Review of creams and effective ointments for vitiligo. Natural based medicines. St. John's wort against vitiligo

Vitiligo or leucoderma refers to diseases caused by the destruction of melanin. People with this defect develop white patches on their skin. This rare disease, which occurs in less than 1% of the total population. Most often, this defect manifests itself between the ages of 10 and 25 years; it is during this period that half of all cases of the disease occur.

The main manifestation of leukoderma is the appearance of white spots on milky skin with clear boundaries. They are localized mainly in the face, knee-elbow folds, arms and legs. Treatment of vitiligo is carried out using medications, hardware techniques and local preparations for application to the skin.

There is no single tactic for complete recovery yet, so more and more cosmetic procedures and drugs to hide the defect. Hardware techniques, including light therapy, have become widespread in treatment.

Let's take a closer look at whether vitiligo can be cured, what are there medications and hardware techniques.

Before vitiligo is treated, a diagnosis should be made to identify concomitant skin pathologies. The therapeutic approach will depend on the presence of other diseases. Leucoderma may be accompanied lichen planus, scleroderma, alopecia, psoriasis. Vitiligo is often accompanied by symptoms of dysfunction gastrointestinal tract, impaired sweating, decreased functional capacity of the liver.

Treatment of vitilingo requires a therapeutic approach

To have an idea of ​​how to cure vitiligo, you should determine the type of disease. There are localized and generalized forms of the disease. In the first case, white areas will appear singly simultaneously with damage to the mucous membrane. The generalized form is characterized by extensive skin damage, up to 80% of the entire body.

Treatment of vitiligo includes the following measures:

• drug therapy with glucocorticosteroids;
• physiotherapeutic procedures using drugs to increase the level of T-lymphocytes;
• vitamin therapy with the administration of drugs internally and externally;
• the use of cosmetic products to protect the skin from ultraviolet radiation and temporarily mask the defect.

Note! Eat clinical cases complete recovery of patients, but they are not explained by the use of any specific means or techniques. There is a high risk of progression of the pathology without maintenance therapy. Although treatment for vitiligo does not guarantee recovery, it is necessary to maintain general condition health and elimination of concomitant diseases.

Medications

Glucocorticosteroid drugs are aimed at suppressing allergic reaction and the body's immune response. Their use is indicated for limited and generalized forms of the disease. In the first case, it is rational to use an ointment for vitiligo based on corticosteroids in order to restore the function of the cells responsible for pigmentation.

In the case of a generalized form of pathology, drugs are more often prescribed in tablet form. These are Dexamethasone, Prednisolone, Triamcinolone and others. Before prescribing medications, the risk of developing adverse reactions. Long-term use of glucocorticosteroids can cause Cushing's syndrome and diabetes mellitus. Due to the risk, treatment is carried out intermittently.

There are known drugs for therapy such as Protopic or Elidel. They are indicated for dermatitis of various origins and psoriasis, but are also effective for leukoderma. Their topical use has an anti-inflammatory effect and suppresses the immune response. Their effect is somewhat similar to glucocorticosteroids. These drugs can be used to treat children and adults in different concentrations.

An integrated approach to therapy is to normalize hormonal levels patient, eliminating depression and identifying influencing factors that have become trigger mechanism in the appearance of pathology. It is extremely important to take vitamins for vitiligo to compensate for the deficiency. Also, people with this diagnosis may be prescribed immunomodulatory agents and antioxidants.

List of drugs

Groups medicines effective for leukoderma:

1. General strengthening. Phytoferrolactol, Apilak.
2. Immunomodulators. Cyclosporine A, Tacrolimus, Isoprinosine, Echinacea.
3. Photosensitizers. Melagenin, Psoralen, Furalen, Lamadin.
4. Antidepressants and neuroleptics. Pyradazole, Neuleptin, Sonapax.
5. Vitamins A, B and E.

Known drugs for the treatment of vitiligo:

• Ammifurin;
• Psoralen;
• Oxoralen;
• Melagenin;
• Vitex;
• New medicine - Sanum Cutis.

Psoralen

The medicine Psoralen is available in the form of a solution for external application and tablets. It is based on plant components and has a photosensitizing effect. When treating vitiligo, the drug Psoralen helps restore pigmentation. Lubricating the damaged areas and taking the tablet product is supplemented with irradiation ultraviolet lamp.

The duration of therapy with this drug is at least 3 months. The medicine is contraindicated for diabetes mellitus, kidney pathologies and persons over 60 years of age. During treatment there may appear discomfort in the form of nausea, rapid heartbeat, dizziness and headache.

Oxoralen

The drug Oksoralen is a dermatotropic drug and is available in the form of capsules with a liquid composition. Shown for complex treatment vitiligo as a photosensitizing agent. Taken before irradiation, washed down with milk. The medicine is contraindicated in pathologies circulatory system, during pregnancy and children under 12 years of age. The minimum course of therapy is 3 weeks.

