Vitiligo limited form of treatment. Vitiligo photo symptoms treatment: what kind of disease it is, causes. Before and after vitiligo treatment

Content

Medicine now has many tools to treat various diseases. However, science knows very little about such a rare pathology as vitiligo. To understand what this phenomenon is, you need to understand the features of the manifestation of the disease and the reasons for its occurrence. Visually, vitiligo looks like a pigmentation disorder, which is characterized by the formation of discolored spots on the skin. This property of the disease is called depigmentation - the disappearance of melanin pigment from certain areas of the skin. Let's figure out what vitiligo is and how to cure it?

Causes of the disease

Science knows neither the exact causes nor the mechanism of development of vitiligo. There is an assumption that the appearance of vitiligo disease can be explained by the following factors:

• exposure to certain chemicals or medications;
• pathology of the autonomic nervous system;
• diseases of endocrine organs;
• hereditary predisposition;
• chronic diseases.

Main signs and symptoms

The main manifestation of the disease is white spots on the body. Foci of the disease can occur at any age, often in childhood and adolescence, and can form on all areas of the skin. The places where the skin is most traumatized are at greatest risk for the appearance of depigmented areas - spots appear on the legs, knees, hands, and elbows.

In areas of vitiligo, sweating is impaired, and the skin becomes unable to respond normally to cold and heat. The hair on the whitened areas of the body in many patients also becomes discolored. Individual spots can disappear spontaneously even without treatment, but as the disease progresses, foci of depigmentation can form at the sites of recent injuries, friction or pressure on the skin.

The initial stage of vitiligo is very mild. It is characterized by minor foci of depigmentation - small spots that look like a noticeable, but not particularly noticeable cosmetic defect that is easy to disguise with clothing. Gradually, the light spots on the skin enlarge and unite, forming large areas of milky white color.

Vitiligo disease does not cause any disturbing symptoms; it is not contagious, but it is difficult to cure. Vitiligo is perceived by patients as a serious aesthetic defect, so the disease can cause severe psychological discomfort. After tanning, discolored areas become very noticeable; the affected areas of the skin are very sensitive to ultraviolet radiation and quickly “burn.”

Diagnostic methods

Specialists diagnose vitiligo based on the existing clinical picture, examining characteristic foci of depigmentation - white spots on the arms, legs, and torso. Difficulties almost never arise when making a diagnosis; it is more difficult to reliably detect the causes of vitiligo. If the dermatologist is not sure of the diagnosis and suspects other skin pathologies (lichen, psoriasis, neurodermatitis), the patient is referred for additional examinations.

Treatment of vitiligo

Various factors contribute to the occurrence of the disease, so its treatment requires an integrated approach. However, dermatologists do not yet have a clear scheme and reliable methods for treating vitiligo and eliminating spots. Most therapeutic measures are aimed at preventing the progression of the disease and reducing depigmented lesions on the skin.

Diet food

The disease vitiligo develops under the influence of metabolic disorders, and therefore an important condition for its successful treatment and getting rid of spots is a special diet. The patient must eat according to the following rules:

• adhere to a fractional diet;
• start each main meal with fresh vegetables or fruits;
• eat foods rich in copper, manganese, selenium - eggs, meat, sea fish, seafood, cottage cheese, nuts, rose hips, wheat bran, legumes, grains;
• refrain from overly spicy foods, alcohol, foods with preservatives, and processed foods;
• do not eat fried food, but eat food baked in the oven, steamed or boiled.

Local treatment

The following ointments, creams, gels and lotions are used as local preparations for the treatment of vitiligo disease:

• hormonal ointments that slow down the breakdown of melanin in skin cells;
• medications that stimulate melanin production;
• medications based on calcineurin inhibitors;
• cosmetic preparations that mask white spots (Covermark, Vitadye cosmetics, self-tanning or whitening products for unaffected skin).

For hormonal treatment of vitiligo, potent corticosteroid drugs such as Fluticasone and Flixotide are used. They are used continuously for three months (once during the day) or six months with breaks: the product is applied to vitiligo spots for 15 days, then a 15-day break follows, and this is repeated six times over six months.

To stimulate the synthesis of melanocytes (pigment cells of the skin) in case of illness, a lotion for vitiligo spots “Melagenin” is prescribed. The solution is applied to depigmented areas of the skin once a day, using until the desired therapeutic effect is obtained. If necessary, short breaks in treatment are taken. Medicines for vitiligo based on calcineurin inhibitors (Elidel, Protopic) are used twice a day for six months.

Systemic therapy

Vitiligo disease requires an individual approach when prescribing systemic medications. The following groups of medications can be used in the complex treatment of the disease:

1. Photosensitizers. They increase sensitivity to solar radiation. An example of such drugs is Vitilem. It is taken continuously for six months, children from 6 to 12 years old take 1 tablet 2 times a day, adults take 1 tablet 3 or 4 times.
2. Corticosteroids.0 These are hormonal drugs that help stop the progression of vitiligo. For example, Betamethasone or Dexamethasone. These drugs are taken at 5 mg per day, the dose of medication for the child is reduced by half. Funds are prescribed for a period of 6 months to 2 years.
3. Immunomodulators. These products stimulate and support the immune system. For vitiligo, it is preferable to use natural treatments - herbal remedies. An example is “Echinacea”. Adults and children over 12 years of age should take 1 tablet 3-4 times a day. Continuous use of the medication is permitted for a period of no longer than 8 weeks.
4. Vitamins, minerals, food supplements. Patients with vitiligo are prescribed ascorbic and pantothenic acid, vitamins B1 and B2, iron supplements, 1% copper sulfate solution. Laboratory blood tests may be performed to determine how to treat a patient and determine the exact dosage of medications to treat the disease.

