Medicalese: White Patch on the Belly After Death (cont.)
People with vitiligo must protect their skin from exposure to the sun. Affected areas of skin can become seriously sunburned while the surrounding skin tans. Affected people must be vigilant about using sunscreen with a high sun protection factor (an SPF of 30 or above) on exposed skin. During long periods outdoors, they should wear long sleeves, pants and wide-brimmed hats.
If the affected area is small, application of creams containing corticosteroids may help restore pigment. Chronic use of steroids, however, can result in thinning of the skin and stretch marks in some areas.
Dermatologists most commonly today use a remedy called PUVA for those seeking to darken white skin patches, especially when the condition is extensive. PUVA involves taking a drug called psoralen, which makes the skin very sensitive to light, followed by exposure of the affected skin to a special lamp that generates only ultraviolet A radiation. Occasionally, when the vitiligo patches are very limited, psoralen can be applied directly to the skin before ultraviolet A treatment.
The downside of PUVA therapy is that it is time-consuming and care must be taken to avoid side effects, which can sometimes be severe. At least a year of twice-weekly treatments is usually needed to restore melanin production. The treatments are 50 to 70% successful in restoring color on the face, trunk and upper arms and legs. But hands and feet respond poorly to this approach. PUVA should not be used in children under 12, in pregnant or nursing women, or in people with certain medical conditions. Long-term use of PUVA can cause freckling and, when used for years to treat psoriasis, PUVA increases the risk of skin cancer. Risks aside, the most effective treatment available now is PUVA. The goal of PUVA therapy in vitiligo is to reverse the effects of the disease and repigment the white patches.