How does vitiligo present?
Vitiligo is an acquired loss of skin pigment caused by the destruction of pigment cells – melanocytes – which produce the skin pigment melanin. This results in well-defined white patches with a smooth surface, of various shapes and sizes, appearing anywhere on the body. They are not infectious or contagious.
The edges of the patches are often more pigmented than the surrounding skin. The condition most commonly affects the fingers and toes, the areas around the ankles, elbows and knees, the lower back and buttock area, and the back, as well as the area around the eyes and mouth. Hair growing within affected areas often turns white.
What are the risk factors for developing vitiligo?
Vitiligo affects around 1–2% of the population and most often appears between the ages of 10 and 30. A family history of vitiligo is a risk factor, although it is not possible to determine precisely how likely it is to occur in children, or whether it will occur at all. Another risk factor is a personal or family history of autoimmune conditions.
The most common of these include:
- Thyroid disorders (in almost 30% of patients with vitiligo): Hashimoto's thyroiditis, Graves' disease
- Diabetes mellitus
- Pernicious anaemia
- Systemic connective tissue diseases: rheumatoid arthritis, systemic lupus erythematosus
- Crohn's disease, Addison's disease, myasthenia gravis, and others
Vitiligo develops as a result of several contributing factors, including genetic predisposition, exposure to stressful situations, reactions to infections, and the state of the immune system. Any skin injury can trigger a cascade of processes leading to skin depigmentation, known as the Koebner phenomenon.
What treatment options are available for vitiligo?
A thorough patient assessment is essential, with particular focus on possible coexisting autoimmune conditions. Treatment of vitiligo is time-consuming, long-term and not always successful. Even with current treatment options, complete remission cannot be achieved in every patient.
From an aesthetic point of view, vitiligo can affect a patient's mental wellbeing and place a strain on their personal and professional life. It is essential to protect the affected patches from sunlight and to use sunscreen with SPF 50+, as vitiligo lesions lack the protective pigment melanin and are therefore highly sensitive to UV radiation, making sunburn more likely. Treatment therefore focuses on repigmentation of the affected areas. The mainstay of treatment is the local application of corticosteroid ointments (medicines that suppress the immune processes responsible for depigmentation of the patches).
Phototherapy – treatment with specific ultraviolet light (UVB 311 nm)
Phototherapy is carried out under a doctor's supervision, typically in a course of 20–25 sessions, 2–3 times a week. A variation of phototherapy is the PUVA method, in which UVA radiation is combined with photosensitising agents called psoralens. These may be given systemically as medication or applied locally to the skin in the form of solutions or baths.
In cases of extensive, widespread involvement, some countries offer irreversible depigmentation of the remaining, normally pigmented skin using chemical agents. This is a significant intervention with lifelong consequences, requiring effective, daily sun protection, since the skin's natural protective barrier is removed.
Vitiligo treatment at Dermarevolta: a step forward in regenerative medicine
Regenera Activa is a new and innovative treatment using the patient's own progenitor cells. These cells can help achieve repigmentation in patches that have been stable for at least 2 years. The progenitor cells are obtained from the patient by the doctor using a patented, purely mechanical procedure, without the addition of any chemical substances. This increases the likelihood of the body accepting the cells and minimises the risk of adverse reactions.
What makes the Regenera Activa method unique?
It is based on the fact that the hair follicle acts as an important reservoir of melanocytes (the cells that produce the pigment melanin). The progenitor cells obtained can then help regenerate target cells in the treated area, leading to repigmentation.
Is the procedure painful?
The procedure is minimally invasive, using skin grafts approximately 3.5 mm in size. The sample is taken from behind the ear under local anaesthesia, so the procedure itself is painless. The tissue is then placed into a device with a special filtration system, which separates the cells without the addition of any chemicals, while preserving high cell viability. This produces a suspension of progenitor cells, which is then injected directly into the areas affected by vitiligo. The procedure is performed once, and a single treatment session can cover an area roughly the size of a palm. About 3 weeks after treatment, the patient undergoes the required number of phototherapy sessions.
Can vitiligo be prevented?
There is no specific way to prevent vitiligo. In general, a healthy lifestyle is recommended, including regular physical activity and a balanced diet. It can also help to take nutritional supplements, vitamins and antioxidants, particularly vitamins A, C and E, beta-carotene, minerals and trace elements.