Physiotherapy

Physiotherapy is very effective in treating vitiligo disease. The most effective types of physiotherapy are:

• UVB therapy – dosed ultraviolet irradiation of affected areas of the skin using a special lamp;
• PUVA therapy - irradiation of the skin with long-wave ultraviolet radiation in combination with photosensitizing drugs;
• laser therapy – exposure of vitiligo-affected skin to laser radiation of varying power;
• electrophoresis on the lesions with a 0.5% copper solution.

Folk remedies

Having tried different methods of treating the disease and still not finding how to get rid of white spots on the body, patients often use unconventional remedies. Traditional medicine includes many home recipes that are good for vitiligo. The most effective are the following:

• St. John's wort infusion. Pour 1 teaspoon of herb into 0.2 liters of boiling water and leave for half an hour. Take the resulting solution after meals, 3 times daily. The course of treatment lasts 3 weeks. After this, it is recommended to take a week's break and then take a second course of taking the drug.
• St. John's wort ointment. Mix thoroughly chopped herb with olive oil in a ratio of 1:10. Boil in a water bath, leave to cool, then strain. The resulting ointment should be stored in a dark place. Compresses are made from it, which need to be applied to vitiligo lesions once a day for 30 minutes. The duration of treatment is 40 days.
• Mountain arnica infusion. Pour 40 g of herb into 0.4 liters of boiling water and leave for 20 minutes. Take 100 ml four times a day before meals.
• Compresses made from red clay and ginger juice. Mix the components in equal parts. Spread the resulting mixture on a piece of gauze, then apply to the areas affected by vitiligo. Keep the compress on the skin until the product is completely dry. There are no restrictions on treatment time.

Surgical intervention

There are several time-tested and innovative methods of surgical treatment of vitiligo, but they all have contraindications and do not guarantee one hundred percent elimination of the disease. Carrying out skin surgeries requires modern high-tech equipment, so the most effective of them involve treatment in Moscow or in foreign clinics. Surgery for vitiligo can be as follows:

• Skin grafting. The operation is performed in the absence of disease progression. The lesions are removed, and in their place healthy skin is implanted, which is taken from other areas.
• Melanocyte transplantation. Melanocytes grown from the patient's pigment cells are placed on a special carrier, which is then applied to depigmented areas of the skin.
• Autologous minigrafts. Skin micrografts are implanted into vitiligo lesions. This method is more complex than transplanting entire flaps of skin, but it has fewer risks and side effects.

How to treat vitiligo in children

To treat a disease in a child, almost all methods are used that are prescribed to adults. The exception is systemic therapy with hormonal drugs. It is used only if there are strict indications, for a minimum time and in the lowest therapeutic doses. UV skin irradiation sessions and PUVA therapy are contraindicated for children under 12 years of age.

According to the famous pediatrician Evgeniy Komarovsky, when treating this disease, it is important to take care of the child’s psychological state. If peers tease him, and ill-mannered people constantly look at spots on his skin, you should try to find the child communication with other people suffering from vitiligo - this will help him overcome emotional problems.

Disease Prevention

After successful recovery from vitiligo, it is important to follow preventive measures that will prevent the disease from returning:

• carefully protect the skin from injuries, burns, cuts, insect bites;
• avoid wearing tight clothes, uncomfortable shoes, jewelry that can rub your neck or fingers;
• refrain from long stays in the cold or under the sun, do not sunbathe, do not visit the solarium;
• eat right, monitor the balance of vitamins and valuable elements;
• avoid contact with chemical compounds;
• undergo regular medical examinations.

Video: how to get rid of white spots on skin

From the video below you will learn a lot of valuable information about vitiligo: how to cure the disease with effective drugs, supplements and vitamins, what innovative methods of therapy can be used in severe stages of the pathology, whether well-known folk remedies will help get rid of the disease. After watching the video, you will become familiar with how long treatment may take and what results it will help achieve. The plot will help you understand how to defeat vitiligo, get rid of unsightly pale spots on the skin forever, and finally return to a full life.

Photos before and after skin disease treatment

You can understand how much your skin condition can improve as a result of vitiligo treatment by looking at photographs of people before and after treatment for the disease. The photographs below of the areas of skin affected by vitiligo will give you the opportunity to roughly assess the effectiveness of therapy and help you decide on a strategy to combat this little-studied disease.

This disease belongs to skin pathology and has another name - leucoderma (translated from Latin - white skin). In Rus', the disease was called “dog” (cow skin) and they were looking for ways to cure the disease, creating various potions and ointments from medicinal raw materials.

The development of vitiligo is based on the body’s loss of the hormone – melanin, because of this, the affected areas of the skin lighten and become milky white.

initial stage The disease is characterized by the appearance of a small single spot, which can subsequently self-destruct or begin to “grow.” Often, as the disease progresses, many new discolored areas appear on the surface of the skin. Thus, vitiligo can cover part or all of the surface of the human body or be localized in one place throughout the life of patients.

