Tuesday, June 25, 2013

Vitiligo Tattoo Treatment

Vitiligo Tattoo Treament


Finding an effective vitiligo treatment can be really difficult for vitiligo sufferers as there are plenty of options but very few seem to offer a good solution for vitiligo sufferers. One breakthrough vitiligo treatment option has emerged in the form of microtattooing or the camouflage tattoo method. This treatment is most appropate for obvious and visible parts of your skin like facial skin or neck. Rather than eradicating the spread of vitiligo patches or treating vitiligo, this treatment is aimed only at camouflaging the de-pigmented look of vitiligo patches, i.e. this is only an aesthetic treatment.

Understanding Micro-tattooing

The treatment uses an unusual approach of implanting artificial pigments into the skin, i.e. the skin’s outer layer is colored using a special technique. The equipment used during this method is very similar to devices used in specialized tattooing methods. In fact, the method in which the pigments are patterned in and around the vitiligo patches is also similar to the manner in which tattoo ink is manipulated when creating tattoo designs. This is why this treatment is often dubbed as ‘medical tattooing’.
The pigments used  are metabolically inert and are different from  tattooing ink. These pigments are immune to the biological changes in the skin or changes induced by external factors, ensuring that the original shades of the pigment are retained for a lifetime.
Due to the highly-specialized and demanding nature of this procedure, the expertise and experience of the micropigmentation technician is critical to the results. The immediate results of this approach and its non-invasive nature have made it a preferred option for many vitiligo sufferers. The procedure is not very expensive and doesn’t require surgical sedation or hospitalization.

Micro-tattooing Limitations

Micropigmentation vitiligo treatment is usually suggested among people suffering from non-progressive vitiligo, i.e. where new white spots or patches have ceased to surface and the existing patches aren't gaining in size. Among people with a history of herpes virus infection or those who have tested positive for HIV, micropigmentation is not recommended. Similarly, people with a medical history of skin problems like psoriasis are likely to be refused this treatment.

Acne Scar Treatment

Acne Scar Treatment


Some types of acne scars cannot be comprehensively cured using conventional acne treatment methods. This is commonly observed in acne scars with deep pitting. These acne scars are characterized by a deep abase, wherein the surrounding scar tissue hardens into thick layers that don’t respond to topical ointments. Boxcar scars are quite similar to scars that develop after a severe attack of chicken pox. Treating such scars through conventional plastic surgery can be very expensive. An equally effective and very undemanding form of treatment is the Punch Elevation method.

Application of Punch Elevation Acne Scar Removal

The overall effectiveness of this procedure depends upon the depth of the scar and the availability of a small amount of surrounding skin for the graft. It is advised that anybody contemplating this treatment should seek proper counseling to understand the precise  degree of improvement that is attainable in your case.

Use of Skin Grafting in Punch Elevation Acne Scar Removal

Most contemporary punch elevation treatments are attained using skin graft. This is regarded a more aggressive option for covering the minimally-punched acne scars. In this case, small skin flaps are grafted on top of the scar site. The grafted skin is taken from the patient’s own body.  The patient's own skin is best to ensure acceptance of the graft.

The biggest advantage of Punch Elevation is that it does not require a significant recovery period.   The skin’s outer, superficial layers are quick to heal. The graft more than covers the original scar, giving the skin a much smoother look.

Punch Elevation Acne Scar Removal

Punch Elevation is a microsurgical technique  performed as an outpatient procedure. The cosmetic surgeon uses a cutting device  called a punch tool. The punch tool is different than conventional tools used in plastic surgery. This is because it can remove small traces of tissues without stretching or impacting the surrounding skin.

A specialized tool is used to excise the base of the scar.  When the scar tissue base is sufficiently punched, the base of the acne scar is more aligned to the outer walls surrounding the scar, i.e. the scar base is elevated. The elevation causes the scar to appear more shallow/less deep.

