Does Skin Grafting Treatment Help In Curing Vitiligo?

Posted on Mon, 18 Jul 2016

Question: Hi, my son is 5 years old and since August 2015 he started having these white marks on his skin. It started with a small white patch on his forehead and his leg and we started treating him for fungal infection. But it started growing and he was diagnosed with vitiligo. Now he has got white hair, his face specially forehead area, hands, legs, feet are all effected. He is been on medicines and steroids since December 2015. There were some minor improvement as some patches disappeared and at some patches the colour of skin started forming. The doctor then changed the medicines in April 2016 and since then nothing much is happening. I was just wondering if there are any chances that his skin will come back to normal or it will stay like this forever. We got happy when few small patches disappeared and started thinking that it might get better and in some time his skin might become normal again. I did hear about some treatments like skin grafting and melanin growth but I think he is too young for any such treatments. Please suggest.

Answered by Dr. Dr. Kakkar (52 minutes later)

Brief Answer:
NB UVB treatment is appropriate for his age and his type of vitiligo

Detailed Answer:
Hello. Thank you for writing to us

I am Dr.Kakkar (Dermatologist). I have read your question and I have noted your concern.

I have gone through the prescribed treatment.

I am so sorry to learn that your son suffers from vitiligo. It must be difficult for you as a mother, though not much concerning for him at this age, since he is still young and not bothered.

Vitiligo is an unpredictable disease i.e how it will behave in future and whether it will increase or stabilize is not totally predictable, nevertheless there are a few harsh facts about this disease which predict its future course.
Vitiligo that starts early in life (childhood) and is actively spreading/ extensive/ distributed widely from the beginning is more likely to be difficult to control with treatment as compared to the disease with adult onset and only a single or a few white patches, which are more amenable to treatment.
His treatment seems to be largely fine to me. Oral steroids are used initially in spreading vitiligo to take control of the disease. They can be continued for 4-6 months, not forever!. They work to arrest the spread of disease.
Since he has generalized disease, he is a good candidate for Narrow Band UV B phototherapy (NB UVB) which is safe and effective in children with widespread involvement.
Skin grafting is not an option for "active disease" i.e vitiligo which is still spreading and moreover he is too young. Skin/ punch grafting or melanocyte culture are usually performed on limited areas and in ''stable vitiligo" patients i.e those patients in whom there were no new patches for at least 1 year.
NB UVB treatment is appropriate for his age and his type of vitligo

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar