Vitiligo Surgery

Vitiligo is a disease of the skin where one loses skin colour in patches. Although specific causes of the illness are unknown, the condition is long term. It can affect any area of the skin and is caused by issues regarding melanin in our body. When the pigment producing cells of our body stop functioning or die, one develops discolouration.

The chronic condition is characterized by the depigmentation of portions of skin on our body. The areas most affected are the mouth, eyes, nostrils, genitalia, wrists, fingers, the inside of the mouth, groin, and armpits. Vitiligo can also sometimes develop at the hair roots, leading to the growth of white or grey hair due to loss of melanin.

Types of Vitiligo

There are two main types of vitiligo: segmental vitiligo and non-segmental vitiligo. When vitiligo affects your whole body, it is known as universal vitiligo. However, this form of vitiligo is rare.

Segmental vitiligo, also known as unilateral vitiligo or localised vitiligo, is a form of the condition where the discolouration affects only one area of the body. Less common than non-segmental vitiligo, its treatment also differs, and it is less associated with autoimmune diseases as a cause. This type is more prevalent in the teenage years.

Non-segmental vitiligo, also known as bilateral vitiligo or generalised vitiligo, is characterised by symmetrical depigmentation of patches of skin. Thus, the patches often appear on both sides of the body. Non-segmental vitiligo can appear at any age, and can be generalised, focal or localised to an area of the body.

Diagnosis

A doctor will use a UV lamp, known as Wood’s lamp, to differentiate the discolouration of vitiligo from that of other skin conditions. Wood’s lamp emits long wave UV-A and very little visible light and throws up the discolouration in contrast.

Your medical history will also be important here. It will be necessary to investigate if there is a history of vitiligo in your family, if you have had autoimmune conditions or have history of autoimmune conditions in your family, if there has been injury to the affected areas – such as sunburn – or if you tan easily, and if you have sought differential treatment, and if so, what and its results. There may also be a skin biopsy and blood tests.

Treating Vitiligo

Treatment options range from use of topical creams, medication, therapies and surgical interventions. It is important to know that the treatment options, though varied, do not always guarantee a lasting result. New patches may appear, since the condition is chronic.

Vitiligo surgery is done when the condition or the skin patch is not growing in size or no new patches occur for a minimum period of six months. At Celestee, we offer three kinds of procedural interventions that you can avail to treat your vitiligo.

Suction blister technique

Suction blister grafting is a technique used to treat patients with stable and resistant vitiligo. In a skin graft, healthy skin is removed from an unaffected part of the body and subsequently transplanted onto a discoloured patch of your skin. Grafting is time consuming, and thus requires in-depth knowledge and consultation before choosing it as an option for your treatment.

In the suction blister method, blisters are created on the donor part of your skin, i.e. the healthy, unaffected part of your body. These blisters are created via suction. Once blisters are formed, their roofs are cut, cleaned, and dissected for grafting. Once the graft has been transplanted, the area is dressed, and the surgery is complete.

Re-pigmentation of the area begins anywhere from one month to three months post surgery. Sometimes, the blisters formed are inadequate for use. Raising the blisters is painful and thus the technique is carried out only in small proportions.

Ultra-thin split grafting technique

This is yet another skin grafting technique that comes recommended for the re-pigmentation it offers. Ultra-thin split grafting does not lead to any scarring at the donor site, is relatively more time saving, and can cover a larger area of the skin as well. It requires a thoroughly trained professional to do it who is able to maintain a quality in the grafts. They determine the ultimate result of the procedure.

In this technique, a very thin layer of the skin, which includes the epidermis, is grafted to transfer the melanocytes to the affected area. When no dermal component is present, good results are highly achievable. The donor site also reports better healing. Ultra-thin split grafting has also be used at times without supplemental UV exposure. This skin grafting technique is often used to treat areas of the body affected by vitiligo that are quite sensitive. One example is the eyelid area, where the skin is naturally very thin. Vitiligo of this area can be treated through ultra-thin split grafting.

Non-cultured epidermal transfer

This is a treatment method used to work on stable or resistant vitiligo. A safe and simple procedure, the surgery is recommended to patients resistant to other therapies for vitiligo treatment. One of the main benefits of the technique is that it is able to treat a much larger area than what a skin graft would allow for.

In a non-cultured epidermal transfer, there are melanocytes and keratinocytes both used. These epidermal cells are extracted from the donor site, such as the thigh, and spread on the affected, de-pigmented area. This procedure requires a proper laboratory setup, well trained professionals, and good expertise with extracting the cells from the donor site. The method shows good results regarding re-pigmentation and is one of the rising methods in treating vitiligo.

Phototherapy

At Celestee, these treatments are followed up by phototherapy. When done with narrow band ultraviolet (UV-B) light, active vitiligo has shown stoppage or slowing down. Care is maintained so as to not over-expose the skin to the UV-B light. Multiple sessions are required of this second line treatment for effective results. Research has shown that when phototherapy has been used in conjunction with other treatments, there has been an improvement in re-pigmentation. Usually, one avails phototherapy two to three times a week.

Vitiligo, while chronic, is not untreatable. With proper diagnosis, consultation and guidance, effective results can be obtained. Technological advancements have brought treatment options much further, with regards to recovery time as well as re-pigmentation chances.