The principle of vitiligo treatment firstly emphasizes early diagnosis and early treatment, patients should go to the regular hospital specialist for confirmation and comprehensive treatment. Secondly, the treatment should be individualized according to the patient’s clinical typing, stage, site, area, age, duration of disease and other factors.
At present, the recognized more effective treatments include various phototherapy, systemic and local glucocorticoids, psoralen, nitrogen mustard alcohol, vitamin D3 derivatives, traditional Chinese medicine, new immunosuppressants such as tacrolimus ointment and pimecrolimus cream, immunomodulators, and autologous epidermal transplantation, etc. It should be emphasized that these treatments must be chosen under the guidance of a specialist.
Among all the measures to treat vitiligo, various phototherapy is one of the fastest developing, most effective and promising treatment methods, which has been well used in major hospitals and has made breakthroughs. In recent years, our department applied narrow spectrum medium wave ultraviolet light, high energy ultraviolet light, 308nm excimer light and 308nm excimer laser combined with other treatment methods for vitiligo has received good results and accumulated a lot of clinical experience.
In 1981, Parrish and Jaenicke found that medium-wave ultraviolet (UV) light with wavelengths between 300 and 313 nm can be used to treat vitiligo. The narrow-spectrum UVB (NB-UVB, 311 nm) therapy based on this theory has achieved superior efficacy than the traditional PUVA therapy in the treatment of vitiligo, and the adverse effects are mild. In our country, due to the difference between rich and poor regions, narrow spectrum medium wave UVB (NB-UVB) with 311 nm wavelength should be the most commonly used and economical way to treat vitiligo. The NB-UVB treatment instruments are various, different parts and different lesion areas of vitiligo patients can have corresponding choices, and the treatment cost is relatively low.
The 304nm high energy UVB is a special type of UVB, it emits high density UVB beam through the equipment, with the help of liquid light guide fiber to make the effective strong light reach the skin lesion area, with high intensity and small spot area, which can protect the normal skin to the maximum and realize the “target site treatment”. The results show that 304nm high energy ultraviolet light treatment vitiligo efficacy is sure, not damage the normal skin, the disadvantage is that the treatment process is easy to appear excessive pigmentation and redness, of course, by adjusting the dose, these side effects can be reduced or avoided. 304nm high energy ultraviolet light The cost of treating vitiligo is between NB-UVB and 308nm excimer laser, which is a good choice for treating vitiligo. In addition, 308nm excimer light treatment vitiligo also has very good efficacy and safety, some big hospitals carry out this treatment.
The best light therapy for vitiligo so far is still laser therapy. It is similar to NB-UVB wavelength, so the treatment mechanism may be similar. NovAk reported that irradiation of in vitro cultured T cells with the same energy of 308 nm xenon chloride laser and NB-UVB showed that the laser caused stronger apoptosis of T cells, so the function was stronger. 308 nm excimer laser has become the best choice for vitiligo phototherapy after 2002 due to its high efficiency, safety and selective action on lesions. The 308 nm excimer laser has been increasingly used in large hospitals at home and abroad, and has been unanimously recognized by patients and doctors. At present, 308 nm excimer laser has become the first choice for vitiligo phototherapy in our department. However, this equipment is expensive and difficult for small hospitals to carry out, which limits its wide application in clinical practice.
In addition to the 308 nm excimer laser, the helium-neon laser that we used to treat shingles and skin ulcers can also be effective in treating vitiligo. Yu HS treated 30 people with vitiligo using 632.8 nm low energy He-Ne laser with an output of 1.0 mW, 1-2 times a week, and achieved good results.
In summary, various phototherapy has become an important part of the comprehensive measures for the treatment of vitiligo, bringing new hope to vitiligo patients.
It is important to emphasize that the success of treating vitiligo needs the long-term joint efforts of both doctors and patients. The patient should keep an optimistic attitude, seek medical attention in time, and actively cooperate with the doctor for comprehensive treatment including various phototherapy. The actual fact is that you will be able to get a good deal of time and effort to get a good deal of money. It is believed that after comprehensive and standardized treatment, most patients will regain their beautiful complexion.