Vitiligo Surgery

Vitiligo is a common acquired depigmentation disorder of great cosmetic importance. The basic pathogenesis of vitiligo or for any of the putative subsets of vitiligo, still remains unknown. The medical treatment of vitiligo is dependent upon the presence of a melanocyte reservoir and is effective in only 60-70% of the patients.

Certain types of vitiligo do not respond well to medical treatment and resistant lesions do persist even in those who respond. In light of these limitations of medical treatment, surgical treatment of vitiligo was first proposed in the 1960s. Over the years, the concept of surgical treatment has been expanded to include surgical “biotherapies” such as autologous, cultured melanocyte transplantation. The disease has a major impact on the quality of life of patients, particularly the Indian population, in which there is a severe stigma attached to the disease, affecting the social and psychological aspects of the patients. Due to these effects, there is a considerable need for active treatment of this disease, in contrast to fair-skinned patients in whom the disease is less apparent.

NEW SURGICAL TECHNIQUES:

Skin grafting

• Normal skin is used as donor tissue and then grafts are surgically transplanted on areas of vitiligo. The new skin grafts start producing pigment.
• Patients who are candidates for this procedure must have stable vitiligo, or vitiligo that has not changed for at least six months.
• This procedure can be used for patients with limited areas of vitiligo and also in those with more extensive disease. Patients can decide to use grafts on one area of the body (such as the face) and choose another therapy for other areas affected by vitiligo (such as the hands).
• Skin grafting has a high success rate — 80 to 90 percent in most patients.