Photo of vitiligo

According to WHO, the disease affects 1% of the world's inhabitants; it equally affects people in European, African and Asian countries. The peak age for the appearance of vitiligo occurs in 10 years of age and older(up to 30), older people get sick less often.

Video:

ICD-10

The etiology of the disease remains insufficiently studied, and in modern medicine, complex psychosomatic mechanisms are named as the causes of vitiligo, without deciphering them in detail.

There are known public people with this disease. Using plastic surgery, the famous American singer hid his achromia all his life Michael Jackson and, on the contrary, another African American woman openly demonstrates and uses it as an exclusive feature. This is a model with vitiligo Winnie Harlow, which is very popular in the world of show business.

Causes

1. Malfunctions of the immune system when tissue metabolism is disrupted and the body mistakenly begins to destroy its cells, mistaking them for hostile.

2. Heredity. Research by American scientists has identified a common genetic defect in several generations of families with cases of vitiligo.

Their discovery also confirms that dark-eyed people experience the disease much more often than people with light-colored irises (blue, gray, green).

3. Hormonal disorders. Malfunctions in the body and metabolic pathologies cause achromia due to a surge or decrease in vital substances.

4. Injuries. Extensive wounds, bruises, frostbite and burns can provoke the death of the epidermis, as a result of which the affected area loses normal functions (heat regulation and protection) and changes color.

5. Diseases of the liver and digestive tract. Stagnation and slower absorption of nutrients negatively affect the condition of the skin and contribute to the development of skin diseases.

6. Exposure to chemicals(medicines, cosmetics, hygiene products, perfumes, household chemicals). In these cases, vitiligo develops in response to irritating substances and their harmful (or inappropriate for the skin) components.

Provoking factors for the manifestation of achromia include:

• physical injuries;
• infectious and (or) chronic diseases;
• psycho-emotional shocks and severe stress.

The disease has a complex development mechanism, so its causes and treatment are strictly within the competence of doctors (dermatologists, immunologists, endocrinologists, etc.).

In children

Most often, vitiligo manifests itself on the face(near the nose, mouth, ears, eyes), hands And feet(from the back, on the fingers, elbows, knees, feet).

Vitiligo - initial stage (photo)

The disease in children can appear after an infection or a sudden malnutrition. Due to underdevelopment and imperfection of the skin and digestive systems, the development of vitiligo is also possible; with age, it may go away or remain.

Usually the disease progresses in the presence of an underlying disease (rheumatism, scleroderma, lupus erythematosus, chronic pathologies of the liver, pancreas, intestines). If vitiligo is detected in a child, you must tell your pediatrician about it.

How to treat?

The main directions in the treatment of vitiligo are:

1. taking or local use of drugs based on glucocorticosteroids (Hydrocortisone, Prednisolone);
2. laser or phototherapy;
3. restorative treatment, diet and lifestyle correction.

TO the newest Vitiligo treatment methods include:

1. cosmetic procedures for skin whitening using special preparations (Eloquin, Monobenzone and Hydroquinone), which allow you to visually even out skin color;
2. autoskin grafting;
3. introduction of one’s own pigment cells from a healthy area to a diseased one;
4. a drug Melagenin plus, the use of this solution based on placenta extract allows you to replenish the melanin deficiency in problem skin. Reviews from recovered patients confirm the lasting effect and the absence of remissions (return of symptoms of the disease).

All innovative techniques are used only after consultation with a doctor; therapy is not carried out during pregnancy and lactation.

Treatment with folk remedies at home

1. Infusions for oral administration. A similar medicine is prepared from herbs that have the ability to improve metabolic processes in tissues (St. John's wort, thyme, calendula, duckweed, etc.).

2. Ointments And compresses. In order to obtain a homemade ointment for vitiligo, a squeeze of medicinal herbs is added to olive or sea buckthorn oil. Compresses are prepared from wine vinegar or vodka with the addition of honey.

3. Baths . These procedures can be carried out using infusions and decoctions of medicinal plants, with the addition of sea salt.
4. Mud . Mud wraps rich in microelements help improve blood circulation and nourish the skin.

All traditional treatment methods are used only after consultation with a doctor!

Currently in medicine there are a number of methods to cure vitiligo. Forever or temporarily - only practice can show. There are cases of complete recovery or stopping the development of the disease. In any case, to achieve a lasting effect, it is necessary to combine the efforts of doctors and patients.

Vitiligo is quite easy to notice; the initial stage has a quite noticeable manifestation. On the skin, the initial stage of vitiligo (photo 2) appears as barely noticeable white spots, the size of which does not exceed 0.2-0.3 cm. Often, such minor symptoms of vitiligo are simply ignored.

Dermatological studies have shown that if a patient has had skin melanoma, the occurrence of vitiligo increases the chances of regression of this disease. Under favorable conditions for the pathology, the initial stage can develop, turning into other forms:

• stationary;
• progressive;
• repigmentation stage.

During the stationary stage White spots(photo 3) do not change, new signs of vitiligo do not appear. With progression, there is a “reproduction” of spots, existing lesions increase in size. The rate of growth depends on the individual characteristics of the body; the symptoms of vitiligo may intensify over several weeks.

Vitiligo after treatment can go into the repigmentation stage. When exposed to chemical agents or taking medications, skin pigmentation disorders become less aggressive. If you ignore the pathology, complications may develop, which include:

• psoriasis;
• focal baldness;
• early gray hair;
• lichen planus;
• scleroderma.