Melagenin

Melagenin is presented in the form alcohol tincture placenta extract. The medicine for vitiligo promotes the production of melanin. It is indicated for external application to white areas, after which irradiation is carried out with an ultraviolet lamp. Initially, the drug leads to redness of the skin, then it begins to acquire a natural shade.

Ammifurin

The drug Ammifurin also belongs to photosensitizing drugs for restoring pigmentation. Photocoumarins in the drug increase the skin's sensitivity to light, which leads to the formation of melanin. The medicine is used simultaneously with the treatment of vitiligo with a 311 nm lamp. It is contraindicated in children under 5 years of age, during pregnancy, with tuberculosis and functional disorders liver and kidneys. Adverse reactions may include headache, nausea and rapid heartbeat.

Ointments and creams

Complex treatment of leukoderma must be carried out with the prescription of special ointments and creams. They may be based on corticosteroids and herbal ingredients. Natural medicinal ointments and creams are more often used to stimulate melanin production and recovery normal condition skin.

Note! Before treatment, you should understand that the course of therapy lasts at least 3 months, and positive result observed only in 80% of patients.

In the treatment of this pathology, it is permissible to use folk remedies, therefore the ointment can be prepared at home using proven natural medicinal ingredients.

Corticosteroid-based ointments:

1. Hydrocortisone ointment 1%. The product is applied to damaged areas of the skin up to 3 times a day and is low cost.
2. Momat. This medicine is available in the form of an ointment or cream of 0.1%, applied to depigmented skin. To have an effect, it is enough to use the medicine once a day.
3. Advantan 0.1%. Available in the form of cream and ointment, it contains methylprednisolone. The drug is suitable for long-term treatment, allowed for children from 4 months. This is a relatively expensive cream, but it can be used during breastfeeding and during pregnancy.

Ointments on plant based may contain several medicinal components. Today, more than 150 plants are known that contain photocoumarins, which are important for the treatment of leukoderma. Most known drug This group is Vitasan cream. It contains extracts of St. John's wort, string, calendula flowers, walnut, additionally there is fir and pine nut oil.

This medicine is applied to damaged areas 2 times a day, in the morning and before bed. The advantage of this cream is the absence of contraindications, with the exception of hypersensitivity to the main component. Its cost is higher than its analogues, from 950 rubles. You can replace this drug with Amodin cream. The medicine contains many useful plant components that improve the absorption of the main substance. The drug has a positive effect on metabolism and blood circulation, helps restore the balance of microelements and vitamins.

Nuclea cream also applies to effective medicines with vitiligo. It contains carrot, avocado and calendula extract, as well as St. John's wort oil and amino acids. It is indicated for long-term use, it is recommended to combine it with another product from the same manufacturer - Synchro cream.

Other local drugs for treatment:

• Malavit gel – contains vitamins, organic acids and essential oils, has no contraindications;
• Anti-Vitiligo – contains a complex of plant extracts and essential oils, created according to a Chinese medicine recipe;
• Retinoic ointment.

A dermatologist together with an endocrinologist will help you decide how to treat vitiligo after examining the body. A cosmetologist and an infectious disease specialist can also take part in the treatment.

Hardware method

Narrowband phototherapy is used to eliminate vitiligo.

Advantages of the method:

• high efficiency with minimal risk unpleasant consequences;
• During the procedure, the skin receives a small dose of ultraviolet radiation, which is selected individually;
• allowed for the treatment of children over 6 years of age and during pregnancy;
• phototherapy is not required additional training by taking photosensitizers, which significantly reduces the risk of adverse reactions.

The procedure involves exposure to ultraviolet light locally, directly on the damaged area. The irradiation continues for several minutes, with each session the duration increases. The entire course can last from six months. A 311 nm lamp is used for patients with vitiligo, which is installed in a hospital in a special booth. In addition, you can buy a compact device for use at home.

Ultraviolet lamps

The use of lamps is allowed at home in case of localized vitiligo; in the case of a generalized disease, irradiation of the dermis is carried out in special rooms in a hospital setting. Phototherapy using narrow spectrum 311 nm suppresses immune reaction, which destroys melanocytes. Gradually, the cells begin to regenerate, their numbers increase, and the skin color acquires a natural shade.

The use of such lamps is effective in combination with various additives. These can be Vitilemna or Melavit tablets, as well as Vitex gel. Before purchasing a UV lamp for home use You should definitely consult your doctor. The specialist will tell you how to use the device correctly, how long the procedure should last, and what medications should be supplemented.

Vitamin therapy

Treatment indicated for vitiligo vitamin complexes, including vitamins B, C, alpha lipoic acid. Among the popular drugs are Thiamine, Riboflavin, ascorbic and pantothenic acid. Mandatory conditions Taking vitamin supplements involves irradiating the skin with ultraviolet light.

How to hide stains

Vitiligo affects the quality of life; many people feel depressed and may even be diagnosed with depression, which is associated with a significant external defect. To hide it and thereby improve it psychological condition It is recommended to resort to the use of cosmetics and some recipes traditional medicine.

