At Cutis Clinic, we offer newly emerging treatments that provide hope for our vitiligo patients. Our combination of phototherapy with anti-inflammatory creams offers our patients outstanding results. Treatments are simple, safe and covered under Medicare for those deemed eligible.
- Vitiligo is an autoimmune skin disorder affecting 1-2% of the population and presents as white patches on the skin
- The majority of vitiligo sufferers are in good health; however, a minority may have autoimmune-related conditions such as thyroid disease and diabetes
- Treatments are successful in the majority of cases, especially if treated early
- Narrowband Phototherapy is a safe and effective treatment for vitiligo
- Phototherapy sessions take less than 5 minutes
- You will need to be able to attend 2 to 3 (sometimes 4) clinic appointments per week
- Combination treatments using topical prescription creams and phototherapy give superior results
- Cutis Clinic’s 20-week vitiligo re-pigmentation program consists of anti-inflammatory creams and a series of phototherapy sessions
- Our success rate for re-pigmentation is close to 80%
- Phototherapy sessions are covered under Medicare for eligible patients, with no out-of-pocket expense
- Specialists at Cutis Clinic treat vitiligo in all ages, including children and adults
Vitiligo is an auto-immune condition that affects the pigment-producing cells of the skin known as melanocytes. In vitiligo, these cells are destroyed by the body’s own immune system with no pigment produced in the affected areas.
Vitiligo presents as progressive white patches on the skin with sharp margins. The most common sites affected are the face, in particular around the eyes, eyelids and mouth. Acral sites (fingers, hands and feet) are also commonly involved. Where vitiligo occurs on the scalp, a condition known as poliosis (white hairs) may result.
In the majority of cases the diagnosis of vitiligo is straightforward and no tests are required. If the pattern is unusual, your dermatologist may elect to undertake a biopsy. As this disorder is related to other autoimmune conditions, we may elect to order blood tests if these have not been performed prior to the referral process.
The course of vitiligo is highly variable. The condition may remain static or stable or may spread over time. In some cases, white patches can spontaneously re-colour, particularly in children, although it is rare for the disease to resolve completely without treatment.
Our Vitiligo Skin Re-Pigmentation Program has a success rate of 80%.
The 20-week re-pigmentation program is designed to kick-start skin colouration in the white patches caused by vitiligo. There are two essential components to this program:
- Anti-inflammatory prescription creams: our specialist dermatologists prescribe a personalised combination of anti-inflammatory creams and vitamin D creams to apply to your white patches. In most cases, we cycle the application of different creams to low pigment areas. Most creams cost between $20-$60 and can be purchased in major pharmacies; compounded products may be prescribed and advice will be given for their purchase.
- Phototherapy sessions: 2-3 sessions are required per week. Sessions are covered under Medicare for eligible patients. Phototherapy uses a metered and precise dose of ultraviolet B light to stimulate the dormant pigment cells within your skin.
Most vitiligo patients experience very positive results with our skin re-pigmentation program.
Contact us today to find out more.
A specialist dermatologist is the best person to assess and manage your vitiligo. It is important to first establish a diagnosis, search for any associated autoimmune conditions and discuss prognosis and treatments, including the success rate of various treatments in relation to your specific pattern of vitiligo.
The use of phototherapy combined with creams gives the highest success rate of all current vitiligo treatments.
As a guide, the following options are available:
This is an option when the person has very fair skin. Strict sun protection is important with daily application of at least SPF30+ sunscreens that are reapplied throughout the day in combination with protective clothing and sun avoidance.
This is achieved with make-up and topical dyes including self-tanning lotions. We recommend Dermablend as the make-up of choice for vitiligo sufferers.
In order to re-pigment the skin, new pigment cells must be produced from existing ones. Pigment cells care located at the base of hair follicles or at the edges of existing white patches.
Cream-based treatments for vitiligo include topical corticosteroids, vitamin D and calcinurin inhibitors. Although not completely understood, steroids may be helpful in skin re-pigmentation, particularly if started early and where only a few patches or spots need to be treated. Steroids are often used to halt the spread of vitiligo.
Patients must apply the cream or ointment to all white patches for at least 3 months before seeing any results. This is the simplest and safest treatment but not as effective as others. This treatment must also be carefully monitored by a specialist dermatologist as steroids can thin and damage the skin if the effects are not regularly assessed. Your treating dermatologist closely monitors for side effects such as skin thinning and skin striae (stretch marks). Because of these side effects, steroid preparations should not be used for extended periods of time. Your dermatologist may combine vitamin D creams with new calcineurin inhibitors as part of your skin re-repigmentation program.
ReCell® is an exciting new technology and a stand-alone autologous cell-harvesting device which utilizes the subject’s own skin cells to regenerate pigmentation. This procedure begins to achieve visible results within 2 months; however, optimal results are only visible after 12 months.
During the past 5 years, use of narrowband ultraviolent B (UVB) phototherapy has gained popularity as the treatment of choice for vitiligo. Narrowband phototherapy or nbUVB uses a specific UVB wavelength which stimulates melanocytes to produce pigment. Initial exposure times to this form of light are short in duration; however, exposure time is gradually increased as the treatment progresses. The amount of UVB exposure is delivered by an extremely precise and highly controllable phototherapy unit. Treatment takes 30 seconds to 3 minutes.
Phototherapy forms an essential part of our Vitiligo Re-Rigmentation Program. If eligible, all phototherapy sessions are bulk-billed and covered by Medicare.
On average, at least 30 -50 treatments are needed before significant improvement is seen. You will need to attend at least two treatments a week, usually three or four. The areas of existing vitiligo are photographed prior to treatment and your progress is frequently monitored throughout the process. Phototherapy can not be used on patients with a personal or family history of melanoma and is not recommended for children under the age of 8.
