With its sometimes dramatic presentation, vitiligo has always been notable and recognizable in those with the skin disorder. Often, the cause and course of the disorder was misunderstood by the general population. However, recently there has been an increased awareness and acceptance — and even celebration — surrounding vitiligo. Social media posts promoting the positivity of vitiligo garner hundreds of thousands of posts and models with the disorder such as Winnie Harlow enjoy success on the runway, in print, and in video.
Although more and more patients are embracing their unique skin pigmentations, there are still many patients who chose to treat them, according to John E. Harris, MD, associate professor of dermatology at University of Massachusetts Medical School (UMMS) . For those patients less interested in changing their skin’s appearance, “we reassure them about their decision… sometimes it’s talking about the possibility to develop other diseases, or about cosmetics, or connecting them to a support group. Either way, we’re here to help them in any way we can!” he told us in a recent interview.
To gain insights regarding strategies for addressing vitiligo, Dr Harris, who is also founding director of both the Vitiligo Clinic and Research Center and the Autoimmune Therapeutics Institute, UMMS, answered a number of our questions.
1. What are the most recent therapies for treating vitiligo? How successful are they?
The conventional treatments include topical steroids, topical calcineurin inhibitors, and different forms of light therapy, including nbUVB, excimer laser, and PUVA (which has largely now been replaced with nbUVB for both safety and efficacy reasons). These can be cumbersome treatments to apply, although with consistent use they can have good efficacy when the lesions have pigmented hair growing within them. If there is no pigmented hair, the lesions tend to be quite unresponsive to any treatments. With use of all these modalities consistently, we expect patients to achieve approximately 5% improvement over 3 months, 50% after 6 months, and 75% or more after 9 months. Newer treatments include topical and oral JAK inhibitors, which are very exciting, seem to be even more effective, and are being tested in clinical trials. One frequently noted problem is that the vitiligo returns once these treatments are stopped, and there are even newer treatments being tested that may be able to provide long-lasting, durable responses.
2. Are people with vitiligo treating their condition with home remedies? If so, which home treatments are they using, and to what effect? Are there any that you recommend?
There are too many home remedies to name or even count! Many people read many things online, such as drinking water out of copper containers, avoiding eating fish with milk, any number of vitamins or herbal supplements, applying human placental extracts to the skin, etc. But there is very little evidence that any of these things are helpful.I wrote a blog about this and other topics, which has been pretty popular and seeks to answer these questions for everyone effectively.
3. Has the number of patients with vitiligo seeking treatment at your clinic increased or decreased?
With all of the excitement around new treatments and even just a better explanation of the existing ones, many have come to our clinic looking for advice and better care. I do think the number of patients seeking treatment is increasing, and we’re working hard to help them!
4. What is the profile of a typical patient with vitiligo who presents for diagnosis and treatment?
There might not be a “typical” patient, everyone has his or her own stage of the disease and goals for treatment. We work with everyone to tailor the treatment approach to suit the patient’s needs specifically. Although I do hear from a lot of patients that they’ve been told there are no good treatments for vitiligo, which is just not true. We see patients of all ages from all over the world. It’s really an honor to be able to serve them.
5. Anything else you’d like us to know?
This is an incredibly exciting time as we’re learning more and more about vitiligo through our research and helping new treatments get developed for the disease. Please stay tuned for news about these new treatments, and consider helping us and others however you can to achieve this!