Vitiligo cure - Repigmentation - Autologous melanocyte transplantation

Vitiligo (Leucoderma) > Possible causes > Signs and symptoms > Differential diagnosis > Vitiligo tattoo > Vitiligo cure - repigmentation - melanocyte transplantation > Recent research > Support groups
Repigmentation by autologous melanocyte transplantation is a possible vitiligo cure in patients with focal or segmental vitiligo.

What is repigmentation by autologous melanocyte transplantation?

In this procedure for vitiligo cure, the normal melanocytes of the patient are harvested from his own normal skin, cultured in a medium and transferred to grow on the vitiligo affected area of skin.
In this repigmentation procedure there is least chance for the rejection of the transplanted melanocytes by his skin and complete cure can be achieved.

Patient's suitability for achieving vitiligo cure with repigmentation by autologous melanocyte transplantation

Not all vitiligo patients can get cure from this repigmentation surgery.
In active and progressive vitiligo, cure cannot be contemplated as fresh areas of skin keep losing melanocytes.
If the vitiligo is stable and nonprogressive for more than a year then this procedure of autologous melanocyte transplantation can be considered.
Vitiligo cure is possible with repigmentation by autologous transplantation in patients with focal or segmental vitiligo.
The affected area of skin must not be extensive as normal donor skin is required for the culture of the melanocytes transplantation.
In patients with Koebner phenomenon, vitiligo cure is not possible as linear depigmentation may start after the autologous transplantation.
Patients with keloid tendency and collagen disorder cannot undergo autologous repigmentation for cure of vitiligo, as keloid scars can develop at the sites of autologous melanocyte transplantation.
Patients with infections, especially of skin have to be treated and totally free of the ailment to be considered for this vitiligo cure.
In this melanocyte transplantation for repigmentation, a strict selection of the candidates for the procedure and a long pretreatment observation is necessary to prevent failures.

Surgical procedure for achieving vitiligo cure with repigmentation by autologous transplantation

After anaesthetising the donor skin area of the patient a thin layer of 5-10 sq.cm of epidermis layer of skin is removed (excellent results with silver skin graft knife).
Care must be taken not injure the dermis, as injury to the dermis can cause scars at the donor site.
Alternatively an electric vacuum suction pump can be used to cause a blister at the donor skin area and the top of the blister is removed.
This epidermis layer is incubated for about one hour in trypsin and if any pieces dermis present is separated from the epidermis.
The epidermis is made into very small pieces and kept in the culture medium for further growth before the autologous melanocytes transplantation.
The culture is centrifuged to separate out the melanocytes.
Alternatively the separated melanocytes can be directly transplanted without further culture.
The vitiligo patch is prepared for autologous transplantation surgery and local anaesthesia is given.
Dermabrasion is done with laser or micromotor and the epidermis is removed.
Care must be taken not to injure dermis layer as injury to dermis may cause scars and cure by autologous repigmentation can get affected.
After the removal of epidermis, the melanocyte suspension is uniformly applied over the exposed dermis layer and the wound is covered with dressing of collagen.
The dressing is removed after a week. The treated patch may appear pink when the dressing is removed.
In about a month, repigmentation will start. The repigmentation covers up the entire area in four months.
In some patients another visit is required for achieving 100% pigmentation and cure.

Advantages of vitiligo cure with repigmentation by autologous transplantation

For vitiligo cure with autologous repigmentation hospitalization is not required.
In most of the cases near 100% results are seen.
Autologous repigmentation can be done on any area of the body.
Larger areas can be covered with melanocyte transplantation with small patches of epidermis; Aesthetic appearance is regained.
Normally no scars are caused in vitiligo cure with repigmentation by autologous melanocyte transplantation.

Idiopathic guttate hypomelanosis white spots - treatment

White spots on skin, lips, fingernails, teeth, tonsils and genitalia > Idiopathic guttate hypomelanosis > Causes - symptoms - diagnosis > Treatment - medication
Idiopathic guttate hypomelanosis treatment includes application of topical steroids or retinoids, dermabrasion or microdermabrasion, cryotherapy, cosmetic cover-up, surgery and grafting. As the white spots are completely harmless best way for this hypomelanosis is to cover them up with cosmetics and forget.

Even if treatment is carried out fresh white spots may keep appearing at new areas.
For individuals conscious about aesthetic appearance cure is available.

Idiopathic guttate hypomelanosis treatment with retinoids

Retinoids like tretinoin have been used with some success in removing guttate hypomelanosis.
Tretinoin is the acidic form of vitamin A and it should be used with caution by people with sensitive skin as it can cause redness, burning and itching.
To avoid these problems the frequency of application must be increased slowly.
Tretinoin applied hypomelanosis lesions can get severe sunburn and exposure of these areas to sunlight must be avoided.
Topical corticosteroids have been found to alleviate the white spots condition to some extent.

Dermabrasion or microdermabrasion for idiopathic guttate hypomelanosis

Dermabrasion or microdermabrasion may also be considered in the treatment of this disorder.
These procedures must be done by a trained Aesthetician or a dermatologist as improper therapy may leave greater scar marks.
Dermabrasion is a painful process to be done under general or light anesthesia. Microdermabrasion is not very painful and can be done at cosmetic spas.

