What Everyone Should Know About Phototherapy for Vitiligo

When vitiligo occurs the patient’s skin is covered with discolored dermatic areas caused by an autoimmune reaction. The human body creates antibodies against its own pigment cells – melanocytes.

Typically, vitiligo occurs in the form of milk-white spots on the skin. Sometimes discolored dermatic areas may be surrounded by contours of more intensely colored, healthy skin.

The Nature of Vitiligo

If vitiligo appears on the scalp, the hair in this area is discolored. Most often vitiligo emerges on the face, around the eyes, mouth, palms, feet, and genitals. Vitiligo is cyclical: the disease develops with a rapid loss of pigment in certain areas, and then the process may stop for some time. Such cycles can be repeated several times throughout the patient’s life.

Facts About the Vitiligo Skin Condition

1. Vitiligo affects about 0.5% to 2% of the global population.
2. Whereas patients with vitiligo don’t experience other symptoms than skin depigmentation, it can largely influence the patient’s social and professional life.
3. Vitiligo is sometimes associated with severe disorders that may also have an autoimmune nature. For instance, almost 30 percent of women with vitiligo attain thyroid disease.
4. Vitiligo is never diagnosed at birth; it starts between the ages of 10 and 30 in most cases.
5. Over 30 percent of patients with vitiligo are likely to have a family history of the disorder.
6. Among other factors causing vitiligo are mental trauma, neuroendocrine disorders, and autoimmune reaction in the body.

Types of Vitiligo

Doctors usually distinguish 2 types of vitiligo:

1. Non-segmental or generalized vitiligo – the affected area goes beyond a certain segment of the body and has a symmetrical two-area location. Typically, it starts near the hands, around the eyes or mouth, on the feet, or in an area of the body where the skin rubs frequently. It’s the most widespread form of vitiligo.
2. Segmental vitiligo or unilateral vitiligo – appears in a single area of the body, such as an arm or a leg. This type of skin condition usually starts when a person is young and is generally progressed for a year until it stops.

In most cases, patients with segmental vitiligo experience color changes in their hair, eyebrows, or eyelashes. This dermatic disease is less common than non-segmental vitiligo.

How is Vitiligo Diagnosed

To diagnose vitiligo, a doctor examines patients to detect the spots on their skin via the Wood’s lamp (black-light lamp). The vitiligo-affected skin areas have a specific glow observed under ultraviolet light. Sometimes, it’s necessary to perform a skin biopsy, a complete blood count test, a blood chemistry analysis (blood counts), and an analysis of thyroid hormones to confirm the diagnosis.

How to Treat Vitiligo

Many patients use cosmetic products like self-tanners or foundation creams to hide depigmented areas. Someone makes tattoos or micro-pigmentation to cover the affected skin. Even though these methods may hide some symptoms of vitiligo, they don’t treat this skin condition and do not bring recovery.

To reduce the autoimmune reaction in the skin, doctors prescribe topical drugs with immunomodulatory action. A surgical method of treatment of vitiligo involves the transplantation of melanocytes into depigmented areas. However, this surgery may be very risky. An alternative treatment for vitiligo is phototherapy.

Phototherapy for Vitiligo

Phototherapy is the safest contemporary treatment of vitiligo recognized by all doctors worldwide. Phototherapy has a high immunomodulatory effect. Since ultraviolet light is a natural stimulant of pigment formation, phototherapy helps effectively eliminate the signs of vitiligo on your skin.

The narrow-band UVB phototherapy with wavelength 311 nm brings the most effective treatment results and is the softest of the entire UV spectrum. This kind of phototherapy is the most comfortable for the skin affected by vitiligo as it’s very sensitive to UV radiation due to the lack of pigment.

Besides, this part of the UV spectrum doesn’t penetrate deep into the skin and therefore doesn’t cause skin aging. This narrow-band phototherapy is convenient and safe for a patient, especially in the case of long-term use, as there is virtually no risk of skin neoplasms development.

How Does Phototherapy Work Against Vitiligo?

Phototherapy has an immunomodulatory and anti-inflammatory effect preventing an attack on the immune system. Moreover, ultraviolet light is a natural growth stimulant for pigmented skin cells. It makes UVB lamps one of the most innovative safe methods to overcome the disease.

What Vitiligo-originated Conditions Are Treated Through Phototherapy?

Dermatologists distinguish 4 common vitiligo forms: generalized vitiligo, segmental vitiligo, universal vitiligo, and lip-tip vitiligo. Patients are examined to detect the disease type and then suitable phototherapy is prescribed. The longevity of sessions and the number of UV-light courses depend on the vitiligo form.

Generalized Vitiligo

It is specified by numerous skin zones with pigmentation loss. Some cells stop producing melanin, and the human-depigmented skin becomes lighter than vitiligo-free zones.

Generalized vitiligo attacks different body parts; vitiligo-affected areas become larger if the skin condition is not being treated. Loss of pigmentation can be seen on the neck, shoulders, face, scalp, and genitals.

Generalized vitiligo appears in childhood if the main cause of the disease is heredity. However, it can attack patients at any age if vitiligo triggers take place (skin traumas, hormone changes, stress, etc.). People who suffer from this disease have a big risk of hearing loss and sunburn. Phototherapy is an efficient way to treat generalized vitiligo.

Segmental Vitiligo

In this case, the damaged areas are small and vitiligo spreads slowly. For example, only one side of the body can be attacked by segmental vitiligo (an arm, scalp, foot, etc.). This skin condition usually occurs in childhood or at a young age (12-20 years old). Segmental vitiligo is being progressed for several years and then it stops.