The most in an accessible way is the use of foundation. For a longer lasting result, you can get a permanent tattoo. It is also effective to apply self-tanning on exposed skin.

Note! Walnut peel will help hide the defect. To prepare the product, you need to grind the peel in a blender and wait several hours until it turns brown. After this, you need to squeeze out the juice with a cotton pad and apply it to the stains. This method is good because it does not leave marks on clothes.

Dermabrasion can also help cover up spots. The technique involves layer-by-layer treatment of the skin at different levels, which will depend on the severity of the pathology and the age of the spots.

Vitiligo can be dealt with if you correctly combine medications and hardware techniques, and also eliminate negative factors risk. During the treatment period it is very important to normalize mental condition, a positive attitude will contribute to a speedy recovery.

Vitiligo- acquired (less commonly hereditary) skin disease, characterized by the formation of spots on it. White spots on the skin are the result of depigmentation of areas of the skin during the development of vitiligo. Vitiligo is difficult to treat, but cosmetic imperfections can be eliminated.

What causes vitiligo?

Vitiligo is a disease of insufficiently studied nature (idiopathic). Vitiligo is believed to be caused by impaired function of melanocytes, the skin cells that produce the pigment melanin (melanin is responsible for tanning under UV exposure).

There is also a version that vitiligo develops as follows: in the epidermis and hair follicles Due to autoimmune disorders, melanocytes die - this is how white spots on the skin appear and expand (in areas of depigmentation).

However, despite the as yet unspecified mechanisms of development of vitiligo, a connection between this disease and a number of factors has been established. The risk of its development increases:

• for diseases internal organs, mainly disorders of the endocrine system (diseases thyroid gland occur in 30% of patients with vitiligo);
• autoimmune diseases;
• dysfunction of the nervous system, stress;
• chronic inflammatory diseases;
• intoxications;
• sunburn.

Vitiligo has age characteristics: In half of the cases it begins between 10 and 30 years of age and rarely develops in older people. In children, localized forms of vitiligo are usually observed, usually against the background of autoimmune and endocrine diseases.

What are the types of vitiligo?

Vitiligo is divided by the nature of the distribution of white spots on the skin (depigmentation).

• Localized - divided into focal (one or several spots located on a separate area of ​​the body that does not form a segment); segmental (one or more spots within a segment) and mucous (depigmentation on the mucous membranes) forms.
• Generalized - include acrofacial (white spots on the skin have spread to the lower extremities and face); vulgar (multiple symmetrical white spots on the skin, scattered in different areas) and mixed forms.
• Universal vitiligo - white spots on the skin occupy 80% of the total area of ​​the skin.

Vitiligo is also distinguished by the nature of its manifestations on the skin and other symptoms.

• Vitiligo pink: before the appearance of white spots on the skin, redness (erythema) first occurs, which is accompanied by itching, and then peeling.
• Vitiligo reticularis: white patches on the skin contain pigmented dots that form a mesh. Vitiligo reticularis most often appears on the skin of the genital organs.
• Vitiligo is punctate: white spots are small, contrasting hyperpigmentation is sharply visible around them.
• Setton's nevus is a colored nevus surrounded by an area of ​​depigmented skin. Sutton's nevus can vary in color from pale pink to brown; enlarge, flatten until completely disappearing, leaving only a depigmented halo.
• Neurodermatouveitis (Vogt-Koyanagi syndrome, Harada disease) is a whole complex of pathologies, including damage to the eyes (uveitis), skin (vitiligo), hair (baldness, graying) and inner ear(dysakusia).

Stable vitiligo is also distinguished - in the absence of growth and spread of white spots on the skin for 1 year.

How does vitiligo manifest?

Multiple or single spotty rashes (pigment loss areas) appear on the skin, which spread over time. Along the edges of the white spots, thickening of the skin color is noted - the spots contrast with healthy areas of the skin. The spot can appear on any area (except the skin of the palms and soles). In this case, the spots tend to spread and grow.

Gradually, the skin becomes more and more intensely discolored (the trend of depigmentation is from ivory to white). As a rule, the severity of depigmentation increases over several weeks, sometimes days, but cases of lightning-fast development of generalized vitiligo overnight have been reported. There is also a slow course of the disease: white spots on the skin form over months and even years.

The hair on the white spots also becomes discolored; Premature gray hair may appear. Most often, white spots on the skin do not cause discomfort, except moral. Only 10% of patients with vitiligo complain of itchy skin.

How to diagnose vitiligo?

Clinical examination and anamnesis data. Examination under Wood's lamp.

How to treat vitiligo?

In the treatment of vitiligo, PUVA therapy (psoralen plus ultraviolet A) - irradiation with long-wave ultraviolet rays - is of particular importance. PUVA irradiation sessions in such patients are carried out periodically for 1-2 years. Selective and narrowband mid-wave phototherapy is also used.

Before (90 minutes before) a PUVA therapy session, psoralen, trimethylpsoralen (neosoralen) are used topically. Psoralens are also available in forms for internal use.

