It depends on each person. It may happen that the spots do not spread, that they do so very slowly over the years or, on the contrary that they do so very quickly. Vitiligo is usually slowly progressive with periods of exacerbation, progressing to become a chronic disease.
On the other hand, the evolution of the disease also depends on the type of vitiligo that is suffered. According to specialists from the Vitiligoorganics, there are the following types:
Focal vitiligo: there are one or several spots in a single location. It usually remains stable for some time.
Segmental vitiligo: it begins abruptly and its evolution time is short. Once established, it does not usually continue to spread.
Generalized vitiligo or vitiligo vulgaris: it can evolve into universal vitiligo, which affects almost the entire surface of the skin and, in general, irreversibly. Subsequently, it remains stable.
In any case, it is infrequent that the skin recovers its normal color, and if it does, it is usually transient.
How is vitiligo treated?
The most appropriate best vitiligo treatment in India will depend on the extent and location of the different spots, as well as the degree of pigmentation of the surrounding skin area.
Although the objective of any of the treatments is always to recover or regenerate the affected melanocytes so that the affected areas recover their pigmentation, or at least stabilize the depigmentation process, therapeutic approaches are not always effective and may have side effects. It is essential, therefore, to individualize the treatment, taking into account the type of vitiligo and other personal conditions of the patient.
Often, there is also a risk of relapse, but even with all this, the treatments help the affected person to improve their psychological state of mind. In addition, in many cases, it is possible to stop the disease and some repigmentation of the patches.
According to the Indian Academy of Dermatology and Venereology (AEDV), depigmentation can be treated in up to 80% of cases. This institution proposes the following treatment options:
Therapeutic abstention, protection and camouflage: depending on the influence of vitiligo on the person’s life, you can choose not to apply any treatment. In this case, the spots can be camouflaged with makeup and self-tanning lotions can also be used. In addition, since white spots do not have melanin, it is essential that people with vitiligo protect their skin from the sun’s rays, applying broad-spectrum photoprotective creams, with UVB and UVA protection, with a factor greater than 30 and avoiding exposure to sun in the central hours of the day.
Medium-high potency topical corticosteroids: this treatment is indicated for people whose spots occupy less than 10% of the body surface and is applied in short batches to avoid side effects.
Topical calcineurin inhibitors: topical tacrolimus and pimecrolimus inhibit a protein present in the immune system that, when activated, triggers inflammatory reactions in the tissues. On the other hand, they activate the proliferation of melanocytes and their precursor cells. These drugs are an alternative to high-potency topical corticosteroids because they do not cause skin thinning or other side effects.
Systemic corticosteroids: they are indicated only in cases of rapidly progressing generalized vitiligo.
Phototherapy: Currently, treatment with narrowband UVB radiation as monotherapy is considered the treatment of choice. It is applied in the most extensive forms of vitiligo and achieves a response in more than half of the patients (65%).
Photochemotherapy and antioxidants: it is based on substances such as Khellin, phenylalanine, beta-carotene (30-120mg/d), and antioxidants (Vitamin E, vitamin C, among others…), which prevent oxidative damage to cells.
Laser therapy: excimer, Bioskin and helium neon lasers, which can be combined with topical treatments. It is considered one of the most effective therapies, along with phototherapy.
Surgical options: there are different techniques, such as autografts, hair follicle suspensions or, in certain cases, transplantation of cultured autologous melanocytes.
Depigmentation therapies: they are based on the application of chemical means, such as hydroquinone monobenzyl ether creams. About three months are necessary for the results to begin to be seen and a year or more to achieve complete depigmentation. Other depigmentation techniques based on physical means can also be used (Alexandrite laser, ruby laser, to name a few)
for more information see this best vitiligo treatment in India .
