Topical Steroids and Vitiligo

Vitiligo is a very unattractive skin disorder and most individuals undergo emotional distress. Social isolation and depression is not uncommon in these individuals. The major benefit of treating the condition is cosmetic.

The treatment is aimed at improving the appearance. There is no magical cure for the condition and there is no magic bullet. The available treatments are slow in action and one has to be patient. The average time to see the benefits of treatment range anywhere from 6 to 24 months.

The treatment of Vitiligo depends on the extent of the condition, the location and size of the white patches and what the patient prefers. No single therapy is effective for all patients and there is a great deal of variability in the results

The available treatments for Vitiligo include medical and surgical therapy. The topical medical therapy for Vitiligo includes:

Topical steroids: topical steroids are widely used in the treatment of Vitiligo. In some cases daily application of the topical steroid may help improve the skin color in some individuals. The steroids are generally only effective during the early stages of the disease.

Once Vitiligo has been established, topical steroids are not effective. There are various strength of the topical corticosteroids ad the weaker strengths are used for children and most adults require the higher strengths

The topical steroid must be applied twice a day to the whitish patch of skin for at least 10-16 weeks. Only the slightest improvement may be visible at this time. If improvement is seen the steroids are continued for a further 3-4 months. At some point time, no more improvement is seen.

Topical steroids are generally the drugs of first choice. Even though they have side effects, these are mild. The major side effects of prolonged topical steroid use include:

- thinning of the skin

- Streaks or fine lines on the skin

- bruising of the skin

These side effects are most common on the thin skin of the body like the face, genitals area and under arms

Thus most physicians recommend the use of less potent corticosteroids

Oral corticosteroids are not used to treat Vitiligo.