What is Vitiligo?
Vitiligo is a skin condition wherein the affected areas of the skin lose their pigment. The patches appear white and have distinctive margins. Vitiligo patients suffer uninterrupted destruction of melanocytes due to which the white patches occur. It is a non-contagious skin condition and affects patients in all age groups.
Types of Vitiligo Surgery
1. Skin grafting Skin grafting requires normal skin to be removed from donor site and transplanted to the affected site. These skin grafts produce pigment that evens the skin tone.
Advantage of skin grafting
This treatment option can be used to treat Vitiligo on the face, hands, and small patches on the body.
Limitations of Skin Grafting
Skin grafting can be done only on limited areas affected with Vitiligo.
Vitiligo surgery work best for patients with stable vitiligo (patients that have no new lesions or no further progression of the condition over 1 2 years) and suffer either from segmental or focal vitiligo.
2. Melanocyte transplants This procedure includes grafting melanocytes surgically and cultured in a laboratory before transplanting them to the affected areas on the skin.
Advantages of Melanocyte transplants
Higher success rate
This surgery allows treatment of larger affected areas.
Limitations of Melanocyte transplants
This surgery requires a large donor to recipient ratio.
3. Miniature Punch Grafting - For conditions like Vitiligo, punch grafting can be extremely effective. This involves removing small bits of skin from the donor area and transplanting them into the tiny recipient chambers made by punching the skin. For larger areas affected by Vitiligo, the procedure can be repeated.
Advantages of Miniature Punch Grafting
Reduction of pigmentation due to Vitiligo.
Helps even the skin tone.
Limitations of Miniature Punch Grafting
Number of grafting sessions would depend on the severity of the condition.
There could be loss of graft during the procedure.
The recipient site may reject grafts.
The procedure could leave a halo effect on the skin (de-pigmentation on the peripheral of the affected areas).
4. Split Thickness Grafting Split Thickness Grafting is the term used when less than entire thickness of the dermis is used. The harvested grafts range from 0.005 to 0.030 inches in thickness and categorised further as thin, intermediate and thick based on the thickness.
Advantages of Split Thickness Grafting
Split thickness grafting has a broad range of application including Vitiligo.
Requires less ideal settings for survival.
Includes less tissue use.
Limitations of Split Thickness Skin Grafting
Split Thickness Grafting cannot be performed on weight bearing parts of the body.
Skin contracts more than full thickness grafts.
5. Cultured and Non-Cultured Melanocyte Grafting
1) Non-cultured Melanocyte Grafting Non-cultured Melanocyte Grafting includes harvesting tissue from the donor areas on the body and incubating them with trypsin for separating the epidermis from the dermis. A cell suspension is then made by separating melanocytes from the epidermis. These melanocytes can then be transplanted into the recipient site.
Advantages of Non-cultured Melanocyte Grafting
Large areas of skin affected by Vitiligo can be treated.
Skin colour matching is remarkable.
Skin tone is evened out.
2) Cultured Melanocyte Grafting Cultured Melanocyte Grafting includes harvesting tissue from the donor sites and incubating them with trypsin for separating the epidermis from the dermis. Melanocytes and keratinocytes are then separated from the epidermis and are incubated in a medium that contains growth factors. After culturing, the suspension is transplanted to the recipient sites.
Advantages of Cultured Melanocyte Grafting
This technique allows larger areas to be treated in a single session.
Skin tone is evened out.
6. Therapeutic Wounding Therapeutic Wounding is the process of causing wounds in a controlled manner on the sites affected by Vitiligo to induce pigmentation. It stimulates the melanocytes and causes them to multiply and re-pigment the lesion.
Advantages of Therapeutic Wounding
Even skin tone.
7. Tattooing Tattooing can be an effective option to camouflage the Vitiligo patches by using artificial pigments and introducing them into the Vitiligo lesions.
Advantages of Tattooing
Vitiligo patches can be camouflaged permanently.
Skin tone can be evened out. .