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  • Presentation

Chemicals that Induce Vitiligo: Hazard & Treatment

Description

The session, led by Simal Desai, the president of the American Academy of Dermatology (AAD), focused on innovative treatments for vitiligo, particularly the often-overlooked approach of depigmentation therapy for patients with extensive and psychologically distressing forms of the disease. Desai emphasized the clinical importance and life-changing potential of depigmentation for certain individuals. He detailed the common methods of depigmentation, such as monobenzyl ether of hydroquinone, which is irreversible and acts by destroying melanocytes, as well as complementary treatments like cryotherapy and laser treatments. He cautioned against the use of certain hair dyes, particularly those containing paraphenylenediamine, which can exacerbate vitiligo. The discussion also highlighted the consequences of certain chemicals, including those found in fairness creams that can lead to chemical leukoderma, a condition that reflects the pursuit of skin lightening in various cultures. Finally, Desai urged attendees to encourage their patients to engage with support networks and advocacy groups, emphasizing the AAD's commitment to improving conditions and treatment accessibility for those suffering from vitiligo.

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Conclusions

  • Depigmentation can be a viable treatment option for patients with vitiligo who do not respond to traditional therapies.
  • Monobenzyl ether of hydroquinone (MBEH) is the primary depigmentation agent used and is effective for certain candidates.
  • The depigmentation process is not immediate and requires patient education regarding expectations and potential side effects.
  • Patients may experience skin irritation and should be monitored closely during treatment.
  • Depigmentation may be particularly beneficial for patients with extensive vitiligo that negatively impacts their quality of life.
  • There is a risk of regrowth of pigment despite full depigmentation, potentially requiring further treatment.
  • Chemical exposure can lead to vitiligo, making it essential to identify environmental triggers in patients.
  • Lasers and cryotherapy can be used effectively for residual pigmentation after depigmentation therapy.
  • There remains a need for continued advocacy and research in the management of vitiligo, especially for access to treatments.
  • Patient support groups and community engagement are critical for addressing the psychosocial aspects of living with vitiligo.
  • van Geel N, Depaepe L, Speeckaert R. Laser (755 nm) and cryotherapy as depigmentation treatments for vitiligo: a comparative study. J Eur Acad Dermatol Venereol. 2015 Jun; 29(6): 1121-1127.
  • Harris JE. Chemical-Induced Vitiligo. Dermatol Clin. 2017;35(2):151-161.
  • Grimes P et al. Depigmentation Therapies for Vitiligo. Dermatol Clin. 2017;35(2):219-227.
  • Li W, Xin H, Ge L, Song H, Cao W. Induction of vitiligo after imiquimod treatment of condylomata acuminata. BMC Infectious Diseases. 2014;14:329. doi:10.1186/1471-2334-14-329.
  • Yoshikawa, M. et al ., J Dermatol. doi:10.1111/1346-8138.13694.
  • Majid I et al. J Cutan Aesthet Surg 2013;6:93-6.