Vitiligo: Causes, Treatments, and Surgical Options

Is there a cure for vitiligo?

I would like to ask the doctor about the causes of vitiligo and whether it can be treated.
My sister has had vitiligo on her foot since childhood, but it seems that no one in our family has this condition.
She is very concerned about it, and it appears to be spreading, as she has also developed patches on her back.
Last year, she heard that Changhua Christian Hospital offers surgery for vitiligo and visited for a consultation.
The doctor mentioned that the success rate is about 80-90%, and that this is the only hospital offering this procedure, with no branches.
The cost of the surgery is approximately NT$30,000.
My sister is considering having the surgery on June 26 (the day after the Dragon Boat Festival), as there are consultations only on Tuesdays.
However, I am worried about the doctor's claims and whether this is indeed the only hospital performing this surgery.
I would like to know if there are other hospitals that offer this procedure, as my sister works in Taipei and would need to take leave to visit Changhua.
I kindly request the doctor to provide a response before the Dragon Boat Festival.
Thank you very much!

Xiao Qian, 30~39 year old female. Ask Date: 2001/06/13

Dr. Zheng Lizhen reply Dermatology

According to research, approximately thirty percent of patients with vitiligo have a family member who also has the condition.
Vitiligo is related to genetic factors, along with certain triggering factors such as trauma, illness, or sunburn that can lead to the onset of this disease.
Current treatments include topical corticosteroids, ultraviolet A (UVA) light therapy, epidermal grafting surgery, and melanocyte culture transplantation surgery, among others.
Epidermal grafting and melanocyte culture transplantation surgeries are performed in some major hospitals.
It is unclear which type of surgery your sister's doctor intends to perform, so it is difficult to comment on whether this is the only option available.
The focus should not solely be on whether this is the only facility offering treatment for vitiligo, but rather on which type of surgery is being considered, its success rate, potential side effects, and precautions, don't you think?

Reply Date: 2001/06/13

More Info

Vitiligo, also known as leukoderma, is a skin condition characterized by the loss of pigment, resulting in white patches on the skin. The exact cause of vitiligo is not fully understood, but it is believed to be an autoimmune disorder where the immune system mistakenly attacks and destroys the melanocytes, the cells responsible for producing skin pigment (melanin). Genetic factors may also play a role, as some individuals may have a family history of vitiligo or other autoimmune diseases. Environmental triggers, such as sunburn, stress, or exposure to certain chemicals, may also contribute to the onset or worsening of the condition.

Regarding treatment options, there are several approaches available for managing vitiligo, although results can vary significantly from person to person. Common treatments include:
1. Topical Corticosteroids: These are anti-inflammatory medications that can help restore pigment in some cases, especially if started early in the disease process.

2. Phototherapy: This involves exposing the skin to ultraviolet (UV) light under medical supervision. Narrowband UVB therapy is commonly used and can stimulate melanocyte activity.

3. Depigmentation: For individuals with extensive vitiligo, depigmentation of the remaining pigmented skin may be considered to achieve a more uniform skin tone.

4. Skin Grafting: In some cases, surgical options such as skin grafting may be performed, where healthy skin is transplanted to areas affected by vitiligo. This is usually considered when other treatments have not been effective.

5. Cosmetic Solutions: Many individuals choose to use makeup or self-tanning products to cover the white patches, which can help improve their appearance and boost self-esteem.

As for the surgical options mentioned, it is essential to verify the credentials and reputation of the medical facility and the surgeon performing the procedure. While the success rate of 80-90% mentioned by the doctor at the Changhua Show Chwan Hospital may be accurate, it is crucial to understand that individual results can vary. It is advisable to seek a second opinion or consult with other dermatologists or medical centers that specialize in treating vitiligo. Many hospitals and clinics offer similar surgical options, so your sister may have alternatives closer to her workplace in Taipei.

Before proceeding with any treatment, it is important for your sister to have a thorough discussion with her healthcare provider about the potential risks, benefits, and expected outcomes of the surgery. Additionally, understanding the long-term management of vitiligo is crucial, as the condition can be unpredictable, and new patches may develop even after successful treatment.

In summary, while vitiligo can be a challenging condition, various treatment options are available, and surgical interventions may be effective for some individuals. It is essential to conduct thorough research and consult with qualified professionals to make informed decisions about treatment. Your sister's concerns are valid, and seeking multiple opinions can help her feel more confident in her treatment plan.

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