In some cases, the cause of skin pigmentation disorders is pityriasis versicolor in humans, the symptoms of which are somewhat similar to vitiligo. This disease is an infectious pathology and usually affects adults.

People of almost all ages are susceptible to the disease, but vitiligo in children(photo 4) under ten years of age is rare. Most often, the skin disease vitiligo appears in teenage girls, especially if they are overly emotional. Experiences and stress contribute not only to the appearance of spots, but to their rapid development.

The initial stage of vitiligo in children can appear even after a common cold, the complications of which have damaged the immune system. In this case, vitiligo appears on the skin as barely noticeable spots of a pinkish tint. Poliosis also occurs - loss of hair pigmentation where signs of vitiligo appear in children.

Even if the disease appears in a pregnant woman, it will not necessarily pass on to her child. Vitiligo appears in a newborn for reasons beyond the control of the mother's body. Vitiligo in infants can occur against the background of concomitant diseases, which include psoriasis in children, or lichen versicolor.

Due to the fact that vitiligo rarely appears in young children, parents may not pay due attention to the disease. This is a serious mistake: without treatment, vitiligo skin disease will progress, which can lead to serious psychological problems. Children who have signs of vitiligo on their bodies often face hostile attitudes from their peers.

It is advisable to start treatment as soon as the initial stage appears. But you cannot make a diagnosis yourself, even if the parents are sure that vitiligo is beginning and obvious pigmented spots have appeared. Problems with pigment production can be caused by hypomelanosis in a child(photo in gal), which also causes light spots to appear on the skin. To identify vitiligo in a child, it is necessary to take blood tests to measure sugar levels and thyroid hormones. In some cases, a histological examination of the area of ​​problem skin will be required. Vitiligo in infants requires treatment in the same way as the pathology in older children.

In children, albinism, a pathology in which pigmentation is disrupted, can also provoke similar symptoms. Such a failure is not just a cosmetic defect: a lack of melanin can lead to visual impairment or intolerance to sunlight.

What kind of disease is vitiligo?

The disease vitiligo (see photo 6) is a pathology in which melanin disappears in some areas of the skin. This is the pigment that gives our skin color; without it, skin pigmentation disorders occur. Vitiligo spots are milky white, can have any shape and increase as the disease progresses. The initial stage of vitiligo under the eyes or in other places appears with one or two barely noticeable spots, which after six months can turn into one local lesion.

Vitiligo disease is chronic and relapsing in nature. Therefore, signs of vitiligo in children or adults may spontaneously appear and disappear. The disease affects any part of the body, vitiligo appears on the back and even on the scalp. Vitiligo often appears on the genitals, back or under the eyes. The initial stage of vitiligo on the hands changes not only the fingers, but also the forearms. The causes of vitiligo can be very different. These include:

• injuries;
• burns;
• immune system failure;
• genetics;
• liver problems;
• gastrointestinal pathologies;
• endocrine problems;
• stress;
• long-term toxic effects.

Due to these same symptoms, leukoderma can occur, the symptoms of which are often confused with vitiligo. Without the help of a specialist, it is difficult to distinguish between these two diseases.

Before and after vitiligo treatment

Drugs for the treatment of vitiligo should be selected by the attending physician. The choice depends on the degree of skin damage, personal characteristics of the body and the stage of the disease. For localized forms, Sinalar, Triacort, Elokom or Hydrocortisone are used; for generalized forms, Triamcinolone, Prednisolone, Dexamethasone and their analogs are used. If the spots did not increase before vitiligo treatment, therapy will not only stop their development, but will also begin to restore the natural pigmentation of the skin.

To defeat vitiligo spots on the face or other areas of the skin, it is also recommended to use vitamin and mineral complexes; in some cases, ultraviolet therapy is necessary. If local treatment cannot overcome the skin disease vitiligo, donor skin transplantation is resorted to.

Local treatment of vitiligo also includes ultraviolet or laser therapy. To get rid of vitiligo on the legs, a simple diet of seafood, corn, rice and apples is recommended. Systemic or local glucocorticoids will help remove vitiligo in intimate places.

Model with vitiligo Chantelle Brown-Young

Despite the fact that vitiligo in girls does not look very attractive, for some people it becomes a peculiar highlight. Example - Winnie Harlow, known as Model with vitiligo Chantelle Brown-Young(photo 8). The initial stage of vitiligo appeared at the age of three, and at one time this was a reason for bullying and ridicule.

By the age of nineteen, this girl is the most famous model with vitiligo disease. This model with vitiligo inspired an online flash mob: fans used cosmetics to imitate characteristic pigmentation disorders. The fashion model with vitiligo became widely known after participating in the show “America's Next Top Model.”

Michael Jackson and vitiligo

While a model with skin pigmentation is not ashamed of her illness, some other celebrities with vitiligo approach the disease completely differently. Vitiligo was also observed in Michael Jackson. Dark-skinned people also develop milky white spots. At first, the singer used cosmetics to hide the defect, and then decided on a serious operation to transplant donor skin.

Photo gallery of vitiligo on the body

Vitiligo is a mysterious skin disease that appears as white spots. To treat the disease, traditional methods and folk remedies are used, which achieve high results. The effectiveness of therapy increases diet compliance. Skin disease is not just a cosmetic inconvenience, but also indicates problems within the body.

Vitiligo appears on the surface of the skin as white or milky spots, which have different shapes depending on the stage of the lesion. The disease has no specific risk group. Vitiligo affects adults and children. People under 20 and after 40 years of age are most often affected.

