The primary goal is to restore the function of the skin & improve the patient s appearance. The choice of therapy depends upon the number of patches, the size of patch & on patient s preference for the treatment.
Skin camouflage uses special coloured cover creams that are put on the white patches of vitiligo. Skin camouflage does not alter the disease but improves the skin's appearance. The aim is to find a colour to match the colour of your skin. The creams can disguise vitiligo very well, which may greatly increase self-confidence.
A steroid cream is sometimes prescribed for a limited period of time (usually a maximum of two months) when a small patch of vitiligo first develops. It may prevent a smaller patch from becoming bigger. Occasionally, skin colour may return over a treated area. Steroids work partly by suppressing the immune system (which probably attacks the melanocytes). Long-term use of steroid creams can cause side-effects which include thinning of the skin and stretchmarks so they are not usually recommended to use on your face.
Tacrolimus orPimecrolimus creams are used as an alternative to steroid cream. They have been shown to restore skin colour to some people with vitiligo. They also work by suppressing cells of the immune system in the skin. It seems to be most effective for vitiligo on the face. It can also be used on the skin of children.
PUVA stands for psoralen and ultraviolet A (UVA) light. It involves taking a special medicine (a psoralen) which makes the skin very sensitive to light. This medicine can be in the form of a tablet or a cream. The skin is then treated with UVA light from a special machine in hospital. This treatment is very time-consuming. Treatment is needed twice a week for up to two years. PUVA may cause side-effects such as sunburn-type reactions or skin freckling. If colour does return to the white patches there is still a chance that it may go white again at a later stage.