They also treat a chronic disease thought to be related to vitiligo.

In the generalized form, glucocorticoids are prescribed orally, for example, betamethasone (Celeston), prednisolone (Medopred, Prednisolone, Prednisolone Nycomed) 5 mg/day for 2 days, then a break until the end of the week). This regimen for 2-4 months provides high efficiency at low risk of occurrence side effects.

For localized vitiligo, glucocorticoids of moderate activity are prescribed externally: ointments (prednisolone) are applied daily to white spots on the skin for 3-4 months. If there is no effect, high-potency glucocorticoid drugs are used daily for 2 months. Repeat the course if necessary after 1-4 months. Triamcinolone (Kenalog, Delficort), fluticasone (Cutivate, Flixotide) are also used.

For vitiligo, hepatoprotectors (essential phospholipids) are prescribed, as well as immunomodulators: polyoxidonium, tyrosine-alanyl-glycyl-phenylalanyl-leucyl-arginine diacetate; enzymes: pancreatin; herbal remedies.

For vitiligo, the risk of direct sun exposure is strictly excluded; the use of sunscreens with a protection index (from 15 to 150) is mandatory. A fortified diet is indicated (vitamin-mineral complexes are additionally prescribed). Separately shown are ascorbic acid (vitamin C), pyridoxine (vitamin B 6), thiamine (vitamin B 1).

When treating vitiligo, extreme caution should be exercised: when using psoralens and performing PUVA therapy, there is a high risk of burns and phototoxic reactions. With local use of glucocorticoids, skin atrophy and telangiectasia are possible. When using depigmenting and cosmetic products, it may develop contact dermatitis.

In a fifth of patients with vitiligo, treatment is ineffective, especially if it is started late.

Vitiligo is a skin disease that occurs infrequently, but causes a lot of trouble for its owner. The essence of the disease is that depigmented spots appear on the skin caused by insufficient melanin production.

The reason for its appearance is not fully understood, but there are effective methods, allowing you to get rid of this defect and even out your skin tone. Several groups of drugs are used for this.

Corticosteroid-based products

The first of these is corticosteroids, which have an anti-inflammatory effect. The fact is that for several years now American and European scientists have been studying the inflammatory nature of vitiligo. That's why this group drugs are often prescribed to patients.

Here are the most popular ones:

As an alternative to this drug, you can use effective ointments for vitiligo Lokoid or Sulfodecortem.

These funds are used in complex therapy skin disease. They should be applied to problem areas of the skin 2-3 times a day.

As a rule, Hydrocortisone is prescribed for vitiligo in both children from 2 years of age and adults, however, before using it, you should consult a dermatologist, since the dosage and order of use may vary depending on the case. Such treatment should be abandoned if the integrity of the skin in the area of ​​depigmentation is compromised, in the presence of acute acne, as well as when localizing spots near the mouth;

• Prednisolone is a hormonal drug with the main ingredient of the same name. The ointment is produced with a dosage of 0.5% of the main substance. Prednisolone is intended to relieve inflammation and eliminate allergic reactions.

It should be used 1-2 times a day, applying a thin layer to problem areas of the face and body. The drug is prescribed for vitiligo by a doctor for adults and children from 2 years of age, but for young patients it is prescribed only in cases of extreme necessity. Like many hormonal drugs, Prednisolone ointment can cause swelling and excess weight. It should not be used during pregnancy, inflammatory and viral skin diseases, as well as in the presence of tumors;

• Advantan - this drug is available in the form of an ointment, cream or emulsion. The main ingredient is methylprednisolone aceponate. It also has anti-inflammatory, anti-edematous and antipruritic effects, so it is usually used to treat dermatitis. However, even with skin pigmentation disorders, this medicine shows good results. This remedy is used once a day, and it is considered quite safe, therefore it is allowed for small children and nursing mothers. Treatment of vitiligo with Advantan is prohibited if the patient has syphilis, viral infections, skin tuberculosis and individual intolerance to its components;
• Elokom-S. This ointment is characterized by a dense, uniform consistency and is based on mometasone furoate at a concentration of 0.1%. She deserves positive reviews patients, because it not only eliminates unpleasant symptoms, but also promotes tissue renewal. Treatment of vitiligo involves using the drug 1-2 times a day. Apply the product to small areas of depigmented skin. Vitiligo can be treated with this remedy for adults and children over 2 years of age. The drug is contraindicated if there are acute infections, especially viral skin diseases, in the first days after vaccination, during pregnancy and while breastfeeding, as well as in the presence of acute acne on the face and body.

These drugs are especially effective in treating skin defects caused by pigmentation disorders.

Herbal products

However, other means are also used in complex therapy.

