 311 nm. Selective the least effective phototherapy, PUVA-therapy (use of photosensitizers inside of psoralens followed by exposure of the skin UVA rays) is much more effective in comparison with selective phototherapy, however, toxic effects, manifested by nausea, vomiting, headache, dizziness, and the risk of skin cancer with prolonged use limit use of PUVA therapy in the treatment of vitiligo. Oscawana 311 nm UVB phototherapy performance comparable to PUVA therapy (restoration of pigmentation over 75% of the area of vitiligo lesions in 70% of patients), however, is devoid of toxic side effects and, moreover, allowed for use in the treatment of children. The most significant therapeutic effect was observed in the presence of lesions on the face, neck, trunk and proximal extremities. With the localization of the fingers and toes effect is less pronounced. In addition, respond better to treatment, the lesions that occurred not more than 2-5 years ago.
Phototherapy, namely oscawana 311 nm UVB phototherapy is considered currently one of the most affordable and effective methods of treatment of vitiligo. Method is fairly safe, but it is important with long-term use. To achieve a good effect requires from 30 to 100 procedures, with a frequency of 2-3 times per week.
Elimination of residual pigmentation (depigmentation) by applying on the Islands of pigmented skin 20% ether of monobenzone is a very effective tool in the treatment of vitiligo with a large area of skin lesions, when for smoothing skin color is better not to restore pigmentation and to whiten the remaining islets of normal pigmented skin (the efficiency of the method is clearly demonstrated to the world by Michael Jackson). It should be remembered that the skin whitening monobenzone is irreversible. Means Dy-o-derm, Dermablend also discolor the normal skin. Clarify that the skin is particularly vulnerable to sunlight and there is a need for continuous use of sunscreens.
Placental therapy vitiligo
The method is quite new and promising, at least showed better results than all other methods of treatment of vitiligo.
For the treatment of vitiligo using drugs on the basis of placenta extract, as well as possibly adding to them hyaluronate copper and zinc, extracts of medicinal plants (Pasternak, St. John’s wort, walnut).
The healing properties of the placenta extract has been successfully used by Cuban specialists, created on the basis of their well-known drugs from Vitiligo Melagenina and Melagenina-Plus. Additive preparation of calcium chloride significantly increases its efficiency, as the presence of calcium ions is necessary for the reproduction of melanocytes and melanin synthesis.
Among the active components of medicinal drugs used in dermatology, hyaluronic acid and its associates with a biologically active metal, called hyaluronate. Hyaluronate is closely related to the processes of proliferation, migration and differentiation of skin cells. Thus, one important function of hyaluronate is the recovery of the skin after damage of any origin.
Hyaluronan in the body interacts with proteins of the extracellular matrix and cell membranes. In many enzymatic reactions, together with the hyaluronate involved copper – and zinc containing proteins responsible for normal functioning of the skin, including in the processes of melanin synthesis, proliferation and migration of melanocytes. Contained in the skin zinc antioxidant, sunscreen effect on the skin tissue. Antioxidant effect is manifested in the fact that zinc cations induce the synthesis of metallothionein – a protein that binds free radicals and thereby prevents aging and loss of skin cells. These properties of zinc has led us to the conclusion about the necessity of introducing him to the new therapeutic agent.
Among the copper-containing enzymes involved in the normal synthesis of melanin and the functioning of melanocytes is necessary to allocate tyrosinase, which produces melanin production (skin pigment). With a lack of tyrosinase reduces pigmentation and skin protective properties under vozdeistviem UV rays.
It is so important functions of hyaluronic acid, copper and zinc for normal functioning of melanocytes led experts to the development of a drug for the treatment of vitiligo, containing hyaluronate, copper and zinc.
Note that the inorganic preparations of copper and zinc, used to treat vitiligo, irritate the skin, and in large doses can be toxic, inaktivera enzymatic activity of proteins. These shortcomings have smoothed associates hyaluronic acid with copper and zinc, as metal ions form chemical bonds with the acid, losing their toxicity. Hyaluronic acid binding cations of metals, prolongue their action, slowly giving their tissues, that is, performs the depositing and transporting function, in this case, she is involved in biochemical processes.
Preparations containing associates hyaluronic acid with copper and zinc, have a synergistic (mutually reinforcing) effects, including the beneficial properties of hyaluronic acid and bioactive metals – copper and zinc. It is not the amount of organic and inorganic components, and a completely new biologically active complexes.
The development of vitiligo is often associated with autoimmune processes conducting to destruction of melanocytes, and the hyaluronate of copper and zinc have immunomoduliruushim effect, and activate not only non-specific immunity, but also affect the cells involved in specific immunity reactions. Therefore, these compounds are able to normalize immunological balance of the skin, especially if it was broken. When locally applied, it will help strengthen the natural defenses of the skin, which is especially needed depigmentation site.
Seed extract parsnip, herb St. John’s wort and shells of walnuts contains the sum of various furocoumarins, and is a member of the drug as fotocencibilisirutee funds.
Thus, the composition containing the associates of hyaluronic acid with copper and zinc, placenta extract, calcium chloride and medicinal herbs has the following effect: it has a direct influence on the enzymatic activity in melanocytes, their proliferation, differentiation and migration, has immunomoduliruushimi and antioxidant properties, protecting the skin from the action of external and internal factors, improves metabolic processes in the skin.
Nutrition in Vitiligo
The diet should contain foods rich in copper: cod liver, seafood, cabbage, tomatoes, lamb, apples, as well as containing zinc: rice, oats, corn.
Prevention of Vitiligo
After treatment, avoid contact with sunlight, even under favorable result. Clear the prevention of disease does not exist. The only thing I note is moderate exposure to the sun and treatment of internal diseases.