Topical Drugs

A topical drug is a medication used to affect a specific area on your body. This type medication is generally applied on the skin in the form of creams and ointments. In the case of Vitiligo topical drugs are used to stop it from spreading, returning pigmentation and removing all pigment by depigmentation. Thisis a trial and error process because you might need more than one topical drug which will provide an overall remedy for your Vitiligo.

 

Topical Corticosteroids

Corticosteroids are drugs that resemble cortisol, which is a hormone produced in your body by your adrenal glands. Corticosteroids work by reducing the chemicals responsible for inflammation to decrease the damage caused to tissues and minimizing the effect of white blood cells in your immune system. Since Vitiligo is considered an autoimmune disorder it is believed corticosteroids can stop or slow down your immune system from attacking your pigment cells and help re-pigment your skin. Some of the prescribed medications are clobetasol, betamethasone and fluocinonide. Corticosteroids have many side effects so talk to your doctor before you start this type of therapy. A side effect depends on the type of corticosteroid, the dosage and length of treatment, which can include:

 

  • Thinning of the skin
  • Acne spots
  • Inflammation of the skin
  • Contact dermatitis
  • Excessive hair growth

 

As with most medications the most common side effects are listed, but it is possible to exhibit unusual side effects your doctor many not be aware of. If you notice any negative reaction because of the medication you are taking talk to your doctor immediately.

 

Vitamin D analogues (Calcipotriol and Tacalcitol)

An analog is a chemical compound that looks like another in the constituents or structure but can have a similar or opposite effect when you take it. Topical vitamin D analogues are used to treat different skin conditions such as psoriasis. Calcipotriol and Tacalcitol are two such medications. The effectiveness on Vitiligo is not conclusive but some patients have shown positive results when it is used in combination with topical steroids or phototherapy.  Vitamin D analogues affect Vitiligo in two different ways in regard to immune function and melanocytes. In the immune response it acts on T cell activation to inhibit pro-inflammatory cytokines genes. In melanocytes it influences the maturation and differentiation.

 

Calcineurin Inhibitors

Calcineurin inhibitors are types of drugs that have immunomodulatory effects. This means they slow down or stop the effectiveness of the immune system of the skin which for a Vitiligo patient means it can stop your melanocytes from being destroyed. Tacrolimus (Protopic) and Pimecrolimus (Elidel) are two such topical drugs your doctor can prescribe. The benefit of using calcineurin inhibitors is they don’t have as many side effects as corticosteroids. Some of the side effects you can experience are redness, skin sensitivity to light and burning or pain.

 

Tar products

V-Tar is a prescription coal tar product used to treat Vitiligo and some patients have seen re-pigmentation on their face after more than two months of therapy. It is applied once a week for five to six hours or overnight and then removed. It is used in combination with other topical therapies and it can be used by everyone.

 

Pseudocatalase (PC-KUS) and catalase/dismutasesuperoxide

The original PC-KUS was developed by Dr. Karin Shallreuter and it was designed based on the hypothesis that patients with Vitiligo have high levels of hydrogen peroxide (H2O2) and low levels of the enzyme catalase. The therapy uses pseudocatalase applied on the skin along with photo or light therapy with narrow band UVB to help the melanocytes start producing melanin. PCAT is the alternative version available in the US and Canada. It is only available at pharmacies that are able to compound the medication.

 

L-Phenylalanine

Phenylalanine is an essential amino acid and your body changes it into tyrosine another amino acid responsible for making important chemicals in your brain which regulate mood and growth as well as many other functions. Topical and oral L-Phenylalanine has helped patients with the stimulation of melanin and migration of melanocytes to depigmented areas. The therapy involves oral and topical application as well as sun exposure.

 

Placentrex and Melangenina

These two products are derived from human placental extract. It is believed they help melanin synthesis by providing tyrosine, an amino acid. The therapy is performed by applying the medication after dermabrasion has been performed on the affected area of the skin. 

 

Doctors don’t know what causes Vitiligo and as of now have not find a cure. This makes it very difficult to find a method of therapy which can be applied across the board. However it doesn’t mean you have to give up because there are many individuals who have overcome this condition. What you have to realize is what works for another person might not work on you so always look for other options because they are available.