Vitiligo Surgery
Vitiligo is a skin condition characterized by the loss of pigment, leading to white patches on various parts of the body. For patients whose condition is stable and resistant to conventional treatments, vitiligo surgery offers a promising option to restore skin color.
What is Vitiligo Surgery?
Vitiligo surgery involves the transplantation of melanocytes (pigment-producing cells) into depigmented areas of the skin. This surgical approach is recommended for patients with stable vitiligo, meaning the absence of new lesions, no progression of existing lesions, and no Koebner phenomenon (development of new patches from skin trauma) for at least 6-12 months. Surgery aims to achieve repigmentation and improve the appearance of vitiligo-affected areas.
Method & Treatment for Vitiligo Surgery
Split-Thickness Skin Grafting
Split-thickness skin grafting is a tissue-grafting procedure used for vitiligo surgery which provides a good, cosmetically acceptable repigmentation at the recipient site and does not lead to significant scarring at the donor site.
Procedure: Dermabrasion or laser removal techniques are used to remove the superficial layer (top layer) of skin at the recipient area. Thin layers of pigmented skin are harvested using a dermatome and applied to depigmented areas. Ultra-thin grafts are used that are free of dermal tissue. The skin is dermabraded around the vitiligo lesion, and then the graft is placed beyond the dermabraded margins. The graft is secured with dressings, and the area may be immobilized.
Treatment: This is best suited for larger areas of vitiligo and often combined with post-surgical light therapy to enhance results and aid in repigmentation.
Applied Areas for Vitiligo Surgery
Vitiligo surgery can be performed on various parts of the body, including:
Face & Neck
Particularly around the lips, eyelids, and cheeks where appearance significantly impacts quality of life
Hands & Feet
To restore color in areas frequently exposed to view.
Genital Area
In cases where depigmentation affects the genital or perianal region.
Trunk & Limbs
To treat larger patches that have been stable and resistant to other therapies.
Precautions and Risks of Vitiligo Surgery
- Ensure the vitiligo is stable with no new or spreading lesions for at least 6-12 months.
- A thorough evaluation of the patient’s medical history, skin type and vitiligo progression are essential to determine the need for surgery.
- It is critical to protect treated areas from direct sunlight to prevent further pigmentation issues. This should be followed before and after surgery.
- As with any surgical procedure, there is a risk of scarring and infection at the donor or recipient sites. However, this is minimized by proper pre and post-procedure care.
- The newly pigmented areas may not perfectly match surrounding skin, resulting in uneven pigmentation.
- Trauma from surgery can sometimes trigger new vitiligo lesions, called the Koebner Phenomenon. However, this is relatively rare.
- Not all surgical interventions guarantee successful repigmentation; multiple sessions may be required.
Post-Procedure Signs to Look Out For
Redness & Swelling: Mild redness and swelling are common but typically resolve within a few days.
Scabbing or Crusting: This is a normal part of the healing process. You must avoid picking or scratching the area to reduce the risk of scarring.
Uneven Pigmentation: It may take several weeks to months for pigmentation to appear and even out; follow-up treatments may be necessary.
Complementary Cosmetic Procedures for Better Outcomes
Vitiligo surgery can be complemented with other cosmetic procedures to enhance results and provide a more uniform skin tone:
Excimer Laser (308 nm) Therapy
Can be used post-surgery to stimulate melanocyte activity and accelerate repigmentation.
Phototherapy (Narrowband UVB)
Frequently used after surgical procedures to boost pigmentation outcomes.
Micropigmentation (Medical Tattooing)
For areas that are challenging to repigment, such as lips or eyelids, tattooing can provide a cosmetically acceptable color match.
Topical Corticosteroids or Calcineurin Inhibitors
Post-surgery, this help maintains results and prevent new depigmentation.