Medical and surgical options for stable white patches on the skin.
Vitiligo causes patches of skin to lose pigment. Treatment is medical first, using creams and light therapy to encourage pigment to return. Where patches have been stable for at least a year and have not responded, surgical pigment transfer can repigment them.
Almost every treatment decision in vitiligo depends on one question. Is the disease active or stable? Active means new patches appearing or existing ones enlarging within the last twelve months. Stable means no change over that period.
This matters because surgery on active vitiligo fails, and can trigger new patches at the donor site. So the first job is often not to treat but to establish stability, which takes time and patience. A clinic willing to operate on active disease is not doing you a favour.
Topical treatments and narrow-band ultraviolet light therapy are the mainstay. Light therapy in particular gives good results on the face and trunk, though it needs sessions two to three times weekly over months.
Response varies enormously by site. Face and neck respond best. Trunk and upper limbs respond reasonably. Hands, feet, lips and areas over bony points respond poorly to anything, because they have few hair follicles, and follicles are where returning pigment cells come from.
Where a patch has been stable for a year and has not responded medically, pigment cells can be moved from your own normal skin. Techniques include punch grafting, thin split thickness grafting and melanocyte cell suspension transfer.
Results are usually good on suitable patches, though colour match is rarely perfect and the treated area may look slightly different in tone. Surgery treats the patches operated on, it does not cure the condition, and medical treatment usually continues alongside.
| Factor | What it covers |
|---|---|
| Extent of disease | Number and size of patches being treated |
| Light therapy | Priced per session, over a course of several months |
| Surgical technique | Punch grafting differs in cost from cell suspension transfer |
| Area treated | Larger or multiple sites need staged procedures |
| Ongoing treatment | Medical treatment usually continues after surgery |
These pages answer the questions that most often come up alongside this one.
Medical treatment and light therapy are priced per course and per session, so cost accumulates over months. Surgical pigment transfer is priced by technique and by the area treated. An estimate covering the planned approach is given after assessment.
No, there is no cure at present. Treatment aims to repigment affected skin and to stop further spread. Many patients achieve substantial repigmentation, particularly on the face, but the underlying tendency remains.
When the patch has been completely stable for at least twelve months, with no new patches and no enlargement, and where medical treatment has not repigmented it. Operating before that risks failure and new patches at the donor site.
Returning pigment cells migrate from hair follicles, and areas such as the hands, feet and lips have very few. That is why these sites respond poorly to all medical treatment and why surgical transfer is often the only option there.
Creams and light therapy are not. Surgical pigment transfer is done under local anaesthetic, so there is brief stinging from the injection and mild soreness at the donor site for a few days.
Pigment returns slowly, usually beginning at two to three months and continuing to improve for six to twelve. Patience is genuinely required, and early judgement leads people to abandon treatment that was working.
Incomplete or patchy repigmentation, colour mismatch, scarring at the donor or recipient site, infection, and the possibility of new patches appearing if the disease was not truly stable.
Outpatient medical treatment and light therapy are usually not covered. Surgical procedures performed as day-care may be considered under some policies, and cover is confirmed before admission.
Published with written patient consent and shown for education rather than promotion. Every case is different and these images are not a promise of results.
Consultations at Kiran Hospital, Katargam, Surat. Outstation and NRI patients can request a video consultation before travelling.