In general, 60-80% of patients respond well to photo-therapy. Patches on the trunk, upper limbs and face respond best, while areas on the hands and feet are more resistant to treatment. Long-standing vitiligo may also be more resistant to change.
If you can see coloured hairs within your white skin patches of vitiligo, the chances are high you will experience successful skin re-pigmentation!
Specialists have used lasers to treat vitiligo for the past decade; however, the results are not as predictable as phototherapy. There are two main types of laser used to re-colour white patches of vitiligo-affected skin. These are fractionated lasers and 308nm Eximer lasers.
Fractionated laser treatment of vitiligo is administered according to a re-pigmentation program pioneered by dermatologists at Harvard University. Cutis dermatologists Dr Davin Lim and Dr. Heba Jibreal have conducted several trials on the use of fractionated laser resurfacing in the course of the past 4 years and have come to the following conclusions:
- Fractional lasers abate or destroy a fraction of the skin, the width of a single hair shaft and at a depth of one fifth of a millimetre. Fractionation is only conducted in the areas of vitiligo. Destroyed abnormal vitiligo cells that do not respond to the normal pigment-forming stimuli are replaced by healthy cells at the base of the hair follicle or from adjacent areas.
- Usually 3-5 treatments are required to achieve re-pigmentation. These treatments are attended at 2-4 week intervals. Healing time for each treatment is approximately 2- 5 days.
- Fractionated laser treatments work in 10%-20% of vitiligo cases. Phototherapy treatments during the Cutis Clinic Vitiligo Skin Re-Pigmentation Program is much more effective, safe, and budget-friendly. We never recommend laser treatment before a course of vitiligo phototherapy.
- Fractionated lasers for the treatment of vitiligo should only be offered as a last resort. Patch tests will need to be conducted prior to resurfacing and are not covered by Medicare.
- Fractionated laser vitiligo treatments are similarly not covered by Medicare. Currently, the only Medicare-funded vitiligo treatment is phototherapy; these are bulk-billed for eligible patients.
308 nm Eximer lasers have gained experimental interest in the treatment of vitiligo.
ReCell® is the latest technology to change the way in which stable vitiligo can be treated. It is a stand-alone, autologous device which utilises the subject’s own harvested pigmented skin and applies it to vitiligo-affected skin.
A small sample of healthy skin is taken and placed into the ReCell® device that merges it into a suspension. Vitiligo-affected skin is then prepared using a laser to remove all dead and unwanted skin cells. This enables the ReCell® suspension to be sprayed onto the skin. The suspension contains the healthy skin cell types that are responsible for healthy pigmentation: keratinocytes, fibroblasts and melanocytes.
Immediately upon the application of these skin cells to the skin, they begin to multiply. A new layer of skin forms within 5-7 days. During this stage your skin must be protected with a dressing to give the healthy, pigment-producing skin cells the chance to adhere to your skin. The skin heals within 7-10 days; however, re-pigmentation continues to improve over the course of a couple of months.
In patients with extensive vitiligo involving more than 80% of the body, monobenzyl ether or hydroquinone may be considered to de-pigment normal skin cells. This process can take six months to two years to achieve. Strict sun protection is required after de-pigmentation. This process is not carried out at Cutis Clinic. Specialist de-pigmentation treatments should be carried out in a hospital setting.
Natural remedies, nutrition and vitiligo
Scientific publications describing dietary and natural remedies pertaining to the treatment of vitiligo are limited. A paper published in 2003 showed promising results in slow-progressing vitiligo treated with ginkgo biloba. For an abstract of this paper click here.
More information on diet and vitiligo.
The initial step of treatment is a firm diagnosis provided by a licensed dermatologist The next step is to exclude any associated auto-immune disorders that maybe associated with vitiligo such as hypo or hyperthyroidism, diabetes and vitamin B12 disorders. All of these disorders can be diagnosed through simple blood tests ordered via your general practitioner.
Our vitiligo specialists have a success rate of 60-80% thanks to our Vitiligo Re-pigmentation Program; however, patients must be motivated to follow this 20-week program with complete dedication. Where narrowband phototherapy treatment is recommended, you must be committed to attending treatments at the clinic at least twice a week. For eligible patients, our 20-week program is bulk-billed and covered by Medicare.
|Specialist consultation||Please contact us for pricing.|
|Phototherapy sessions||bulk-billed for eligible patients|
|Cost of prescription creams||$20-$60|
|Skin Re-Pigmentation Program
(20-week photo-therapy course)
|Please contact us for pricing.|
A Medicare rebate is available for eligible patients, a valid referral from your General Practitioner is required.
Fractionated laser treatments for re-pigmentation are NOT covered under Medicare
Call us directly to make your appointment. Consultation slots are readily available during the week and on Saturday mornings. Phototherapy can be commenced on the day of the consultation for those with a confirmed vitiligo diagnosis.
A referral from your GP will enable you to claim a percentage of the consultation free from your health insurance provider. The Cutis Clinic vitiligo department is managed by Dr Davin Lim.
Vitiligo can be highly variable in extent, spread rate and response to treatment. In the past decade, several new treatments have emerged for the improvement of this once untreatable condition. With the combination of narrowband phototherapy and topical treatments, success rates are now in the order of 60%- 80%.
Our Vitiligo Skin Re-pigmentation Program has been designed as a 20-week combination of two of the most powerful vitiligo treatment methods that kick-start the re-pigmentation process. Our patients usually commence with anti-inflammatory creams and vitamin D preparations together with narrowband photo-therapy. The majority of patients notice new pigment formation within a few weeks of therapy. Areas such as the face and neck seem to respond much better than the extremities.
Contrary to popular belief, vitiligo responds well to a tailored treatment program.