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http://www.lasersandlifts.com.au For much more on vitiligo treatments and phototherapy https://www.instagram.com/drdavinlim/ For lots of up to date procedures and videos Realself reviews: http://www.realself.com/find/Australi... Google + for up to date info. Posted daily. https://plus.google.com/u/0/b/1139391... Vitiligo is a common autoimmune disorder affecting the pigment producing cells. In Brisbane, up to 2% of the population will have vitiligo. Frequently involved sites include the face, including the perioral and periocular areas, flexural areas, acral areas of the hands and feet, and around naevi. Hair roots may also be involved, a condition known as ‘poliosis.’ One third of vitiligo patients have a family history of autoimmune disorders including thyroid disease, diabetes and pernicious anaemia. The primary aim of management is to halt the progression of depigmentation, and if possible obtain repigmentation of effected areas. Conservative management: It is appropriate to consider whether initial treatment maybe to use no active treatment other than a high factor sunscreen and camouflage cosmetics. This especially applies to stable, nonprogressive vitiligo in fair skin patients. Topical treatment: Trial of a potent topical corticosertoid for 8-10 weeks. Consider Diprosone ointment for trunk and body, Advantan ointment for facial areas. Topical corticosteroids must be used with caution, monitor for skin atrophy.Topical steroid sparing agents such as Tacrolimus should be considered as adjunctive treatment,or alternatives to steroids. These preparations are not associated with skin atrophy, however skin irritation maybe commonly encountered. Phototherapy: The use of narrowband phototherapy has replaced PUVA due to the superior efficacy and improved safety profile. Narrowband phototherapy should be considered if vitiligo is widespread, progressive or in patients who fail topical modalities. It should also be considered in patients with a significant impact on their quality of life. A minimum of 30-50 phototherapy sessions are needed to determine efficacy. Lasers in Vitiligo treatment: The role of lasers in the treatment of vitiligo is limited. Clinical trials using fractional lasers for stable vitiligo are currently being undertaken in various International centers and at Westside Dermatology. The laser of choice is the Eximer 308- however in most cases this is not covered under insurance, unlike phototherapy. Psychological treatments and support groups: The impact of this condition is often underestimated. Consider psychological and support group referral. Support groups can be arranged via vitiligo.org Investigations for vitiligo: Given the strong association with autoimmune conditions, screening thyroid function tests, glucose level and B12 levels should be conducted at baseline, and repeated every 2 years, earlier if there are clinical indications. Diet can play a role in the treatment of vitligo. I supplement my patients with Vitamin D and Gingo at 40-60 mg daily. Thanks for watching- please do not ask me if I know anyone else around the World who owns a phototherapy device, as I really do not know of other dermatologist who may or may not treat vitligo. Dr Davin Lim, Vitligo expert. Dermatologist. Brisbane Australia For bookings to see if you are suitable for phototherapy, call reception on 07 38713437. A referral is needed as I am a Specialist Dermatologist.