The site is closed with micro-sutures or skin glue which will further camouflage the scar and/or the sutures marks. In either scenario, tiny bits of the surrounding skin are used to establish the borders of a now flatter, smaller, nearly invisible area. The scar site is overlaid by new skin, initiating the healing process.

Punch Elevation Acne Scar Removal

Understand that the overall effectiveness of this procedure depends upon the depth of the scar and the availability of a healthy skin to establish the sutures and graft. It is advised that anybody contemplating this treatment should seek proper pre-treatment counseling to gain a precise approximation regarding the probable degree of improvement.

Vitiligo is not harmful to the health – there is no physical pain or irritation – it is merely an absence of pigment in patches (lesions). This means that it is a condition that is merely symptomatic. The reasons treatment for the condition is so sought after is two-fold. First, the white skin is not protected from the sun, which makes it vulnerable to burning. This lack of skin  protection can also have long-term health consequences-- most notably, the increased risk of skin cancer. The other, more immediate effect is the social and psychological embarrassment. People with depigmented skin on the face appear odd, especially if their normal skin is of darker complexion. Vitiligo can appear on any part of the body (and sometimes all of it) and is not always easy to hide. Arms, hands and face are typical problem areas,  affecting a sufferer's self-confidence.

While we all have flaws on our body that we are not happy with, they are rarely as eye-catching as vitiligo. It's not as common as obesity, but, like obesity, it does not garner sympathy. Due to the lack of education, people tend to stare or ask ill-informed questions. Vitiligo sufferers can go a lifetime feeling unattractive or unworthy purely because of the color of their skin. There are certain societies, such as in parts of India, where a man can divorce his wife if she develops vitiligo. One can easily shield  from the sun but not from the opinions of others, even just the perceived opinions of others.

There has been no definitive cause found. The signs point to an auto-immune condition, as it is often accompanied by thyroid problems and familial links are common. The theory here is that the body's own immune system attacks the melanocytes in the skin. Sometimes it pools around the hair follicle but sometimes even the hair loses its pigmentation. Sometimes it is symmetrical, sometimes it is not. For some reason the asymmetrical type is slower to spread but less reactive to treatment. While theories abound, a definitive reason for this has yet to be discovered.

So, despite the prevalence of the condition, and the amount of research conducted on the matter, no one treatment has been shown to be more effective or suited to all sufferers. What may completely cure one person's vitiligo may just as easily have no effect on the other, or even have negative effects. Dr Boissy explains, "The health care provider or the patient has no clue as to how the disease will progress in a patient, or how they will respond to the various treatments." And unfortunately, cures can only ever be seen as temporary, with resurgences common months or years after treatment has ended: "In general, current therapies can only provide repigmentation to about 60% of patients, with only about 60% of lesional area repigmenting, and only about 60% of pigmentation being permanent (while additional new lesions may frequently arise)."

There are a variety of ways that people react to having the condition. Of high importance to some, particularly those who have it on the face, is to cover up the effects. This can be done with medical camouflage, available on the NHS. A specialist will match up your skin tone to a kind of hard-wearing make up and teach you to apply it yourself. This does not solve the problem medically or psychologically, but can certainly help those who feel particularly insecure about the visual impact of vitiligo.

A topical treatment is usually the first port of call in the treatment of vitiligo in the attempts to remove or at least stop the spread of the condition. This is provided in the form of corticosteroids and, as with most steroids, there are some side effects with prolonged use, such as thinning and streaking of the skin. These steroids are not so effective as the more robust light therapy treatments.

PUVA is the one of the more extreme but successful methods of treatment and is a form of light therapy. This treatment involves the ingestion of psoralen, a medicine that makes one's skin more photosensitive, before exposing the affected areas with UVA. Due to this particularly unprotected exposure to pure UVA, these treatments do have the unfortunate result of increasing the patient's risk of skin cancer. This is why it is recommended only to those with wide vitiligo coverage and with people with much darker skin, where the vitiligo is much more noticeable. It is the only form of light therapy available on the NHS, but is certainly something that one should think about carefully before undergoing, due to the long-term skin damage. This was a treatment that I was denied in my teens for which I am, some time later, extremely grateful.