AND next group represent plant-based ointments:

• Vitasan - cream based on extracts from medicinal plants: St. John's wort, nettle seeds, walnut kernel, carrot seeds, pine nut kernel. This composition increases the skin's sensitivity to sun rays, stimulates the growth of malanocytes and pigment formation. Vitasan should be used 2 times a day for 2 weeks, and it is advisable to periodically be in the open sun. Treatment of vitiligo with this remedy is contraindicated if there is an individual intolerance to the ingredients that make up the cream;
• Psoralen is an ointment based on psoralea drupes. This drug is designed to enhance melanin production and sensitivity to ultraviolet radiation. This medicine should be used under the strict supervision of a doctor; it is sold by prescription. Every day you need to rub it into problem areas 2-3 times a day. Treatment for vitiligo lasts for 3-3.5 months. Despite the fact that this drug is herbal, it has many contraindications: diseases of the kidneys, thyroid gland, liver, as well as pregnancy, lactation and childhood up to 5 years.

Products based on vitamin-mineral complexes

Besides these herbal preparations, I also use other medications based on vitamins and minerals:

These medications are used to treat vitiligo, but many sufferers need cosmetics, which quickly mask imperfections. Viticolor gel is suitable for this. This is a non-toxic, water-resistant product that is applied to white spots. No contraindications were identified when testing this cream.

The choice of the optimal remedy for vitiligo depends on individual characteristics organism and the degree of manifestation of the disease. Severe symptoms require the use of corticosteroids. Hydrocortisone is the most accessible domestic drug that shows good results. In this regard, many dermatologists and their patients prefer it.

To increase local immunity and skin sensitivity to sunlight, it is recommended to use plant-based ointments or creams. Vitasan is safer and can therefore be used at any age and condition. Vitiskin hydrogel is also suitable for these purposes.

Vitiligo is a skin disease that is of keen interest to modern scientists, since the mechanism of the appearance of depigmented spots is not fully understood. Conclusions are being drawn about the inflammatory, genetic or autoimmune nature of the pathology, but there is no consensus yet.

For this reason, external remedies are not enough to eliminate defects on the face and body and to prescribe more full course treatment should consult a doctor.

Vitiligo is a chronic autoimmune disease, characterized by the absence of melanin pigment in areas of human skin, which tends to spread lesions throughout the body. In the world, 1% of the population suffers from this disease, most cases in percentage registered in India - 8% and Mexico - 3% of the total population of the countries. As one of the treatment methods, various ointments are used for the manifestations of vitiligo.

The disease affects all segments of the population from ordinary people to the stars, the earliest recorded case of the disease is 1 year, the latest is 80 years. Doctors do not have a consensus on the treatment methods for vitiligo. Some experts do not consider it a medical problem, since the patient does not experience physical suffering, but rather classify it as a psychological or social problem, since vitiligo causes psychological stress and discomfort in the patient in society. Nevertheless, the disease requires an integrated approach to treatment: elimination of the causes of the manifestation, physiotherapy and vitiligo ointment - as the main remedy for reducing the boundaries of discolored areas of the skin. Treatment of vitiligo is aimed at:

• increasing natural melanin production by stimulating melanocytes (cells that produce melanin);
• control of the spread of spots to other parts of the body;
• elimination of the causes that created the preconditions for the onset of vitiligo (severe nervous shock, hormonal imbalance, normalization of the gastrointestinal tract).

Properly planned therapy can stop the spread of the disease and reduce the area of ​​affected areas. External preparations - creams, ointments, gels require systemic use, the effectiveness of therapy depends on several factors, but the first changes will be seen after 4 months of treatment:

• the area of ​​the affected areas - the smaller it is, the sooner the treatment result will be visible;
• the size of the spots - the smaller they are, the better they respond to treatment; large spots are more likely to not respond to therapy;
• symmetrical spots on one side of the body are more susceptible to the effects of drugs than similar areas on the other side of the body;
• spots on the lips, in the corners of the mouth, and on the tips of the fingers respond less well to treatment than spots on the body.

Improving the patient's condition means resuming the process of skin pigmentation or stopping the spread of the disease.

Types of ointments

For the treatment of vitiligo, pharmacies offer a range of drugs for external and internal use. The leading place among products for external use is occupied by ointments of two groups: hormonal and steroid, produced in the form of creams, ointments, and gels. For vitiligo, cream and ointment differ in the amount of active ingredient; ointment is a more concentrated product and is able to penetrate deeper into the layers of the skin.

Hormonal ointment is applied to the affected areas, since the active substance, when it reaches the depigmented surface of the body, has an immunosuppressive effect.

The drug changes the functioning of the immune system in this area, providing cells with the opportunity to normal functioning and melanin production. Corticosteroids (adrenal hormones) are active substance of this drug. Hormonal ointments of this type can inhibit adrenal function.

Steroid ointment contains other types of hormones, has an immunosuppressive anti-inflammatory and anti-allergic effect, but can increase skin sensitivity, interfere with the body's absorption of vitamins C and D, and promote the elimination of chromium from the body. When prescribing steroids, the doctor must additionally prescribe to the patient for prevention purposes vitamin supplements. The active ingredient in steroid ointments for vitiligo is the hormone cortisone. Both should be used in courses with caution to avoid excessive stress on the body. Usage steroid drugs for the treatment of vitiligo in short time gives a positive result, but can lead to an irreversible relapse, since vitiligo tends to recur, and sometimes become aggressive. Glucocorticoids are the active ingredient of this drug.

