Vitiligo is a skin condition where patient has white patches on skin in different body parts. This occurs due to destruction of cells which makes colour pigment in our skin. These cells are known as melanocytes. Vitiligo or white patches can also be seen mucous membrane of mouth and nose and retina of eyes. It also causes whitening of hair in affected areas.
Vitiligo is believed to be an autoimmune disease as its cause is not been established evidently proved yet. There are many assumption or theory regarding cause of vitiligo. The reason due to which pigment-forming cells, melanocytes are destroyed is not known but some doctors believe that due to a group of three genes it occurs. According to them these genes are responsible for depigmentation of skin. Researches are being done in this field. Some researchers are of view that melanocytes are destroyed by themselves while some believe that other factors trigger this destruction. They blame sunburn, emotional stress and other such factors for vitiligo, but there is no evidential proof of that. Most widely believed theory is that cytokines a protein produced by body changes melanocytes which leads to depigmentation or vitiligo. People with auto immune disease are at higher risk of developing vitiligo. It may pass in family too.
Suction blister epidermal grafting is an established technique for the treatment of resistant and stable vitiligo especially over small and cosmetically important areas like the face. However, certain areas, such as lips and eyelids, require special considerations because of their anatomic peculiarities.
Melanocyte transplantation is the latest surgical method for the treatment of stable vitiligo / leucoderma
and loss of pigmentation.
Melanocytes are the skin cells which produce melanin. A complete absence of skin colour usually means the melanocytes have been destroyed. Thanks to an innovative treatment, it is now possible to take melanocytes from a healthy area of skin and transfer them in a suspension onto the damaged area of skin. This process is not a time consuming, laboratory cell culturing technique but is a process that can be carried out in a clinic in one to three hours. It is important to note that this is not a melanocyte culturing process.
Who is suitable for Melanocyte Transplantation?
There are two main categories of patients that are most suited to melanocyte transplantation.
a) Patients who have white patches on their skin as a result of leucoderma such as piebaldism and halo nevi or after laser tattoo removal or who have dischromia on burn scars.
b) Patients who have had stable vitiligo patches for a period of at least 6 months are good candidates to undergo melanocyte transplantation.(best vitiligo treatment in delhi)
The vitiligo surgery a best vitiligo treatment in Delhi aims at complete re pigmentation of the white patch which blends with surrounding area of skin. But surgery is not considered an option in all cases of vitiligo. Many factors are considered before surgery such as age of the patient stability, size and location of the patch etc.
Vitiligo surgery is used when patient has stable disease, ie vitiligo which has not progressed since long. No new patch has appeared and disease is confined to few patches. Surgery is better option with segmental vitiligo. Success of surgery can vary with different parts of body. In cases of active unstable vitiligo or progressing vitiligo surgery is not advised. Surgery is not advised in cases of childhood vitiligo too.
Response according to type of vitiligo:
- Segmental - Best response and most suitable. Success rate 94% ( See below)
- Focal - Very good response and suitable. Success rate 80%
- Vulgaris - Responds well on lower extremity, poor response on face. Success rate 75%
- Acral - Poor response in all areas. Success rate 20%
Success rate of treatment is 94% i.e. 94% of the treated patients develop pigmentation over 65% to 100% of the treated area. A statistical figure of success rate applies to a group of people and not to an individual patient.
Recurrence of vitiligo after treatment:
- Segmental - Almost no recurrence
- Focal - Minimal chance of recurrence. It can develop in vulgaris type.
- Vulgaris - can recur.
- Acral - Very high rate of recurrence.
Is one operative session enough for complete recovery?
Sometimes a few white spots remain. Approximately 30% patients require repeat surgery for complete recovery.
Most Advanced Method
Melanocyte transplantation is the most advanced surgical method to treat vitiligo / leucoderma (Best Vitiligo Treatment in Delhi). Large areas can be treated. Repigmentation occurs in about 4 to 6 months and cosmetic results are superior to other surgical methods such as skin grafting and punchgrafting. Difficult areas like bony surface, areola, genitals and knuckles can be treated with excellent results.
What happens post-treatment?
The treated site is protected by a dressing for one week. Verbal and written post treatment instructions are provided. Dependant on the site that was treated, no further dressing is required and you will need to follow the instructions that were given. There is usually no bruising or swelling. Some patients may feel minor discomfort at the biopsy and treated site for a few days which can be treated with a mild painkiller if wished. Recovery is remarkably quick.
When dressings are removed the treated area appears bright red. Repigmentation is seen only after 4 to 6 weeks in brown skin population and 8 to 12 weeks in Caucasians. It takes about 6 months to achieve maximum results.
Complications & Side Effects
- Since no medicines are used except post-operative antibiotics, there are no side effects.
- Scarring and Koebner's phenomenon are rare complications. Trauma of surgery may cause new lesions (Koebner's phenomenon) and is seen in approximately 2% of our patients. Use of oral prednisolone at surgery may prevent Koebner's phenomenon.
- There may be a hypopigmented ring at the borders of treated and repigmented patches in some patients. Usually this ring disappears automatically or with application of local steroids, or by repeat surgery.
- Bacterial infection. All patients are given oral antibiotics to prevent chances of infection.
Advantages of Melanocyte Transplantation
- It is less time consuming. It takes only 3 to 5 hours after that patient is free.
- It gives better result compared to other treatment methods such as skin grafting or punch grafting.
- It gives high colour matching so transplanted area blends with surrounding area of skin.
- It covers large area in a single session, thus less number of sessions are needed.
- Minimal donor area is required as a large area can be treated with a small donor area.
- It is a highly successful procedure.
- Very rare chances of complications or side effects.
- It gives fast results and pigmentation may be complete in 1-2 months.