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So, you are newly diagnosed with vitiligo or have noticed lightening of your skin in certain patches and suspect you are dealing with vitiligo? Your first two questions are bound to — will the vitiligo spread, and what are the treatment options? The answers to both questions are less than straightforward.
Will My Vitiligo Spread?
It is possible that you will, after first noticing signs of depigmentation, go on to develop further white patches in various parts of the body. This may happen slowly, over many years and even decades, or the vitiligo can spread more rapidly as well. There is, unfortunately, no way to tell whether you personally will develop further white patches or not, nor when.
What Are The Treatment Options For Vitiligo?
People whose vitiligo is limited to small areas of the skin in places not usually exposed to the sun may not need any treatment, nor do they need to make any lifestyle changes.
Limiting your exposure to sun is of prime concern, because the areas of skin where your pigment was destroyed are much more prone to sunburn. You'll need to be very diligent about the use of a sunscreen with a sun protection factor of 30 or above at all times, even when you're driving a car or sitting in an office with windows, for instance. Covering depigmented areas of skin with clothing will help prevent sunburn.
Note: The flip side of keeping your skin out of the sun to protect yourself from skin cancer is that you may develop a vitamin D deficiency. You will want to talk to your doctor about taking vitamin D supplements.
Topical corticosteroid creams, though unlicensed for the treatment of vitiligo, may help prevent the spread of white patches and can even restore some of your lost pigment to your white patches. They may be an option for you if less than 10 percent of your body is affected by vitiligo, you're not pregnant or trying to conceive, and you have no other contraindications. Note that topical corticosteroids cannot be used on the face for the treatment of vitiligo, as well as that they may not have the effect you are hoping for.
Camouflage makeup is another management option for people with vitiligo who would like to hide the white patches from others. By asking your doctor about this option, you will be able to find a makeup professional trained in exactly this. Such camouflage treatments aren't anything like normal makeup — some can remain on your body for days at a time very successfully.
People suffering from vitiligo that covers much of their body and that has not responded well to topical treatment may also benefit from phototherapy. Talk to your doctor about this option, though be sure to also ask them about the possible risks. There is some evidence that this light therapy increases the risk of skin cancer slightly.