Q: I am 32 years old and suffering from vitiligo. My doctor has prescribed Vitix gel, Antoxid tablets to be taken every morning, Trimop forte tablets to be taken every alternate day, and Dexona 4 tablets to be taken twice a week. Am I on the right treatment? Do I really need the steroids prescribed?

A:A number of medical therapies, most of which are applied topically, can reduce the appearance of white patches with vitiligo. Some of the most commonly used ones include:

• Topical steroid therapy
• Psoralen photochemotherapy (also known as psoralen and ultraviolet A therapy, or PUVA therapy)
• Topical psoralen photochemotherapy (often used for people with a small number of depigmented patches affecting a limited part of the body)
• Oral psoralen photochemotherapy (used for people with extensive vitiligo, affecting more than 20 per cent of the body)
• Depigmentation—this treatment involves fading the rest of the skin on the body to match the areas that are already white. For people who have vitiligo on more than 50 per cent of their bodies, depigmentation may be the best treatment option. Patients apply the drug monobenzylether of hydroquinone.

Surgical therapies must be considered only after proper medical therapy is provided. Surgical techniques are time-consuming and expensive and usually not paid for by insurance carriers. They are appropriate only for carefully selected patients who have vitiligo that has been stable for at least 3 years. These include:

• Autologous skin grafts
• Skin grafts using blisters
• Micropigmentation (tattooing)

In addition to medical and surgical therapies, there are many things you can do on your own to protect your skin, minimize the appearance of white patches, and cope with the emotional aspects of vitiligo. What you are taking is good for your vitiligo. Even the pulse dosing of steroids that is being administered to you is correct. More information on the site, extent and duration of your patch/patches of vitiligo may help us help you more.