Objectives: To offer practitioners an innovative and simple alternative to treat Acral and acute Generalised Vitiligo. These technique offers the patient fast, comfortable and effective administration with visual improvement demonstrated in as little as 2 weeks. The success of this technique may also be used to treat other forms of acute or recalcitrant hypopigmentation such as guttate hypomelanosis, post-inflammatory hypopigmentation and chemical leukoderma.
Introduction: Affecting 0.5-1% of the world population across all ethnic groups, the pathogenesis of vitiligo is argued to be a multifactorial combination of auto-immune; genetic; viral; neural or oxidative stress. The disorder is characterised by patches of hypopigmentation resulting from melanocyte destruction. Whilst traditional methods for re-pigmentation have included grafting (epidermal culture / melanocyte culture) and excimer laser, the combination of automated micro-needling and a specific anti-mitotic drug has made for a successful and innovative technique.
Materials / method: As micro-channels are punctured into the skin, a corrective cascade is activated by the release of regulatory growth factors. The effect is non-ablative and non-thermolytic. The created channels furthermore facilitate the infusion and distribution of a specific anti-mitotic agent with a proven effect to multiply melanocytes and form pigment. Subsequently this combination therapy sees the activation and migration of healthy melanocytes to enable successful re-pigmentation on lesions which have been stabilised for at least 6 months. Treatment is performed fortnightly for at least 4 sessions.
Results: In patients where the active phase of the condition is in remission and lesions have been stabilised for at least 6 months, it may be observed that hypopigmented lesions reduce in size with melanocyte migration travelling 2-3mm following each procedure. Best results are achieved for patients experiencing acute generalised or acral vitiligo where lesion sizes are 2-4mm in diameter. The specific anti-mitotic drug used, seems to isolate then stimulate damaged melanocytes only. There is minimal effect on existing healthy melanocytes. As such post-operative dyschromia is reduced.
Conclusion: This innovative technique is suitable for stabilised conditions on all ethnicities, ages and sexes. As a non-surgical and non-thermolytic procedure, the treatment is safe, fast and effective with none to very minimal discomfort. Patient downtime may be likened to a mild sunburn in appearance and sensation. This typically resolves in 36-48 hours. The procedure offers an impressive and affordable alternative by comparison to dated, painful or complicated modalities.
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