There are medications to treat vitiligo plant composition and based on vitamin complexes and minerals. They increase the sensitivity of the affected skin to sunlight, nourish it, improve blood circulation and stimulate the functioning of melanocytes. Vitiligo cream is sold in pharmacies with or without a doctor's prescription.

Review of popular ointments for vitiligo

Currently the most popular treatment skin problems are drugs from the group of glucocorticoids with the active substance cortisone. IN comparative table Below are the most common and effective hormonal ointments from vitiligo.

As shown in the table, bacterial, fungal and viral skin diseases are contraindications for almost all drugs against vitiligo. Wilkinson's ointment can easily cope with these problems. Sulfur or zinc cream or ointment will help relieve the dermis of inflammation, microdamage and acne, but before using them you must apply it to the damaged or inflamed area suppressants pathogenic microflora. If the scalp is damaged, you should use sulsen shampoo or gel. Active ingredient These products - sulsen - eliminates dandruff and reduces the manifestations of the disease. Many drugs contain salicylic acid, which is contraindicated for people who are hypersensitive to it.

The use of Protopic is contraindicated for the treatment of young children, and Russian drug Prednisolone is used with caution in hypertensive patients because it has the property of retaining water in the body.

It is worth noting that long-term use of ointment with corticosteroids should only be under the supervision of a doctor and as prescribed for the treatment of vitiligo. Drugs can negatively affect the metabolism of patients and cause atrophy of the skin, blood vessels, or provoke an exacerbation.

Indications and contraindications

Dermatologists advise going to the hospital when the first signs of the disease appear. With early therapy, its effectiveness will be higher. On initial stage disease, the doctor will select ointments for the treatment of vitiligo with minimal or no side effects. Indications and contraindications are detailed in the instructions for each drug. When prescribing therapy, the doctor takes into account the patient’s health status, the presence of chronic and hereditary diseases, weight, age, lifestyle and other factors. Among the most common contraindications is individual intolerance to the drug. Do not apply ointments to the area around the eyes and lips, or to damaged skin surfaces. In this case, you should wait until the tissues have completely healed. Indications for taking a particular drug are determined by the doctor on an individual basis.

Can foundation hide blemishes?

For some situations where use medicinal ointments according to the indications, it is not allowed, or an urgent camouflage effect is needed, it is worth choosing an effective cosmetic product that will help hide skin defects. This can be self-tanning or any other tinting product. It is matched to the basic skin tone so that the melanin shade of healthy tissue blends in color with the defective one. Concealer It won’t get rid of vitiligo, but it will help you feel more confident at the event. A two-pronged approach to masking spots is common: first, self-tanning or other camouflage-type products are used - gels, creams, lotions - they help even out the basic skin tone and have good durability, and then the tone is brought to an even shade with foundation. You can also bleach other areas of the dermis and apply foundation. When used this way, the foundation will last longer, better covering blemishes.

If it is impossible to pass drug treatment Traditional medicine recipes will help, both for the treatment of vitiligo and for coloring spots. You can discolor other areas of the body (this medical procedure is resorted to in cases where the area affected by vitiligo is more than 50% of the body area). Sunscreen must be applied to the skin of a patient with vitiligo. This will help protect against sunburn, which will not aggravate the contrast between the affected areas of the body and healthy ones. Corrective cosmetics are indicated for those who have manifestations of the disease on visible areas of the body, and whose treatment does not involve the application of ointments, like the face. The most common product that gives an immediate effect and has a waterproof property is Viticolor or Vitex gel. Permanent makeup will also help hide unwanted manifestations of the disease.

Vitiligo is a type of skin disease in which the skin loses its natural pigmentation due to the destruction of melanin. The result of this is discoloration of areas of the skin and its variegation. Common people Russian name This disease sounds like a “dog,” which is most likely due to the variegation of the skin in vitiligo.

Another name for the disease is leucoderma, which in Latin means White skin. The name vitiligo can come from the Latin “vitilum” (flaw, defect) or “vitilus” (calf), associated with both irregularities in skin color and the variegation of calf skin.

Causes of vitiligo

A person is not born with this skin feature, but acquires it under the influence of various external and internal factors. The highest frequency of onset of the disease occurs in the first ten years of life, puberty, as well as pregnancy and menopause in women. There is also a connection between the appearance of the first signs of the disease and periods of greater solar activity (spring and summer).

The factors that provoke the onset of the disease are very diverse.

Autoimmune processes

In which antibodies to its own tissues appear in the body, they play an important role in the occurrence of vitiligo. This is confirmed by the fact that patients with vitiligo often have other autoimmune diseases (systemic lupus, rheumatoid arthritis, thyroid lesions, for example, Hashimoto's goiter, type 1 diabetes mellitus, Addison's disease, alopecia areata).

