Vitiligo Surgery

Melanocyte grafting

 

What is Vitiligo.

 

Vitiligo is a condition in which, there is absence of or nearly absence of pigment producing cells in skin. Pigment producing cells called melanocytes are responsible for particular skin colour of a person.

 

Is Vitiligo runs in the family?

Even even though Vitiligo has a genetic basis only less than half of those with Vitiligo know someone with Vitiligo in their family. If you have Vitiligo it does not necessarily follow that your children will develop it.

 

What causes Vitiligo.

 

There is an absence or inactivity of the pigment producing melanocytes in the Vitiligo patch. This may be due to an autoimmune condition in which the antibodies on immune system destroys some of its own cells.

 

Vitiligo is not infectious.

 

There is no medical evidence of any link between diet and Vitiligo.

 

Can Vitiligo be treated.

 

Most of the patches of Vitiligo will stop spreading within 6 months and start re-pigmenting in  another six months.

 

Some medicines used either as local creams or as oral tablets, followed by sun exposure will help regimentation in most of the cases

 

 

Use of local creams that modulate immune response and have anti-inflammatory effects are the first line of localised patches of vitiligo. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phototherapy.

 

Phototherapy has become one of the most accepted therapies for Vitiligo. However, it require regular visit to hospital. Here no medicine is taken inside, only exposure to narrow band 

ultraviolet B (NB-UVB) (311 nm) is enough. Patient is exposed to gradually increasing doses of UVB, given from specialised UVB chamber. It works not only as a regimenting therapy, but also arrest the progression of disease.

 

Who needs Vitiligo surgery?

 

Segmental Vitiligo, or patches which are refractory to regimentation with medical treatment are good candidates for Vitiligo surgery. Only patience with stable Vitiligo are selected for surgery usually when the patient doesn't report any new lesions or increase in size of the  the existing lesion, for 1 year  or more, are considered stable. Even though there is no age limit for surgery, results are better  in young patients.

 

There are different kinds of surgical procedures done in Vitiligo. Appropriate surgical method is considered according to the area affected and age of the patient. Each method have its own advantage and disadvantage. 

We usually prefer cell grafting either as pure cultured melanocyte or non cultured melanocyte epidermal cell suspension. This method have the advantage that larger area can be treated at a single session with small patch of donor skin and the regimentation is almost uniform.Here a small piece of skin is harvested from the donor site, usually at the outer part of upper thigh, is treated with trypsin and incubated and then centrifuged in special media, so that a suspension of melanocyte and epidermal cell suspension is obtained at the end. This suspension is directly applied to laser ablated Vitiligo patches, or again only melanocyte are separated  from the suspension and cultured in special medium so the melanocytes are expanded 100 times the number and which is then applied to laser ablated Vitiligo patches as before. The area is dressed and immobilised to sufficient time.

 

The onset of pigmentation usually occurs in 3 - 6 weeks and within 3 - 6 months achieve significant pigmentation.

Most of the times no need for general anaesthesia or hospitalisation for this procedure.

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