vitiligo

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  • What is Vitiligo?

    Vitiligo is a skin condition whereby the pigment cells of the skin, that is, the melanocytes are destroyed in certain areas, hence causing white patches to develop on the skin. Normally, Vitiligo is more commonly seen in exposed skin areas such as the face, neck or hands, but it can similarly affect any other part of the body equally. For some people, such skin condition may even be visible inside of the mouth, on the eyes or on the hair, through noticeable loss of colour.
    Generally, people in the mid-twenties are more prone to having Vitiligo. However, it has also been found that such skin condition may occur to anyone at any age range. Vitiligo has a propensity to develop further with time, causing loss of pigmentation in larger skin zones. The pace and amount of the loss of skin pigmentation cannot be predicted though. Contrary to the beliefs of people, Vitiligo is a non-contagious and non-infectious skin condition, however, it may be linked to hereditary or genetic markers.

  • Main Types of Vitiligo

    There are normally two main kinds of Vitiligo:
    1. Segmental
    Segmental Vitiligo, which is also known as unilateral or localised vitiligo,happens more frequently in children, through the white patches that affect only one area on your body.
    2. Non- Segmental
    Non-segmental Vitiligo also known as bilateral or generalised vitiligo is one of the most common types of Vitiligo. In this type of Vitiligo, the patches of the skin where de-pigmentation occurs, usually shows some form of symmetry. In other words, the white patches of skin progress symmetrically on both sides of the body, affecting the same body parts at the same time.

  • What causes Vitiligo?

    The main cause of Vitiligo is normally the death or the malfunctioning of the skin pigment cells, that is, the melanocytes. The affected areas begin to lose pigmentation and turn to a white colour. The real reason behind such a skin condition can be the existence of an autoimmune disease whereby the body starts to attack its own cells. In some cases, Vitiligo can also be found in people who have family members with such a skin condition, and hence, can be passed on through the genetical factors. Additionally, specific events such as extreme sunburn, skin injury, excessive stress or certain hazardous chemicals may also trigger Vitiligo in an individual.Normally, vitiligo can start at any age, but often appears before the age of 20.

  • What are the symptoms of Vitiligo?

    Vitiligo can be easily identified in a patient through the loss of pigmentation in the skin. Such a discoloration of the skin is first visible in areas such as the hands, feet, face, neck or lips. It can also be followed by loss of melanin in the hair, causing the hair to turn to a white or grey colour. Such discoloration on the skin and hair continue to expand into greater patches all over the body. There may also be premature whitening of the eyelashes, eyebrows or beard. In some exceptional cases, there may be change or a loss of colour in the inner layer of the eyeball. Vitiligo may thus affect an individual on different levels, normally:

    • Many parts of the body, which is commonly known as generalised Vitiligo, whereby the discoloration progresses symmetrically on the body areas.
    • Only one side or part of the body, which is commonly known as segmental Vitiligo, whereby the skin condition occurs at a younger age to progress for one or two years and finally cease.
    • Acrofacial Vitiligo, which consists of the fingers or toes to be mostly affected.
    • Mucosal Vitiligo, which causes the mucous membranes and lips to be affected.
    • Universal Vitiligo, which implies the depigmentation of almost the whole-body area, which is very erratic.
    • Focal Vitiligo, which consists of only one or a few dispersed white patches in very discrete body areas. This is most common in children.

    For some patients, Vitiligo may not only be accompanied by physical symptoms, but psychological distress as well because of their appearance.

  • Who is affected by vitiligo?

    Normally, it cannot be predicted as to who are more prone to having or developing Vitiligo. As at today, the total number of people who are affected by Vitiligo is estimated to about 65-95 million people all over the world. However, the actual number of sufferers may be much greater than this, as Vitiligo are underreported in many cases. The occurrence of Vitiligo is normally equally for both men and women alike, and irrespective of the race or ethnicity of an individual. However, Vitiligo is more visible in people with darker skin colours.
    In addition, people who have other autoimmune conditions such as the hyperthyroidism, may be more prone to having Vitiligo as compared to others. Yet, this is very rare as most patients affected by Vitiligo do not necessarily have other autoimmune conditions.

  • Vitiligo Treatment

    The treatment for Vitiligo can be estimated based on the depigmentation of the skin and the ability to restore the normal appearance of the skin colour. The Vitiligo treatment consists of a number of techniques, such as the light therapy, the systemic steroids, de-pigmentation, and even surgery. Traditional treatments include therapies with steroids and UVA light (PUVA), whereas contemporary treatments consist of the narrowband UVB light, antioxidants and oral corticosteroids. In addition, natural supplements can also be used to avoid additional spreading of the skin condition. The effects may not always be permanent, but such treatments can constantly help to control the further propagation of the skin condition.