Genetic predisposition

Available genetic predisposition to vitiligo. This position was proven in experiments by R. Spritz from the University of Colorado. They established not only a relationship with a family predisposition to the disease, but also proved that people with light (gray or blue eyes) are less likely to suffer from vitiligo than brown-eyed people. Also, the incidence of the disease is higher in the Negroid race.

Neuroendocrine causes

These are sharp fluctuations in hormone levels and stressful conditions that can initiate the onset of the disease.

Trophic disorders

These are nutritional disorders of the skin and underlying tissues associated with skin injuries (mechanical, chemical, radiation damage). So, after a mechanical violation of the integrity of the skin, an inflammatory reaction with an autoimmune component is triggered, which leads to the destruction of cells producing the melanin pigment. With frequent exposure to the sun, the existing process of skin depigmetation quickly and noticeably progresses.

Medicines

The effect of drugs and some chemical substances can also cause areas of skin depigmentation to appear.

Liver diseases

There is a relationship between vitiligo and liver pathologies (parnechymal changes and bile stagnation), as well as helminthic infestations and giardiasis.

At the tissue level, vitiligo is associated with the death of melanocytes, and at the cellular level, with inhibition of tyrosinase, an enzyme that is involved in pigmentation.

Symptoms of vitiligo

The disease manifests itself in the appearance of clearly defined spots or foci of a milky white color on the skin. Typical places for their location are areas around the mouth, ears, nose, eyes, on the back of the hands and feet, fingertips, armpits, elbows and knees, groin and perianal area. The darker the patient's skin, the more distinct the boundaries of the lesions. May also be affected hairy part head or beard and mustache area in men.

There are several types of depigmented spots:

• Tricolors have a pigmented outline where the white skin transitions to healthy skin.
• Four-colors have an additional highly pigmented border.
• Inflammatory ones are limited to the raised shaft.
• The bluish ones have a corresponding coloration.

Localized form - lesions in limited areas of the skin

• The focal form of the disease is isolated, often single spots or lesions on one or two areas of the skin.
• Segmental vitiligo is a unilateral lesion within the dermatome (segment of skin supplied by one spinal or cranial nerve).
• Mucosal vitiligo is a lesion of the mucous membranes.

The generalized form is manifested by extensive skin changes

• Vulgar vitiligo - lesions are scattered throughout the body.
• Acrophysical – the face and limbs are affected.
• The total form is also called universal vitiligo and is characterized by extensive areas of depigmentation spread over many segments, occupying up to 80% of the skin.

In addition to skin lesions, other symptoms may be observed:

• lightening or graying of hair in affected areas,
• leucoderma,
• alopecia areata,
• eye damage with chorioretinitis (inflammation of the posterior choroid eyes, including the retina).

For most patients, vitiligo progresses slowly but steadily without treatment. There are also cases of spasmodic depigmentation or independent restoration of pigment.

How to make a diagnosis

Diagnosis is carried out by a dermatologist. To do this, he is based on skin examination data and uses a special Wood's lamp, in the rays of which the areas of depigmentation have clear outlines and glow with white-blue fluorescent light. If necessary, areas of skin are taken for a biopsy, which confirms or refutes the diagnosis most accurately.

Not all white spots on the skin are caused by vitiligo, and this disease has to be distinguished from a large number of pathological conditions.

Here are just a few: post-traumatic scars, hypopigmentation due to eczema or atopic dermatitis, chemical leucoderma, secondary syphilis, pityriasis versicolor, tuberous sclerosis, focal scleroderma. Selenium deficiency, hypomelanosis spotted, visceral leishmaniasis. Leprosy, lichen sclerosus.

Treatment methods for vitiligo

Despite the fact that in medical literature Cases of spontaneous recovery from the disease and spontaneous restoration of skin pigment without any treatment have been described; the risks of constant progression of the process are high. Therefore, a reasonable patient tactic should be limited to seeking medical care see a dermatologist.

Since the disease affects not only the skin, but also the immune system. endocrine and nervous systems, then treatment involves an integrated approach and is divided into the use of local and systemic drugs various groups.

Glucocorticoids

These are drugs that suppress inflammatory (including autoimmune) and allergic reactions.

For a localized form of the disease Local treatment with hormonal ointments is indicated.

• The first stage is ointments with medium activity: Hydrocortisone butyrate (Lokoid, Laticort), Hydrocortisone butyrate (Lorinden, Locacorten), (Flumetasone) Fluorocort, Triacort (Triamcinolone), Esperson (Dexamethasone), Alcomethasone (Afloderm). Course duration is 3-4 months.
• If there is no effect, switch to highly active ointments: Mometasone fuorate (Elocom), Fluticasone (Cutivate), Methylprednisolone aceponate (Advantan), Fluacinolone (Sinalar, Flucinar), Clobetasol (Dermovate), Betamethasone (Celestoderm, Beloderm) for two months with repeated courses in 1-4 months.

