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What are the various treatment options for vitiligo?

Q: I am suffering from white patches for the past 12 years. I tried ayurvedic, allopathic, homeopathic medicines etc. With most medicines the problem gets almost cured but suddenly flares up again. A doctor gave me melanocyl tablet and lotion, azaron and serbin forte. Almost 75% of the problem was cured in 1 year. But again it has started increasing. My doctor suggested Vitcofol injection continuously for 90 days. Now he has given 2 tablets of melanocyl to be taken daily in the morning; after 90 minutes I have to rub the melanocyl lotion; after 30 minutes I have to expose myself to sunrays for 5 minutes. I take 1 ml of the Vitcofol injection daily. Now I am not able to identify if the white patches are reducing or increasing.

A:The natural course of vitiligo is one of gradual evolution, slow progression and unpredictable end. Various treatment options available are: 1. Topical corticosteroids 2. PUVA therapy a) Topical b) Systemic Psoralens like 8-methoxy psoralen (8MOP), 5-methoxy psoralen (5MOP) or trimethyl psoralen (TMP) are utilized to stimulate melanogenesis utilizing sunlight or artificial ultraviolet light (UVA) sources. 3. Placental extract a) Topical b) Systemic 4. Systemic corticosteroids 5. Immunomodulators like levamisole 6. Surgical repigmentation by blister grafting, punch grafting, partial split thickness grafting or cultured epidermis or melanocyte grafting. 7. Depigmentation: 20% monobenzyl ether of hydroquinonone in cream locally may be used to depigment permanently the normally pigmented skin in extensive vitiligo cases. You can also use dermacolor (German made), a camouflage system to cover your face spots and good cosmetic look. In your case, unless one assess your clinical condition, it will be difficult to suggest any further line of treatment. Do visit a good dermatologist. Keep one thing in mind that treatment should not be more dangerous than disease itself. Vitiligo usually is a depigmentation of the skin and no systemic component is there.

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