loss of melanin, can it  be reversed in pigmentation disorder

loss of melanin which is cause in depigmentation disorder also called vitiligo can not be reversed and it will be there for life. But there are hope that creams can prevent the progression of the condition. A drug commonly used to treat inflammation of the lining of joints could also be a potential new treatment for disfiguring skin condition vitiligo. The drug, tofacitinib, is typically used to treat moderate to severe rheumatoid arthritis, a chronic inflammatory disorder affecting the lining of the joints. It belongs to a family of drugs known as Janus kinase (JAK) inhibitors that have been approved for use by the US Food and Drug Administration (FDA).

Tofacitinib could be used to treat hair loss caused by alopecia areata, an autoimmune disorder in which the immune system attacks the hair follicle and since the cause of depigmentation and loss of melanin is caused by auto immune disorder it could be a hope for those suffering from this condition.

Introduction and Symptoms

Depigmentation of skin occurs when there is a major loss or absence of melanocytes (the cells in skin that produce melanin, which is the pigment that determines skin colour). This absence of melanin results in a condition called vitiligo, where patches of skin become pale-white or pinkish.

Risk factors or causes

The exact cause for loss of melanin which leads to depigmentation is unclear. Researchers have said it may be an autoimmune disorder. This means that the body’s immune system destroys its own cells, including the melanocytes needed for pigment. Age, race, and gender are not significant factors.

Treatments

Various methods can be employed in the treatment of skin depigmentation, and vitiligo in particular. Skin camouflage is the correction technique where a coloured cream is applied to the white patches that have come about through depigmentation. As the name suggests, this method makes your skin colour to look the same throughout your body. Camouflage creams that contain sunscreen (SPF 30 and above) are an even better option, since UV rays from the sun damage depigmented skin over time. Topical corticosteroids can stop or slow the spread of vitiligo. They may also re-pigment the white patches, but should never be used in treating children, pregnant women, or on the face. Phototherapy, which is treatment using UVA or UVB light, is another effective option. The only major cause for concern is the risk of developing skin cancer from over-exposure to UVA light. Discuss this issue with your healthcare practitioner before treatment. Skin grafting is performed by surgically taking some of your unaffected skin to replace the depigmented white patches. Complete depigmentation is the bleaching of your normal skin so it becomes the same colour as the affected skin throughout your body. 

Self care

The practical steps a person with depigmented skin can take for self-help revolves around protection from excess sunlight. Wear protective clothing to cover your skin, including sunglasses and a hat that shades your face and ears. Before going outdoors, apply sunscreen with SPF 30 or higher, and indications on the bottle which show that it protects against both UVA and UVB. Infants and children with vitiligo should not be exposed to direct sunlight. Since lack of sun exposure can result in a deficiency of vitamin D, it is highly advisable to take vitamin D3 supplements each day, which can be purchased from local stores. Foods with high levels of vitamin D, such as eggs and oily fish, should also be incorporated into your diet. Besides sun-control measures, anti-inflammatory creams like Tacrolimus and vitamin D analogues help in restoring pigment in some people. 

Drugs used in treating

Drugs used in treating depigmentation are grouped into corticosteroids, psoralens, Immunomodulators, and vitamin D. Corticosteroids primarily stop further spread of white patches and initiate re-pigmentation. Psoralens are used with UVA treatment, while Immunomodulators help prevent the immune system from destroying melanin. Vitamin D3 analogues improve proper production of skin cells.