For generalized vitiligo resort to systemic administration of glucocorticoids in tablets. To reduce side effects from such treatment (Cushing's syndrome, diabetes mellitus) use pulse therapy or alternating removal therapy with short high doses, alternating with certain breaks in taking funds. Prednisolone, Methylprednisolone, Dexamethasone, Triamcinolone are prescribed in tablets.

Photosensitizing drugs

They cause an increase in the sensitivity of melanocytes to the effects of ultraviolet radiation, under the influence of which skin pigments are actively formed. This group of drugs is plant furocoumarins.

• Beroxan contains two parsnip furocoumarins (bergapten and xanthoxin).
• Methoxalen, Puvalen, Oksoralen, Lamadin contain only xanthoxin.
• Meladinin – isolated from amia major (contains xanthoxin and imperatorin).
• Ammifurni - similar to beroxan with the addition of isopimpinellin, also isolated from amium.
• Psoralen is isolated from psoralea.
• Psoberan – made from figs.

Ultraviolet lamp for treatment

It is used to irradiate the skin after taking photosensitizing agents and has a long wavelength of radiation (320-420 nm). This method is called PUVA therapy. It is contraindicated during pregnancy, in children under five years of age and persons over 60 years of age, with cancer pathologies, hypersensitivity to ultraviolet radiation, blood diseases, of cardio-vascular system, liver, kidneys.

A more gentle way of ultraviolet irradiation of vitiligo areas is treatment with a lamp with medium length waves (311 nm) without prior photosensitization with drugs. This method is called narrowband phototherapy. It has a gentler effect on the body, almost no side effects, but is less effective. The duration of the procedure is from 1 to 5 minutes. Studies by Californian dermatologists claim that even long courses of ultraviolet irradiation (up to 36 months) do not lead to skin cancer in patients.

Other means

To combat vitiligo, treatments for psoriasis and dermatitis - Elidel and Protopic - are also used. These are preparations for external use, based on the anti-inflammatory drug macrolactam ascomycin. The drug suppresses T-lymphocytes and inhibits the body's immune response, while simultaneously providing an anti-inflammatory effect similar to glucocorticoids.

In children, 0.03% is used, and in adults, 0.1% ointment is used. The duration of the course is from three months to six months. The most pronounced results are achieved on the face. The area of ​​the hands and feet is less susceptible to therapy. The drug is used both in isolation and in combination with narrowband ultraviolet irradiation. The drug works only locally and is not absorbed into the blood.

Systemic therapy

Systemic therapy also involves the use of correction hormonal disorders, treatment of depression and neuropsychiatric diseases that could lead to the development of vitiligo. Medicines that restore the deficiency of ascorbic acid, copper, immunomodulators, etc. are also prescribed.

New in treatment

• Laser therapy

• Skin whitening

This is an attempt to equalize the tone of the affected areas and healthy skin. Today, the most popular means for this procedure are injections of eloquin, hydroquinone (2-4%) and its monobenzyl ether (Monobenzone) externally. All drugs are quite aggressive and have a lot of side effects, so they cannot be considered a panacea in solving the problem of depigmentation. In addition, the price tags on them are quite steep (an injection of eloquin costs about 50 thousand rubles), and lightening occurs in sections, so it requires almost permanent use drugs.

• Surgical treatment or autologous skin grafting

More effective for patients with small lesions. This method is expensive, traumatic, and can lead to postoperative purulent complications or transplant rejection reaction and, unfortunately, does not guarantee a lasting effect.

• Melanocyte transplantation

This is the introduction of pigment cells taken from healthy areas of the patient’s skin into his problem skin.

• Melagenin plus

This is an alcoholic extract of human placenta produced in Cuba. Under the name Melagenin, the drug has been on the market since 1998 and is characterized by average effectiveness against localized forms of the disease.

• Creation of a vaccine

In 2013, scientists from medical school at the University of Chicago, in a series of experiments on mice, they tested a protein vaccine that suppressed autoimmune reaction leading to vitiligo. However, until now there has been no information about the completion of work on the vaccine.

• Sceness drug

The Australian drug Sceness, registered in Europe for the treatment of erythropoietic protoporphyria, also holds promise for the treatment of depigmentation in vitiligo.

Treatment of vitiligo with folk remedies

• It is immediately worth noting that the uncontrolled use of herbal photosensitizing agents (St. John's wort, amia, psoralea) can lead not to a cure for vitiligo, but to sunburn.
• Natural immunomodulators such as duckweed also do not provide any positive effect.
• The course of herbal treatment also includes plants containing copper (, arnica, yarrow) and adaptogens (Rhodiola rosea, Eleutherococcus, Aralia).
• To the interesting folk methods One can also include the Chinese medicine drugs Xiaodan and Xiaodianlin, which are not known to help anyone other than followers of these areas of medicine.

Summing up the prospects for treating vitiligo, we must admit that this process is painstaking and time-consuming, leading to recovery in approximately 20% of cases, with spontaneous recovery in approximately 5% of patients.