There are a number of ways to alter the appearance of vitiligo without addressing its underlying cause. In mild cases, vitiligo patches can be hidden with makeup or other cosmetic camouflage solutions. If the affected person is pale-skinned, the patches can be made less visible by avoiding sunlight and the sun tanning of unaffected skin. However, exposure to sunlight may also cause the melanocytes to regenerate to allow the pigmentation to come back to its original color.
Home UVB narrowband phototherapy is a very common a approach that treats vitiligo. The exposure to a UVB light comes from a small UVB narrowband lamp that gives a specific wavelength of only 311-313 nanometer. The power of the lamp is very low and there is no heat. The success rate is very high in children and in adults when the spots are on the face and neck. Exposure times vary; treatment frequency ranges from two to three times per week with a gradual increase in exposure every subsequent session.
The source for the UVB narrowband UVB light can be kind of a fluorescent lamps that treat large areas in a few minutes or high power fiber-optic devices in a fraction of a second, in a clinic.
Long-wave ultraviolet (UVA) light from UVA lamps, with Psoralen, called "PUVA", is given in clinics. It helps in most of the cases. Psoralen can be taken in a pill 1–2 hours before the exposure or as a Psoralen soaking of the area ½ hour before the exposure.
Lately, UVB narrowband replaces PUVA since this treatment does not involve Psoralen since the effect of the UVB narrowband lamp is sufficient.
The traditional treatment (if any) given by most dermatologists is corticosteroid cream.
Studies have also shown that immunomodulator creams such as Protopic and Elidel also cause repigmentation in some cases, when used with UVB narrowband treatments.
In late October 2004, doctors successfully transplanted melanocytes to vitiligo affected areas, effectively repigmenting the region. The procedure involved taking a thin layer of pigmented skin from the patient's gluteal region. Melanocytes were then separated out and used to make a cellular suspension. The area to be treated was then ablated with a medical laser, and the melanocyte graft applied. Three weeks later, the area was exposed to UV light repeatedly for two months. Between 73 and 84 percent of patients experienced nearly complete repigmentation of their skin. The longevity of the repigmentation differed from person to person. In the 1980s, dermatology professor Aaron B. Lerner had pioneered a skin transplantation therapy for vitiligo.
In early 2008 scientists at King's College London discovered that piperine, a chemical derived from black pepper, can shorten the repigmentation process in skin and reduce the UVB exposures, produces a longer lasting and more even pigmentation.
A limited 2003 study in India of 25 patients with limited and slow-spreading vitiligo given orally-taken Ginkgo biloba found it to be "fairly effective therapy for arresting the progression of the disease". A 2008 review of natural health products found studies to generally be of poor quality but concluded that L-phenylalanine used with phototherapy, and oral Ginkgo biloba as monotherapy showed promise.
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