Idiopathic guttate hypomelanosis treatment by cryotherapy and surgery

Cryosurgery or cryotherapy also have been tried successfully. In this method of therapy white spots are frozen resulting in the death of thin layer of skin at the affected area.
Soon the normal skin takes over and cover-up the dead skin and the white spots disappear.
Surgical removal of the affected skin and grafting of the healthy skin has been successful.
Although these procedures may remove the current hypomelanosis, there is no treatment to stop fresh lesions from appearing. Idiopathic guttate hypomelanosis on leg
Hence it is advised to tackle the root cause. Sun tanning and tanning beds may be avoided by young fair-skinned individuals, especially young women, to prevent possible idiopathic guttate hypomelanosis white spots at a later life.

Skin care - Fordyce spots treatment and cure

White bumps on skin, lips, fingernails, teeth, tonsils and genitalia → Fordyce spots overview → Fordyce spots treatment and cure → Nevus depigmentosus
Fordyce spots require no treatment as they are benign and harmless. However for aesthetic appearance, treatment and complete cure is available.

Topical applications for fordyce therapy

The acidic form of vitamin A is Tretinoin and it is also known as ATRA (all-trans retinoic acid).
It is a medicine most commonly used in treating acne.
The topical form is available as gel and cream. For the cure of fordyce spots this ointment must be applied daily till the condition resolves.

Individuals with sensitive skin must use this cautiously and if any adverse reaction starts must discontinue immediately.

Women who are pregnant or who are planning a pregnancy should not use it as tretinoin is a teratogen and can cause fetal abnormalities.
They can only consider the therapy for fordyce spots after child birth.
Better results are achieved when tretinoin used along with AHAs (alpha hydroxy acids) which is another topical solution for acne.
Individuals undergoing therapy for fordyce disease with the above drugs should protect themselves from sun exposure as the treated skin can get severe sun-burn and sun poisoning.

Fordyce spots on the upper lips (enlarge)

Use of super pulsed laser therapy

For patients seeking improvement of aesthetic appearance from this condition, therapy with CO₂ super pulsed laser has been found to be very effective and safe.

Excellent results with complete re-epithelization was achieved.

No side effects were observed and in the medicated area no remnants of the fordyce condition were seen in 15 days.

Diathermy, liquid nitrogen freezing and TCA peels have been used for fordyce spots treatment and cure with varying levels of success.

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Milia treatment - milk spots cure - prevent milia

Overview > Causes, signs and symptoms > Milia treatment, cure and how to prevent milia
Milia treatment and cure in newborn babies is to keep the infant clean and well-fed and wait for the baby milk spots to cure by themselves.

Milia are harmless and may take long time to resolve in adults and in some cases may not resolve at all.
Fresh milia milk spots may appear again.
For aesthetic appearance if the affected individual wishes, the milia can removed.

In adults milia treatment, if required, is by exfoliation, dermabrasion, electrodesication, cryosurgery or simply removing the contents by incision and extraction.

Milia treatment and cure by exfoliation

There are a number of exfoliating creams and ointments available.
You can apply once in a day before going to bed.
 In some individuals these creams can cause rash like symptoms and take care to test the suitability of the cream for the treatment by applying it on a small area on your arm.

Alpha Hydroxy Acids containing creams and vitamin A derivative creams have been found to be effective.

Alternately dab and hold a fairly warm towel on the face for 5 minutes to moisten it and make it fairly warm.

This soaks up and softens the milk spots.
Keeping the face moist and warm use a exfoliating scrub to remove surface debris on the skin.
By this treatment the skin covering may loosen and open, causing the contents to come out.

Continue this treatment once in two days till all the milk spots resolve.
The skin on the eyelids is very delicate; take care not to injure it in scrubbing.

Microdermabrasion for the treatment and cure of milia

This is the procedure used in beauty parlours and beauty spas. It is better to have this procedure done by a trained Aesthetician.

Earlier abrasive crystals or wands having rough surface were used. With the advent of technology nowadays a variety of machines are available for microdermabrasion.

Effectiveness varies from person to person and machine to machine. As this procedure is usually priced high think twice before going in for this.

Milia treatment and cure by extraction

It will be better if this is done by a trained aesthetician or a dermatologist.

Face is first cleaned and dabbed with warm face cloth.

With sterile needle the centre of the bump is punctured and a small opening is made.

A gentle squeeze on the spot is made with a suitable forecep (made for such purposes) and the contents are removed. Some antiseptic cream is applied on the cut and it heals in a day or two.

Dermatologists sometime use electrodesication or cryosurgery for the treatment of milk spots.

How to prevent milia

In adults taking certain precautions one can prevent milk spots.

Use only tested skin care products from reputed manufacturers.
Avoid heavy makeup and do not smother the skin with heavy comedogenic lotions and face creams.

To prevent milk spots avoid prolonged sun exposure. If required to go out in the sun, use effective and light sunscreen.

If you are getting milk spots afresh, try periodical exfoliation to prevent milia from forming.

Take medical advice if milk spots are chronic as it could be due to some underlying disease or due to hereditary factor.

Hence for adults milia treatment and cure is possible and by taking precautions it is possible to prevent milia.

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