    When should you expect results and how long does it take to treat vitiligo?

    The principal rule of any treatment is that you need to be vey patient and allow a minimum of three to six months before the results are visible. Also, in the case of re-pigmentation, the skin tends to depend on the appropriate combination of the treatments, such as the use of UVB light therapy and topical creams can easily help to recover the normal pigmentation of the skin. For some patients though, the results may not be visible before 8 months or even more, as the treatment varies for different individuals and also on the severity of the skin condition. Therefore, the best method to see effective results quickly, is to use a combination of treatments.

    What is Narrowband UVB & how it treats vitiligo?

    The narrowband UVB is actually considered as the “gold standard” treatment in the case of Vitiligo and is one the most effective and rationalized way to ensure the re-pigmentation of the skin. This is considered as being the most appropriate treatment, especially when Vitiligo has affected 20% or more body surface area. Phototherapy helps to mark and treat the affected body zones without causing any side effects.
    The phototherapy sessions usually consist of a unit which is used to emit rays of the Narrowband UVB directly onto the affected skin area. The treatment session can normally last for only a few minutes and can be carried out several times in a week. Your patients can also continue their Vitiligo treatment at home by the use of more user-friendly and easy to use units, such as the Dermalight 80 comb.
    PUVA therapy is also another mode of treatment of Vitiligo which has proven to work efficiently in the re-pigmentation of the skin. However, it may entail several drawbacks such as light sensitivity reactions, nausea, and in some cases, even long-term skin cancer. Thereby, making the narrowband UVB light therapy much safer and effective as compared to other means of treatment.
    Phototherapy is normally well suited for children and adults alike, and it has been proven, medically certified and tested free of any risk of skin cancer or any other related complications.

  • Types of Vitiligo treatment

    PUVA-Psoralen plus UVA light

    The PUVA therapy consists a combined treatment using the UVA light therapy and a drug namely, the Psoralen. The psoralen is taken orally or topically, and then a light therapy unit is used to emit UVA light rays onto the affected skin part. The duration of the session can last for up to three sessions per week. The side effects of the PUVA treatment consists of occasional stomach upsets, burning, cataracts and liver tissues. This type of treatment is normally more suitable for adults as compared to children, mainly die to their side effects.

    Topical Therapy

    Using topical steroids normally consist of using topical products to treat Vitiligo.However, this is not considered as a convenient treatment for Vitiligo on its own. The main reason is because there are some side effects that may be involved. Therefore, the topical corticosteroids are advisable to be used mainly through physicians’ prescribed products. Topical treatments are normally not advisable for children.

    Oral Therapy

    Oral therapy usually consists of oral steroids which help in the normal stabilization of active Vitiligo in patients. Such a treatment helps to stop new spots of Vitiligo from expanding further and can be ingested daily or few days during a week. The dosage and the timing of the oral therapy though needs to be well maintained as they may entail side effects in the patients. These may include increasing blood pressure, weakening of the bones and increasing blood sugar levels. Hence, special monitoring is required during such treatment. The oral therapy can work best when combined with other treatments, such as the light therapy, but only under the prescription and supervision of a professional as some medications may not react well to phototherapy, especially antibiotics.

    Surgical Therapy

    Surgical therapy normally consists of the transplantation of the functional melanocytes from normal pigmented skin areas to areas of abnormal skin pigmentation. However, this is considered as suitable only for few vitiligo patients and the severity of the skin condition. The patients more appropriate for this kind of treatment are generally those with localised, stable or segmental Vitiligo.

    Natural Health Supplements

    If you want to advise your patient for a more natural and safest mode of treatment, you should definitely start with the natural health supplements. In the case of Vitiligo, antioxidants help to stabilize the abnormal skin cells, which are more prone to damage by oxidative stress. Oxidative stress can be described as a disparity between the manufacture of the free radicals and the capacity of the body to cleanse or offset their destructive effects through neutralization by antioxidants. Natural health supplements are full of antioxidants which can help avoid such adversities. For example, Vitamin C has the capacity to block the harmful effects of the oxidants on the melanocytes owing to its strong and powerful antioxidant properties. Furthermore, oxidative stress can also be prevented before arriving at a non-reversible phase, by incorporating Vitamin C in your patients’ diets, which can stabilize and restore the normal skin colour.

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