Lesions are formed due to the lack of melanin, a pigment that affects skin color. Pigment cells (melanocytes) are destroyed due to skin malfunctions. The hair in the affected area also becomes discolored.

The spots affect any part of the body, often located on the genitals, on the outside of the hand, between the buttocks. The area of ​​occurrence of lesions is not only the skin, but also the retina of the eyes and the mucous membrane of the mouth. The shape of the spots is round and oval, at the initial stage the diameter is 20 - 30 mm, and later they increase and connect with each other.

The boundaries between the lesion and healthy skin are clearly visible. The only difference between the areas is the color; there are no scales in the hearth. The spot itself may have changes in color intensity inside or along the edges. As the disease progresses, the lesions coalesce and irregularly shaped lesions form. The advanced stage of vitiligo can occupy a wide area, for example, the buttocks, abdomen, and back.

The disease does not affect the functioning of internal organs. It has a negative effect on the condition of the skin - it becomes sensitive to ultraviolet rays, and the functioning of the sweat glands deteriorates.

The course of the disease is chronic, starting with a small, inconspicuous spot that slowly increases in size. The formation of lesions lasts for months or years. Because vitiligo is difficult to treat, some patients remain ill for the rest of their lives.

The disease is caused by a number of factors that lead to disruptions in the natural formation of melanin in the melanocytes of the skin.

The causes of its occurrence in modern science have not been fully studied, so there are many possible factors.

• stress, depression, syringomyelia and other mental disorders;
• autoimmune diseases due to defects in the functioning of the immune system;
• hereditary diseases;
• worms;
• dysfunction of the glands;
• overuse of medications;
• diseases of the endocrine system;
• hormonal imbalances;
• skin injuries (burn, cut, mechanical irritation);
• lack of iron and copper in the body;
• liver diseases;
• stomach problems;
• contacts with aggressive chemicals;
• decreased immunity;
• infectious diseases;
• strong physical activity.

Traditional treatment

Therapy for vitiligo includes a set of procedures - ultraviolet radiation (PUVA therapy), quartz treatment, and medication.

PUVA therapy

The main method of treatment is PUVA therapy - the procedure involves ultraviolet radiation of the affected skin with the selection of the required intensity and wavelength.

For better absorption of ultraviolet radiation by the body, the patient must take special medications. The procedure is carried out over 2 hours.

After several sessions, skin pigmentation is restored.

Drug treatment

Therapy is based on glucocorticoids, whose task is to suppress autoimmune processes and allergic reactions. External manifestations are eliminated with ointments - initially with medium activity (Hydrocortisone, Fluorocort, Triacort). The course of treatment is at least 3 months.

Then you should use high activity ointments (Cutivate, Beloderm, Elokom). The duration of treatment is no more than 2 months.

For the patient to recover, it is necessary to eliminate hormonal imbalances and any mental disorders. Treatment is facilitated by the intake of vitamins and microelements, so complexes containing ascorbic acid and copper are often prescribed.

Laser therapy

The affected area is exposed to laser radiation of a certain wavelength. Greater results are achieved at the initial stage of the disease. The first procedures last a few seconds, gradually increasing the time.

Skin Whitening Injections

Medicinal substances (Hydroquinone, Monobenzone) are injected into the affected area. As a result of the injection, the skin brightens and the spots become invisible. But the medications themselves are expensive and require repeated use.

Surgical intervention

In case of huge skin lesions, autotransplantation is performed. This method is dangerous, as skin rejection or suppuration may occur. But the effect of the operation is impossible to predict.

Scientists are developing new technologies for the treatment of vitiligo.

Treatment at home

Traditional medicine shows high effectiveness in combating the manifestations of vitiligo and relapses of the disease.

Phytotherapy

The treatment is plant-based. The advantage of using herbs is that there are no side effects.

An important point is to use purified medicinal preparations.

Herbal medicine eliminates the external manifestations of vitiligo and improves the general condition of the body, which has a positive effect on the course of the disease and prevents recurrence.

Therapy should be carried out for a long time, even after cosmetic defects have been eliminated.

The effectiveness of the use of medicinal preparations is explained by the composition, which includes furocoumarins, tannins and hormone-like substances, polysaccharides, alkaloids, vitamins, and microelements. They increase skin resistance to ultraviolet radiation.

Recipes:

1. Ingredients: 4 tbsp. l. St. John's wort and sage, 3 tbsp. l. plantain, 2 tbsp. l. oregano, nettle, chamomile and marigold. Mix herbs and brew. The collection should be taken half an hour before meals three times a day.
2. Ingredients: 2 tbsp. l. St. John's wort, 200 mg water. Prepare an infusion from the ingredients. Take 1 tbsp after meals. l. three times a day. For children, reduce the dosage to a teaspoon. The course of treatment is 3 weeks. Then take a break for a week. The total duration of treatment is six months.

Therapeutic baths

Water procedures with the addition of special preparations can stop the development of white spots and reduce the external manifestations of vitiligo. The procedure must be carried out daily for 20 minutes. To do this, dilute the necessary substances in warm water.

1. Pine oil 10 drops.
2. Valerian tincture 50 ml, pine extract two tablespoons.
3. 2 tbsp. l. St. John's wort, 200 ml vegetable oil. Mix the ingredients and heat in a water bath for 3 hours, then filter.

For greater effectiveness, a decoction of calamus, geranium, string and St. John's wort is added to the water.

As a result of the use of medicinal baths, white areas of the skin become darker. The treatment calms and heals the body.

External means

The use of decoctions and ointments directly affects the foci of vitiligo, the main task is to quickly restore the aesthetic appearance.

Recipes:

1. Take 1 tbsp. l. leaves and pericarp of walnut, 100 ml of vodka. Prepare an infusion, which can be used to treat the lesions up to 2 times a day for 2 months.
2. Fresh bean leaves and honey are needed. Grind the plants to a similar pulp, add a small amount of honey. Treat the disease areas on the skin with the mixture, cover with a cloth and apply a heating pad. The procedure takes 30 minutes every day. Duration of therapy is 3 weeks, take a break of 7 days, repeat treatment twice.
3. Mix 2 tbsp. l. yarrow, spring primrose, sage. Brew the herbs in two liters of boiling water. Leave for at least half an hour.
4. Ingredients: lovage juice – 3 tbsp. l., dandelion juice - 1 tbsp. l., common cocklebur juice - 2 tbsp. l. Mix the ingredients and lubricate the fires.

For sensitive skin, you need to take parsley seeds and lemon juice. Prepare a decoction from the seeds, mix the ingredients. Apply the mixture to white spots.

Treatment with traditional medicine involves alternating medications and using sunbathing, starting with 1 minute and gradually increasing the time.

Diet

A balanced diet helps increase immunity, improve skin condition, and normalize metabolism in the body. The patient should follow a healthy diet.

• fruits and vegetables;
• fish;
• mushrooms;
• legumes;
• pumpkin seeds;
• porridge (wheat, buckwheat, barley);
• weak green and mint tea;
• iodized salt.

• pickles and smoked meats;
• beef;
• bakery products;
• sweets;
• alcoholic drinks;

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Treatment of VITILIGO in Tashkent. (Uzbekistan) ⠀ Treatment of vitiligo helps stop the progression of the disease and return the skin to a healthy appearance, and patients to a normal psychological state. ⠀ Find out today: +998-94 637-40-43 +998-90 935-20-25 ⠀ Vitiligo is characterized by a decrease in the level or complete loss of melanin in the skin and hair, which results in the formation of discolored spots on its surface. Their presence may be evidence of serious pathological processes in the body. Due to the appearance of white or milky spots on open areas - on the face, legs, knees, hands, elbows, chest and back - patients experience psychological stress, may become depressed and isolate themselves from the outside world.

Vitiligo - symptoms and treatment

What is vitiligo? We will discuss the causes of occurrence, diagnosis and treatment methods in the article by Dr. Sergei Anatolyevich Agapov, a venereologist with 37 years of experience.

Definition of disease. Causes of the disease

Vitiligo (from lat. "vitilus" - calf) is a chronic skin disease in which clearly limited milky-white depigmented or hypochromic spots appear on various parts of the body and hair becomes discolored. These disorders occur due to the destruction or sharp decrease in the number of melanocytes - pigment cells - in the lesions.

The average incidence of the disease is 0.5-1% of the entire population. This disease is least common in China (0.093%), Northern European countries (Denmark - 0.38%), and most often in some states of India (8.8%).

Vitiligo can begin at any age - from birth to 80 years of age. In 50% of cases, the disease occurs before 20 years of age, and in a third of patients - before 12 years of age. Moreover, with age, the prevalence of the disease gradually increases: it manifests itself in 0.45% of people under 1 year of age; in 1% aged 1 to 5 years; in 2.1% aged 5 to 12 years.

Vitiligo is most often found in women. This is due to the fact that due to cosmetic inconveniences, they more often seek medical help.

In 15-20% of cases, vitiligo occurs in members of the same family, and the prevalence of the disease among first-degree relatives, i.e., parents and children, is 7%, and among identical twins - 23%. This indicates a clear role of genes in the development of the disease.

Patients with vitiligo often have other diseases:

• thyroid disease - thyroiditis - 0.62-12.5%;
• diabetes mellitus - 4.6-17%;
• focal alopecia - 12-14%;
• Addison's disease - 2%.

Currently, the cause of the disease is considered to be an autoimmune process. It involves CD8 + T cells - cells of the immune system. They target melanocytes and destroy them, leaving areas of the skin without pigment formation. Clinically, it appears as white spots.

Why this process occurs is not fully understood. There are several different theories and hypotheses of pathogenesis that are combined into the convergence theory.

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of vitiligo

A typical sign of vitiligo is a milky-white patch with clear boundaries, often with jagged and jagged edges. It can be round, oval or irregular in shape, and in size - from a few millimeters to several centimeters in diameter. Its appearance is often preceded by erythema and itching.

During the period of progression or regression, “islands” of healthy skin are observed in the form of dots around the hair follicles.

Vitiligo is also accompanied by discoloration of hair growing in areas of depigmented skin. This symptom is called poliosis.

Hair loses color at any location of the spots, but more often in the scalp, eyelashes, eyebrows and beard area in men.

If hair becomes discolored against the background of clinically healthy skin, this indicates an isolated lesion of the hair follicles. This type of vitiligo is called follicular.

Based on location, form, prevalence and clinical manifestations, several types of vitiligo are distinguished.

Common (common) vitiligo

This type of vitiligo is the most common. It is characterized by randomly arranged multiple white spots, often with an asymmetrical distribution and variable localization.