UVB Narrowband Phototherapy is the newest and seemingly most effective method of treatment for vitiligo. It is in fact so new that it is not available on the NHS. Still, Dr Boissy describes it as 'the most effective phototherapy method available' and is not too arduous on the patient

If these
light therapy treatments do not prove effective, further treatment becomes a lot more drastic. A patient might choose to undergo skin grafts, whereby healthy skin from one area will be attached to the white skin in another. This is not always successful, very time-consuming and can lead to scarring, so is seen as something of a last resort. So too is depigmentation, where the rest of the skin is turned white to match the vitiligo lesions. This is done in order that the patient can be all one colour again, even if it is all white. This process can take one to four years and involves the daily application of a lotion called Benoquin. This may seem like a drastic manoeuvre but this is the effect that vitiligo can have. The patient wants to be whole again, even if it is a slightly different whole. It is heartening to read Dr Aaron B Lerner's (Yale University School of Medicine) testament that, "I have never had a patient who was unhappy after being depigmented." Still, there is no denying that this is a big change, and as with all vitiligo treatments, not without its side effects, such as repigmentation and the very real social issues that come with completely changing one's skin colour.

Several holistic treatments are also felt to have a positive effect on the repigmentation of vitiligo lesions. Piperine, a product derived from black pepper, has recently gained prominence in the treatment of vitiligo. Dr Boissy is, however, less sure: although here are several basic science studies on the promotional capacity of piperine on melanocyte proliferation and activity, there are no clinical studies on the use of piperine in the literature confirming its putative effectiveness." Similarly, gingko biloba, though cited by some as a natural treatment for vitiligo because if its relation to the thyroid, has not been put to the clinical test, so evidence of its success is merely anecdotal.

It is easy for someone with vitiligo to feel somewhat alone and uncared for. The condition is not seen as a major health risk and psychological, social and even sexual effects that are debilitating to the subject, are not quickly recognized by doctors or the general public. Relatively little research is put into treatment, and sufferers often feel as though they are not being taken seriously. However, an online community has been building over the past years, building a network of vitiligo sufferers to help support one another where this support may not be available. Vitiligo Friends is one of the biggest and blends an informative database of case studies and treatment with MySpace-style profiles and busy message boards. It is a place to go to vent your frustrations at the condition, confide your worries and to console others. It is encouraging to see how supportive users are to each other and must have made a big contribution to easing the worry of vitiligo sufferers worldwide.  A similar network is available in the UK specifically, called the Vitiligo Society, which even commissions its own research into treatments.

All of this, the various physical treatments and the psychological support, can help in dealing with vitiligo. It is a frustrating and worrying process, not knowing where your vitiligo will spread to next, if this a treatment will work or if the cure will even last. It is horrible feeling unattractive. It is deeply upsetting to be so wary of the sun and, when feeling vulnerable, to have one's worries ignored or dismissed. And the treatments and support can help with all of this, to a degree. The final aspect, something that it seems comes with time, is to accept the vitiligo as part of yourself and embrace it.

Responses to vitiligo, to its treatment, to its cures all vary hugely from person to person, but Dr Boissy agrees that what does not vary is that the best attitude towards dealing with vitiligo is a sensible approach to sun protection and a healthy body image.  For myself, I feel I am nearly there. I stopped pestering my dermatologist for treatment years ago and stopped wearing camouflage not long after. I'm still cautious in the sun and sometimes when I see photos of myself all I see are the lesions on my face but mostly I forget it's there. When I allow my facial hair to grow I look like a badger, and I love that now. My perspectives on the world in general, are ever so slightly different to what they might otherwise have been and all the richer for it.