However, if it appears because of some trigger (skin trauma, sunburn, hormonal disorder, etc.), it is necessary to treat the cause as soon as possible. Segmental vitiligo can transform into a generalized one or its other forms. UV-light treatment is suitable to make patients’ skin vitiligo-free.

Universal Vitiligo

This type of vitiligo causes depigmentation in more than 80% of the human body. Universal vitiligo occurs rarely and requires urgent treatment. The depigmented skin looks untidy together with a negative influence on the internal organs. Tissues stop producing melanin and skin becomes more sensitive, allergy- and cancer-predisposed. Phototherapy is one of the few therapies that are suitable for universal vitiligo treatment.

Lip-tip Vitiligo

Depigmentation is observed on the human face. Lip-tip vitiligo is the loss of natural skin color resulting from melanin-producing failure. In most cases, this skin condition has a symmetrical form on the patients’ faces. A nasolabial zone is the most lip-tip vitiligo-predisposed.

Individuals feel discomfort in society because of depigmentation on their faces. Besides micro pigmentation and drug therapy, phototherapy is used for lip-tip vitiligo treatment. It brings visible results after a month of regular UV-light sessions.

Can Phototherapy for Vitiligo Be Used by Patients at Home?

In the early 2000s, people had to spend a great deal of time attending medical institutions to undergo phototherapy in special cabins with fluorescent lamps that emit light of a certain wavelength.

These days we have a great opportunity to use newly-designed phototherapy lamps for treating vitiligo at home whenever we need it. Unlike the fluorescent cabins in the doctor’s office, home-designed lamps allow for treating individual parts of the patient’s body like the head or hand instead of irradiating the whole body.

What Is the Cost of Phototherapy for Vitiligo?

In fact, the annual medical cost for treating vitiligo sizes $49 million in the USA. Phototherapy lamps for vitiligo help considerably save time and money. Whereas one session of phototherapy for eczema costs around $150, patients can pay around $400 once for home-designed lamps and use them numerous times.

There is a range of general recommendations to take into consideration.

The Safety Measures to Remember When Conducting Phototherapy at Home

Home-based therapy is safe and efficient. Consider the following recommendations for sufficient results and no-risk treatment (without side effects):

• Don’t sunbathe or attend the tanning salon 2 weeks before the procedure.
• Don’t perform chemical peelings at least 2 weeks before the procedure.
• Don’t visit saunas, baths, and swimming pools 3 days before the procedure.
• Don’t put on lotion or moisturizer 24 hours before the procedure.
• Don’t take medicines that make you more sensitive to ultraviolet light.
• Always wear safety glasses during each treatment session (the phototherapy company usually provides patients with them).
• Cover the parts of your body on which you’re not applying phototherapy with sunscreen.
• Be sure to keep your eyes closed during the entire session (especially if you treat eyelids).
• Keep the correct distance from the UVB lamp according to the phototherapy device instructions throughout the session.

What Should You Do After the Procedure?

Moisture your skin with odorless creams (Eucerin, Aquaphor, or Cetaphil) at least once a day.

Apply sunscreen with the SPF filter (not less than 35 is recommended).

Avoid sunbathing and sauna during the treatment course and 2 weeks after its completion.

Don’t scrub or peel your skin during the whole course of photo treatment and 2 weeks after the last UVB therapy session.

Can I Start Treatment with the High Dose of UV?

Never start your treatment with high doses of ultraviolet radiation. Even though narrow spectral ultraviolet light is generally safe for your body, high and uncontrolled doses of ultraviolet can cause burns and intensity of the disease.

Therefore, phototherapy begins with a small dose of UV, which increases with each procedure. The doctor prescribes the initial dose depending on the individual sensitivity of the patient to the UV light and their skin type by the Fitzpatrick skin classification.

How Many Procedures Are Required for Vitiligo Treatment?

The length of vitiligo treatment depends on the severity of the disease and the overall health condition of a particular patient. Most patients require from 20-25 to 30-35 procedures per course. One course of treatment lasts for about 2-4 months.

Typically, patients undergo 2 sessions of phototherapy for vitiligo per week. If necessary, the patient can repeat a course after some time. Note that sessions are prescribed on a course-to-course basis. Each case is individual.

When Will I See the Effect of the Treatment?

The results from phototherapy for vitiligo are quite individual. Usually, the pigmented dots on the white skin areas affected by vitiligo disappear after 10-12 procedures. These dermatic zones gradually cover more areas of the skin affected by vitiligo until the pigment fills out all white spots.

How Long Does the Effect of the Treatment Last?

If vitiligo doesn’t progress and new white spots don’t appear, the therapeutic effect of the phototherapy for vitiligo can be very long, and remission can last up to decades. In the case of vitiligo progressing, then it’s first necessary to stabilize the process. In this regard, phototherapy is an effective method. At the same time, patients should try to find the cause of the disease worsening.

What Will Happen If the Treatment Is Temporarily Terminated?

Many patients wonder what happens if they take a small break in their treatment for a vacation or a business trip. It’s possible to take a break during the course. A patient just needs to visit a doctor to adjust the course depending on the duration of the break so that the skin gets used to regular exposure to UV rays and doesn’t get burned.

What are the Side Effects of Phototherapy for Vitiligo?

After the session of narrow-band phototherapy, a patient may experience erythema, itching, and mild burning or pain. However, most patients report that these symptoms disappear a few hours after the treatment.

Consider phototherapy for vitiligo as a long-term investment that can bring multiple benefits. Phototherapy can help you forget about white spots on your skin and greatly improve your quality of life. With home-designed lamps, you can also save your budget on something more pleasant. Start enjoying your life right now!