As discussed earlier, vitiligo is a skin disease of much social concern. If you haven’t read it, head here to gain more information – Vitiligo – What Should Be the Target of Treatment?.
Vitiligo is a condition that has been stigmatized for wrong reasons. Because of lack of awareness about it, vitiligo patients often have to bear the brunt of society’s judgment and ridicule. This disease that manifests onto a person’s appearance often acts as a deal breaker in relationships and matrimonial matters, owing to society’s standards of beauty.
Many believe that vitiligo is a result of an impure body, and suggest that the system needs to be cleansed from the inside, so as to get to the root of the problem and getting rid of it. The act of cleansing the body from the inside is also known as the ‘internal approach’. In this internal approach, we treat the problem using medication that alters the problem inside the body.
The internal approach, however, has its limitations. Most scientists believe that any defect in the body is highly linked to the person’s gene makeup, and vitiligo is one of those defects. A person can either have a defect coded into their genomes, in which case a cure may not be available, or the person can have susceptible genes wherein they have a disease which goes with medication/restrictions. In both these cases, allopathy works differently.
Why does ‘cure’ attract patients so much? The answer is simple: Wishful thinking. Most patients think that these diseases are a result of abnormalities in the body that are caused by external toxins, but this stands true only for infections. But like most other lifestyle diseases, a cure is not possible because there’s nothing external to work on – it’s the internal defect that has to be worked on. So, like any other lifestyle diseases, treatment can merely restore old bodily functions, not cure them. Vitiligo can be treated both externally and internally – externally using creams, focused treatments etc. Some might recommend dietary restrictions, or drinking water in order to help cure the disease. However, these are unbalanced and biased approaches.
The internal treatment for vitiligo has two approaches: 1. controlling the offending RBCs using medication, and 2. Salvaging or supporting the re-function of melanocytes.
Controlling the offending WBCs: the medication given in this approach targets the offending WBCs, and stops them from causing further damage. However, this has its side effects. This is because only a small amount of WBCs are actually causing the discolouration issue, and the medication targets all the healthy WBCs as well. Hence, all the internal treatments for WBCs can have side effects like lowered hemoglobin, reduced RBC count, and reduced function of WBCs.
For external approach: creams, injections in the targeted patches, and phototherapy are common. Some different grades of phototherapy are ultra v A and ultra v B, sunlight, excimer lasers, etc.
Each treatment has a different advocate supporting them.
Dr. Dhepe of Skin City proposes a combination approach. In this, there is a judicious combination of both internal and external approaches pose fewer side effects, and makes for efficient treatment. The safest internal as well as external approaches should be chosen to get the desired effects, as the requirement of possible doses/sessions is less, as are the side effects. A combination of creams, lasers, injectable immune modulators, and miniature punch grafting skin surgeries can be selected from, depending on the choice of the patient.
On a personal note, Dr. Dhepe suggests that the best way to deal with vitiligo is to undergo no treatment at all, but treat it as a natural part of one’s body. This will help disable the stigma around this harmless skin condition.