It is localized exclusively on the hands, feet, fingers and face, most often around the eyes, mouth, lips and nasolabial triangle. Typically occurs in adults.

This form of the disease is accompanied by complete or almost complete depigmentation of the skin (more than 80-90%). Areas of unchanged skin sometimes remain on the scalp, axillary and pubic areas.

Focal (focal) vitiligo

With this type of vitiligo, single spots or several scattered lesions appear in one area of ​​the body. Most often they appear in the area of ​​innervation of the trigeminal nerve, less often in other parts of the body.

More common in children. Accounts for 15% of all types of vitiligo.

The lesions are located within one, sometimes several segments. Usually the process is unilateral, but can be bilateral, strip-like and polysegmental.

The face is mainly affected in the area of ​​innervation of the trigeminal nerve, less commonly the thoracic, cervical, lumbar and sacral dermatomes are affected.

In 50-70% of patients with segmental vitiligo, poliosis (graying) of eyelashes and hair is observed. The location of lesions along Blaschko's lines is reported.

Only the mucous membranes of the mouth, lips, anus, penis and vulva are affected. If rashes are observed in other areas of the body, then they speak of ordinary, widespread vitiligo.

Stippled vitiligo (confetti spots)

It manifests itself as characteristic depigmentation in the form of small spots 1-2 mm in diameter. They are located randomly or perifollicularly (near the hair). It is considered a sign of disease progression, but can also be observed with PUVA therapy.

There are three types:

It is characterized by the presence of an erythematous inflammatory margin along the periphery of the spot, scaling and itching. It is a rare form of the disease, usually temporary, lasting from several weeks to months.

Occurs in 34% of patients with widespread vitiligo. Characterized by the eruption of new lesions at the site of acute and chronic injuries:

• physical (wounds, scratches);
• mechanical (friction);
• chemical and thermal (burns);
• allergic contact dermatitis;
• tattoo;
• vaccination;
• constant pressure;
• inflammatory dermatoses;
• radiotherapy and phototherapy.

Presumably it arises due to adhesion defects - the attraction of one molecule to another.

Halo phenomenon (perinevus vitiligo)

Halonevus is diagnosed in 18-26% of patients with vitiligo. In some cases, it precedes vitiligo. It is a nevus surrounded by a halo of depigmented skin, which indicates regression of the nevus itself.

Vitiligo-like depigmentation can occur in patients with malignant cancer, which is most likely due to the destructive effect of T lymphocytes on melanoma cells and at the same time on melanocytes of normal keratinocytes.

Syndromes associated with vitiligo

They are severe and rare forms of vitiligo that affect organs other than the skin.

Pathogenesis of vitiligo

Most scientists accept the theory of convergence of the pathogenesis of vitiligo. It involves the combination and interrelation of various factors in the development of the disease.

Genetic factor

Genomic linkage analysis has identified autoimmune susceptibility (AIS) loci associated with vitiligo. AIS1 was found to be located on chromosome 1p31.3–p32.2, AIS2 on chromosome 7 and AIS3 on chromosome 8. AIS1 and AIS2 were found to be associated in families with vitiligo along with other autoimmune diseases, while AIS3 was found in subgroup of non-autoimmune families.

Another gene associated with vitiligo and lupus erythematosus (SLEV1) is located on chromosome 17. It is associated with generalized vitiligo associated with other associated autoimmune diseases.

Autoimmune factor

Autoimmune processes that lead to the death of melanocytes include:

Oxidative stress

The appearance of vitiligo is influenced by the accumulation of reactive oxygen species within the epidermis, especially hydrogen peroxide (H 2 O 2). Its concentration can reach one millimole. This leads to changes in mitochondria and death of melanocytes.

Autocytotoxicity

During the synthesis of melanin, toxic metabolites are formed inside the cells, and phenols or quinones are formed outside the cells. These substances can accumulate and cause melanocyte damage in genetically susceptible individuals.

Melanocytorrhagia

The melanocytorrhagia theory proposes that vitiligo is a primary melanocytorrhagic disorder with altered melanocyte responses to friction that causes their detachment (adhesion defect), death, and subsequent loss through the epidermis.

Deficiency of survival signals

A lack of survival signals in the skin of a person with vitiligo leads to programmed death of melanocytes. In normal epidermis, stem cell factors released from neighboring keratinocytes regulate the growth and survival of melanocytes by binding to the membrane tyrosine kinase receptor c-kit. Reduced numbers of c-kit receptors and decreased expression of stem cell factor from surrounding keratinocytes may contribute to the death of melanocytes.

Neurohumoral factor

Psychological stress influences the release of neuropeptides, different cell behaviors, and the expression of innate and adaptive immunity in the skin. Evidence supporting the neurohumoral pathogenesis of vitiligo includes the common origin of both melanocytes and nerves from neural crest cells, changes in sweating and nerve structure in affected skin, and the expression of specific neuropeptides in patients with vitiligo.

Vitamin D deficiency

In vitro studies have shown that vitamin D3 increases melanin synthesis and tyrosinase content in cultured human melanocytes, and also protects melanocytes from ultraviolet B-induced death. This promotes the return of color to vitiligo patches.

Hyperhomocystinemia

It has been suggested that the increase in homocysteine ​​levels due to vitamin B12 and folic acid deficiency, which occurs in patients with vitiligo, interferes with normal melanin production. It slows down the action of the enzymes histidase and tyrosinase in the skin.

