The primary goal of Vitiligo / Leucoderma
therapy is to repigment the affected skin. However, it is not
always possible. All the treatment modalities available for repigmentation
may fail to achieve it. In this situation, depigmentation therapy
can be considered.
Guidelines for Depigmentation Therapy:
1. Unresponsive to therapy or unwilling to treat. Desire for permanent
depigmentation in a patient with Vitiligo / Leucoderma.
2. More than 50% body surface area affected by disease. After
proper evaluation, patients with 30% to 50% involvement can also
be considered for depigmentation treatment.
3. Willingness to accept that repigmentation is no longer possible.
How Does Depigmentation Benefit Vitiligo
Vitiligo does not cause any physical disability. Patients are
disturbed because of cosmetic disfigurement and uneven skin color.
Depigmentation removes all brown colouring and makes skin uniformly
white. It is impossible for others to know that this white colour
is due to Vitiligo. For the patient, there is no longer evidence
of cosmetic disfigurement and so the social stigma associated
with Vitiligo / Leucoderma is removed.
What method is used to acheive Depigmentation?
Mononbenzyl ether of hydroquinone (MBEH) or monobenzone is the
key to depigmentation. Local application of a cream containing
MBEH leads to loss of melanin pigment of skin. There is no injection
or oral medicine which can lead to depigmentation.
The patient applies MBEH 20% cream, once a day to a small patch
of one arm for a week. This is to test for sensitivity.. Thereafter,
it is applied two times a day to one or both arms and face, mainly
the exposed parts. Patients will experience a gradual process
of depigmentation. Skin slowly lightens and ultimately becomes
white. Once the exposed parts are depigmented, patients can use
the cream on other parts of the body.
The entire process can take 1 to 2 years to achieve complete depigmentation.
In some patients it may be longer, up to 4 years. We do not advise
application of cream to entire body at one time. This is because
application of this cream at one site usually leads to loss of
pigment at distant sites, eg application of MBEH to the arm may
lead to depigmentation of the chest or abdomen.
Will the color of hair and eyes change?
No. The cream does not affect melanocytes
of eyes and hair roots. Color of hair and eyes will not change.