What is vitiligo and how to treat it in children and adults

Vitiligo is a disorder of skin pigmentation of a chronic nature, which is manifested by milky white spots of different sizes, prone to fusion. In addition to the skin, the color can change the mucous membranes, hair, retina and the shell of the brain. The reason is the cessation of the production of melanin - a pigment that gives a shade to the skin and hair. Not delivering physical discomfort, the disease worsens only the psychological state of a person.

• Causes of
• Symptoms of
• Consequences of
• Diagnosis of
• Treatment of
• Diet of
• in children
• In pregnancy
• Treatment with folk remedies

Causes of

There is no single answer to the question what is the cause of vitiligo. However, there are several theories on this score:

• The theory of self-destruction is the degeneration of melanocytes( cells that produce melanin) due to infections or exposure to toxins.
• Autoimmune - due to malfunctions in the body, melanocytes are perceived as foreign target cells and attacked by immunity.
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• Biochemical disorders - a decrease in the production of a catalase enzyme capable of neutralizing free radicals, leads to their accumulation in the skin and the destruction of melanocytes.
  

  
  

• Genetic - the gene for vitiligo can be transmitted by inheritance.

Among the reasons for the appearance of vitiligo, the following are distinguished:

• Genetic predisposition - the disease is transmitted as a dominant trait, the probability of a child born with vitiligo from a sick parent is 50%.Even if the disease is due to trauma, it is fixed at the genetic level.
• Dysfunction of the endocrine system - hormonal failures worsen the formation of enzymes in melanocytes.
• Excessive stress on the nervous system - stress, depression, mental trauma, disrupt the communication of organs and tissues with the central nervous system, and melanocytes may not receive instructions for producing enzymes.
• Skin lesions - scars, burns( sunny including), rubbing clothes and shoes injure the layer of skin where the melanocytes are located. In some cases, they are not restored.
• Diseases of the gastrointestinal tract - dysbacteriosis, intestinal invasion, chronic diarrhea syndrome change the chemical composition of the blood and cause a shortage of microelements necessary for the development of pigment.
• Exposure to chemicals - low quality cosmetics, formaldehyde, phenol and its compounds( used in the manufacture of paints, rubber) are one of the most common causes of vitiligo. Defeating cells of the epidermis, chemically aggressive substances disrupt their functioning.
• Decreased immunity - surgery, infections, excessive physical exertion can provoke the emergence of vitiligo, especially in people with a predisposition.

Symptoms of

The disease develops according to a certain pattern:

• Appearance on the skin surface of a single spot of a rounded shape or with torn edges, discoloration can occur gradually or within a few hours.
• Hyperpigmentation around the spot - the focus is surrounded by a rim of a darker color than the healthy skin.
• Propensity to increase and merge - stains grow and connect with each other. The speed of the process depends on the individual characteristics of the organism.
• The location of the foci is possible on any part of the skin, except for the palms and feet, where there is no melanin. Most of the spots are formed on the face, on the bending surfaces of the limbs, in the armpits, on the buttocks, around the scars, in the places of frequent trauma to the skin.
• Symmetry - for unknown reasons, the spots on the left and right half of the body try to occupy an identical position.
• Hair discoloration - Inside the lesion, the hair follicles lose melanin, which causes the hair to lose its color both on the head and on the head. The appearance of early gray hair is characteristic of 30% of patients.
• Point foci in the form of a grid - their appearance is characteristic for the skin of the breast, genital organs and inner thighs.
• Violation of the functions of sweat glands - secretion of sweat in the depigmented areas is difficult.
• Stability of color in ultraviolet irradiation - the foci of disease do not darken from exposure to sun, although the healthy skin around them does not lose the ability to sunbathe.




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Consequences of

The disease is not infectious and is not transmitted on contact. Vitiligo patients do not experience physical discomfort( itching, burning of the skin), nevertheless the disease can lead to a number of psychological problems. People who have lesions on their face, avoid appearing in society, feel shame and insecurity, are in a stressful state.

Vitiligo often has a secondary character, being only a manifestation of other diseases, for example, it indicates abnormalities of the thyroid gland, appearing several months before the first hormonal failures, or it serves as a reaction to the taking of certain medications.

Diagnosis

The diagnosis is made by a dermatologist. The procedure consists of several stages.

During the survey, it turns out:

• the presence of similar symptoms in relatives;
• hereditary predisposition;
• possibility of autoimmune diseases;
• the date of onset and the rate of progression of the disease;
• exacerbation in the last 6 months;
• skin reaction to sunburn( for the appointment of phototherapy).

Inspection helps distinguish vitiligo from other diseases by external signs:

• symmetry of spots( observed in 90% of cases);
• form of foci( mostly round, only 10-15% dotted or irregularly shaped);
• presence of the hyperpigmentation ring;
• absence of peeling, crusting or erosion( exception - attachment of secondary infection);
• hair discoloration;
• the presence of spots around the moles.

Biopsy, when a piece of skin is taken with a scalpel from the center of the hearth and viewed under a microscope, helps to identify:

• absence of melanocytes - complete or partial;
• collagen fibers with changes;
• presence in the ridge of the focus of melanosomes( a component of melanocytes) in large quantities.

