Vitiligo Surgery

The surgical treatment of choice is free hand micrografting. This transfers pigment cells from normal skin to white areas of vitiligo. 

Once transferred these pigment cells produce melanin, this results in re-pigmentation in the affected areas. Surgical repurposing of melanocytes gives the fastest response as results are seen at one week.

You can see changes as early as 5-7 days. Maximal results can take up to 6-12 months, depending on the surface area treated. The time is as follows-

• Recipient site healing: one week
• Repigmentation: patchy for first 4 months, increases over 12 months
• Donor site (area where pigment cells are taken): heals over 4-6 weeks

It’s a complex procedure & goes something like this-

1. Donor site harvesting under local anaesthesia. Ultra-thin free hand split harvest.
2. Recipient site preparation with dermabrasion or erbium.
3. Transfer of micrograft to prepared site.
4. Dressings left in-situ for one week
5. Repigmentation. 

Dermatologists follow strict guidelines for surgery as this is last line management, read more to see if you are a suitable candidate.

Yes, they can be lifelong. This is providing your vitiligo is stable. We can’t promise you will not get new patches elsewhere. In 95% of cases pigment transfer is permanent in the sites treated with surgery. 

You are not a candidate if –

• Your vitiligo is not stable for more than 9 months to one year. For new onset vitiligo, you are best treated with narrowband UV & topical creams. 

• Your vitiligo has Koebner or worsens with trauma.

• Children under the age of 14.

• You have a history of keloid scarring.

Book a consultation with our dermatologists at Cutis. They will examine your skin & advise you accordingly.  

We treat any area, bar the genitals. Frequently treated areas include-

• Face including eyelids
• Hands
• Feet
• Neck
• Lips

Poliosis or white hairs can be repigmented with this technique or better yet, follicular unit transplantation, or FUE.

Not as much as topical creams & phototherapy. You can go on a diet if that helps you psychologically. A vitiligo diet consists of –

• Eating antioxidant rich foods such as fish, nuts, green leafy vegetables
• Refraining from acidic foods like tomatoes 

Diet does not add much to your progression & result, but it is harmless. 

ReCell is best for large area BURNS. It can partially re-pigment vitiligo however the results are not as good as micrografting. ReCell costs more, & harvests less viable pigment cells as most are lost in the process. 

Our dermatologists have had over 10 years of experience using this method, & we prefer free hand micrografting for vitiligo. 

Side effects are rare & must be differentiated from expected healing. The biggest side effect is vitiligo progression post-surgery. This means vitiligo recurs at both the recipient or treated area & the donor site. 

Other side effects include-

• Scarring in donor site
• Marked cobble stoning in vitiligo recipient site
• Infection
• Delayed healing

Surgical treatment is partially covered under Medicare. Cost depends on the treatment area.

• Narrowband UVB- Bulk Billed, no charge
• Creams are less than $1.90 per day

Mesh grafting for vitiligo is of historical value only as it is not widely performed in current times. This technique is a way of expanding the surface area of split-thickness grafts. 

The reason it is not used is that this graft has too many gaps between the network, meaning vitiligo re-pigmentation is patchy. 

Much like mesh, punch grafts are seldom used. This is a full thickness graft as compared to split grafting. Full thickness grafts will result in cobble stoning of the recipient site. 

Punch grafting is also limited to surface area. Only small patches of vitiligo can be treated.