Classification and stages of development of vitiligo

Complications of vitiligo

Hearing impairment

Melanin may play a significant role in establishing and/or maintaining the structure and function of the auditory system. It modulates the transmission of auditory stimuli by the inner ear. Because vitiligo affects all melanocytes, hearing problems sometimes occur. Several studies have reported that familial vitiligo is associated with hearing impairment and hypoacusia—decreased sensitivity to sound.

Eye disorders

People with vitiligo do not complain of eye damage, but they may experience depigmentation of the iris or retina. Thus, a thorough ophthalmological examination revealed choroidal disorders in 30% of patients and iritis (inflammation of the iris) in 5%.

Aseptic meningitis

This pathology can occur when leptomeningeal melanocytes are damaged. It is accompanied by fever for 2-3 weeks, headache, and increased intracranial pressure.

Diagnosis of vitiligo

Vitiligo is a clinical diagnosis. In the case of hypochromic and inconspicuous spots, it is recommended to use a Wood's lamp for diagnosis. Upon examination, it allows you to identify lesions with clear boundaries of bright blue-white color.

Since vitiligo is often associated with autoimmune diseases, the following tests are recommended:

• blood test for thyroid-stimulating hormone (TSH), free triiodothyronine (T3) and free thyroxine (T4);
• blood test for antibodies to thyroid peroxidase (TPO) and thyroglobulin (Tg);
• analysis for antinuclear antibodies (ANA) and antibodies to native DNA;
• determination of blood glucose levels.

Histological examination reveals that melanocytes and epidermal pigmentation are completely absent. At the edge of the lesions, superficial lymphocytic infiltrates are detected around the vessels and follicles. Degenerative changes in keratinocytes and melanocytes are found in both borderline lesions and adjacent skin. In some cases, an increase in the number of Langerhans cells, epidermal vacuolization, and thickening of the basement membrane are observed.

Differential diagnosis:

1. Hereditary or genetically induced hypomelanosis:
2. piebaldism;
3. tuberous sclerosis;
4. Ito hypomelanosis;
5. Waardenburg syndrome;
6. Germansky-Pudlak syndrome;
7. Menkes disease;
8. Ziprkowski-Margolis syndrome;
9. Griscelli syndrome;
10. anemic nevus;
11. depigmented nevus.
12. Post-inflammatory hypomelanosis:
13. lichen planus;
14. toxic drug reactions.
15. Paraneoplastic hypomelanosis:
16. mycosis fungoides;
17. melanoma-associated depigmentation.
18. Parainfectious hypopigmentation:
19. pityriasis versicolor;
20. pityriasis alba;
21. leprosy;
22. leishmaniasis;
23. onchocerciasis (river blindness);
24. treponematoses (endemic syphilis, pinta).
25. Post-traumatic leukoderma:
26. chemical and thermal burns;
27. injuries.
28. Professional and medicinal depigmentation:
29. phenol;
30. systemic drugs (chloroquine, fluphenazine, physostigmine, imatinib);
31. topical medications (imiquimod, corticosteroids, hydroquinone).
32. Systemic diseases:
33. sarcoidosis;
34. scleroderma.
35. Idiopathic disorders:
36. idiopathic guttate hypomelanosis;
37. progressive macular hypomelanosis.

Treatment of vitiligo

Systemic therapy

Local therapy

Topical corticosteroids:

• methylprednisolone aceponate once a day;
• alklometesone dipropionate 1 time per day;
• betamethasone dipropionate 1 time per day;
• clobetasol propionate 1 time per day.

Treatment with local corticosteroids is carried out continuously or with periodic withdrawal of drugs:

• continuous method - the drug is prescribed once a day for 2-3 months (not recommended for localized spots on the face);
• intermittent technique - the drug is prescribed once a day for two weeks, then after a two-week break the course is repeated; As a rule, 4-6 courses of therapy are prescribed.

Topical calcineurin inhibitors:

Vitamin D3 analogs are also taken - 0.005% calcipotriol ointment in combination with 0.05% betamethasone dipropionate cream.

An extract of the human placenta is used - Placentrex gel 1-2 times a day for 4-6 months.

Fluorouracil is prescribed in the form of a 5% cream in combination with microneedling or dermabrasion twice a day for 15 days.

Photo and laser therapy

Surgery

Camouflage

Given the psychological impact of the disease on the patient's quality of life, especially when affecting the face, neck and arms, camouflage is considered an important part of the treatment of vitiligo. It should be used at all stages of the fight against the disease.

• Temporary camouflage - makeup, foundation, special paints, self-tanning.
• Permanent camouflage - micropigmentation and tattoos. It should be used with caution due to the unpredictable course of vitiligo.

Depigmentation

Indicated for patients with universal vitiligo and pigmented islands of normal skin.

For depigmentation the following are used:

Forecast. Prevention

The prognosis for universal vitiligo is unfavorable. In other forms of the disease, spontaneous repigmentation may occur in 15-20% of cases.

Treatment for vitiligo can take several years. Successful results of therapy are observed in 60-80% of cases.

There are no special measures to prevent the disease.

To stop the progression of vitiligo, patients should adhere to the following rules:

• avoid stressful situations;
• do not injure the skin;
• avoid intense ultraviolet radiation;
• In sunny weather, protect the affected skin with photoprotective agents.

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