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Surgical Therapies

Currently, there are various Surgical Therapies available for treating Vitiligo and they must be considered only after proper medical therapy is provided. Surgical techniques are time-consuming and expensive and usually not paid for by insurance carriers. They are suitable only for carefully selected patients who have Vitiligo that has been stable for at least 3 years.

The Surgical Therapies available today include:

• Autologous Skin Grafts: For this therapy, the doctor removes sections of the normal, pigmented skin and places them on the depigmented areas from one area of your body and attaches it to another area. This type of skin grafting is sometimes used for patients with small patches of Vitiligo. There are several possible complications of autologous skin grafting. Infections may occur, scarring may develop, a cobblestone may appear, or a spotty pigmentation, or may fail to repigment at all. Treatment with grafting takes time and is costly, and it is considered neither acceptable nor affordable by many.

• Skin Grafts Using Blisters: This procedure requires the doctor to create blisters on your pigmented skin by using heat, suction, or freezing cold. The tops of the blisters are then cut out and transplanted to a depigmented skin area. The risks of blister grafting include scarring and lack of repigmentation. However, there is less risk of scarring with this procedure than with other types of grafting.

• Micropigmentation (tattooing): This process involves implanting pigment into the skin with a special surgical instrument. It works best for the lip area, particularly in people with dark skin. However, it is difficult for the doctor to match perfectly the color of the skin of the surrounding area. The tattooed area will not change in color when exposed to sun, although the surrounding normal skin will. So even if the tattooed area matches the surrounding skin perfectly at first, it may not later on. Tattooing tends to fade over time. Additionally, tattooing of the lips may lead to episodes of blister outbreaks caused by the herpes simplex virus.

• Autologous Melanocyte Transplants: In this process, the doctor takes a sample of your normal pigmented skin and places it in a laboratory dish containing a special cell-culture solution to grow melanocytes. When the melanocytes in the culture solution have multiplied, the doctor transplants them to your depigmented skin patches. This procedure is currently experimental and is impractical for the routine care of people with Vitiligo. It is also very expensive, and its side effects remain unknown.

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