Treatment of

With the help of therapy, they try to control the disease, reduce its cosmetic manifestations and restore the production of melanin. To treat vitiligo apply an integrated approach.

Local treatment is used to reduce the size of spots, their uniform darkening. Includes the use of ointments and creams:

• corticosteroids, which reduce the immune attack and restore pigmentation( Prednisolone, Betamethasone, Diprospan);
• inhibitors of calcineurin that relieve inflammation and suppress the attack on melanocytes( Protopik, Elidel);
• photosensitizing agents that enhance the absorption of ultraviolet( Melagenin, Psoralen).

Systemic drugs are connected in the absence of the result of the semi-annual local treatment and with the rapid progression of the disease:

• ingestion of immunosuppressants( Cyclosporin A, Levamisol, Isoprinosine, Cyclophosphamide);
• continuation of hormone therapy.

Physiotherapeutic procedures:

• Light treatment is ultraviolet irradiation with waves of medium length of type B, sometimes with the application of photosensitizing agents. The course lasts about a year and consists of sessions of 5-10 minutes 2 times a week.
• PUVA therapy - UV irradiation of a long spectrum of type A together with the intake of photosensitizers 2-3 hours before the procedure( Ammoidin, Lamadine, Metoxaralene, Oxoralen, Pouvalene, Trioxaralen).Sessions last 5-30 minutes, are held every other day. The effect is achieved by repeating the procedure 100-200 times.
• Laser therapy - is aimed at activating the work of surviving melanocytes. Improvement of metabolic processes in the skin promotes the development of enzymes responsible for the formation of melanin. Sessions for 30 minutes should be done 15-20 times.

Indications for the use of surgical techniques:

• the location of foci in open areas of the body, which causes psychological problems;
• no results from conservative treatment for 12 months;
• remission of the disease - the suspension of the formation of new spots and the growth of existing ones over the last 1-2 years;
• no contraindications - tendency to scars, intolerance to UFO and laser therapy.

Among the side effects of surgical intervention are: uneven pigmentation, scars, rejection of transplanted sites.

Diet

To prevent an exacerbation of the disease will help a balanced diet, which necessarily includes the intake of vitamins, zinc, copper. Among the recommended products of dietitians:

• lean meat( rabbit, chicken), liver;
• fish and seafood( squid, shrimp);
• dairy products;
• greens( parsley, celery, spinach);
• fruits and vegetables of red and orange flowers, citrus;
• seeds, nuts, bran;Beans, cereals,
• .

It is advisable not to use:

• meat and fish fatty varieties, rich broths;
• products containing preservatives, dyes, fragrances, sweeteners;
• sweets, flour products;
• coffee, strong tea, chocolate;
• fizzy drinks, alcohol.

Sometimes compliance with a gluten-free diet also contributes to a cure.

In children

Vitiligo in children under 5 years of age is usually associated with a slow adaptation of the immune system to environmental changes. Such spots do not require treatment, and eventually pass. An exception is hereditary predisposition.

For treatment suitable drugs are prescribed and adults, but in smaller doses. Ultraviolet irradiation is possible in limited order, PUVA therapy for children is not applied. Be sure to follow the diet. Also, parents should pay special attention to the psychoemotional state of children - often skin defects cause fears and complexes in them.

During pregnancy

The presence of vitiligo is not reflected in the course of pregnancy or fetal development. However, foci of the disease can appear in pregnant women faster than in other people, arising in places of stretch marks.

Treatment( especially medical and laser therapy) should be postponed until the end of the period of pregnancy and lactation. Cosmetic means for masking spots should also be used with caution, after consulting with a doctor. Do not get carried away and folk medicine methods - many recipes include the use of components that can provoke allergic reactions or cause poisoning.

You need to contact a specialist pregnant - this will help determine whether vitiligo is an independent phenomenon or a consequence of another, more severe disease.

Treatment with folk remedies

There are many recipes for normalizing the activity of melanocytes at home, but they need to be used only after discussion with the doctor:

• tincture of mountain arnica - 20 grams of herbs to insist in 1 cup of boiling water for 30 minutes,3 parts and take before meals during the day;
• decoction of wild rose berries - pour the crushed fruits with boiling water in a ratio of 1:10, boil, insist for several hours and drink 1 tablespoon before eating 2 times a day;
• decoction of nettle - 2 tablespoons of leaves boil 2-3 minutes in 1 glass of water, strain and take inside 1 tablespoon before eating;
• duckweed - to crushed raw material add an equal amount of honey, eat 1 teaspoon of the mixture 3 times a day;tincture of duckweed in a proportion of 1: 1 with water can also rub the stains;
• St. John's Wort - 1 tablespoon leaves and flowers of the dried plant immerse in 1 cup of boiling water for 30 minutes, strain and drink 1 tablespoon 3 times a day after eating 3 weeks, then break for 1 week, continue treatment for 5-6 months;for external use, pour the herb with vegetable oil in the proportion of 1:10, stand for 3 hours in a water bath, use for 1 month;
• sesame - grind grain in a coffee grinder, eat 1 teaspoon 2 times a day;
• rubbing with pepper - ground black pepper mixed with soda in equal parts, rubbed into the foci of depigmentation;
• greasing with birch tar - apply the product on the stains 2 times a day for a month, then take a break for 2 weeks and repeat the course.