Primary morphological elements are non-cavity primary elements. Skin depigmentation causes

Vitiligo is a skin disease characterized by the appearance of depigmented patches different size and outlines of milky white color on well-defined and often symmetrically located areas of the skin. About 1-3% of people suffer from this disease. Sometimes it has a family (hereditary) character. The disease can begin at any age, but more often affects young people - in half of the cases, the disease occurs in 10-30 years.

Changes in appearance disturb patients and instill in them self-doubt. The spots are especially noticeable on tanned skin Therefore, people try to avoid the sun's rays. And this is correct, because the lesions do not contain melanin, which means that burns quickly occur in these places when exposed to ultraviolet radiation.

Causes of Vitiligo
Theories of the origin of the disease are different. Many consider vitiligo a disease of the whole body, and the appearance of white spots on the skin is only its most noticeable external manifestation. It can accompany Addison's disease, diabetes mellitus, pernicious anemia.

The cause of vitiligo may be hereditary abnormalities in metabolism; fetal injury and malnutrition during prenatal development; disturbances in the work of the endocrine glands (thyroid, adrenal glands); malnutrition of tissues as a result of chronic diseases of the digestive system; trauma, stress leading to vascular disorders and changes in circulation nutrients and products of their metabolism in cells.

Risk factors

heredity;
sunburn;
poisoning;
stress;
chronic diseases internal organs, nervous and endocrine system;
age up to 30 years.

Vitiligo symptoms
characteristic symptom diseases are milky white spots with uneven outlines. In these places, the skin is completely devoid of melanin pigment. There is no itching or pain. Such spots can occur at any age, on any part of the skin, in unlimited quantities (from 1-2 spots to covering almost the entire surface of the body). If the stain appears under the hair, eyelashes or eyebrows, they turn white.

Vitiligo lesions are highly sensitive to sunlight. Since the lack of pigment makes the skin defenseless, direct sunlight must be avoided. Otherwise, there may be severe burns or dark, hyperpigmented rims appear around the spots. Foci of the disease tend to spread to healthy areas over time.

Diagnosis of vitiligo

Which doctor should I contact?
The diagnosis of vitiligo is established by a dermatologist during an external examination. Special attention refers to the symmetry of the location of discolored areas of the skin. Typical locations for spots: elbows, knees, eyelids, etc. The spots do not peel off, which makes it possible to exclude fungal disease. An accurate diagnosis is extremely important, because sometimes the disease is disguised as other ailments, and its treatment is quite expensive.

Analyzes and examinations
To confirm the diagnosis of vitiligo, the patient is examined under the rays of a Wood's lamp. This is a special device that gives light in a certain ultraviolet spectrum. Most often it is used to diagnose fungal infections, but it is also very useful in the case of vitiligo. In the rays of this lamp, vitiligo spots become white-blue. Healthy skin is light blue in color.

What is dangerous?
The very presence of discolored spots on the skin is not dangerous, but when examining patients with vitiligo, one or another metabolic disorder is always found. They can manifest themselves in the form of allergic dermatosis, combined chronic diseases of the digestive system, pneumopathy, progressive myopia, baldness, psoriasis, intestinal dysbacteriosis, various disorders of the central nervous system, etc.

Vitiligo treatment and rehabilitation
Treatment is mainly cosmetic purposes. Small spots can be masked with foundation or tanning lotion that does not stain clothes and remains on the skin for several days. Should enjoy the sun protective equipment and photoprotective preparations (inside and outwardly). One of the most modern methods of treatment is the irradiation of spots with ultraviolet light with a wavelength of 320-390 nm in combination with the use of drugs that increase the sensitivity of the skin to it - PUVA therapy. However, this treatment is lengthy, and the results may not meet expectations - often the restoration of the pigment occurs partially and unevenly.
The best results to date are obtained by medium-wave narrow-band UV therapy, which uses ultraviolet with a wavelength of 311 nm. It is also necessary to treat the underlying disease, which must be prescribed by the attending physician (usually it includes a certain diet, enzyme preparations, etc.).

Forecast
The prognosis for vitiligo is doubtful, as the spots tend to spread over time. However, they are only an aesthetic defect and do not bother patients in any other way. Proper Treatment gives great chances for the restoration of pigmentation, especially if it is started in the first years after the onset of the disease.

Nota Bene!
Don't forget to use sunscreen with a high protection factor while relaxing in the active sun. After all, skin devoid of melanin is not able to protect itself, and burns quickly occur on it.

Interesting fact
One of the most famous people suffering from vitiligo was Michael Jackson. He had the so-called universal form of the disease, when about 80% of the skin loses pigmentation. This is confirmed by the appearance of vitiligo in his eldest son.

Prevention of vitiligo
Since the causes of the disease have not yet been precisely established, methods of preventing it also cannot be fully substantiated. It is necessary to avoid injuries, contact with chemical reagents. It is desirable to prevent the development of chronic diseases gastrointestinal tract And nervous system. However, all these measures may not be sufficient against the background of a genetic predisposition to the development of the disease.

Expert: Kobozeva E.I. dermatovenereologist

Prepared from:

Adaskevich V.P., Kozin V.M. Skin and venereal diseases. - M.: Medical literature, 2006.
Koshevenko Yu. N. Vitiligo: clinic, etiology, pathogenesis, treatment, rehabilitation, prevention. - M.: Cosmetics and medicine, 2002.
Skripkin Yu.K. Skin and venereal diseases. - M.: Triada-farm, 2005.

Primary morphological elements Cavityless primary elements

Spot

Spot (macula)- limited change in skin color without disturbing its relief and consistency. Spots on the skin are called the term "exanthema", on the mucous membrane - "enanthema".

According to the mechanism of occurrence, vascular, pigmented and artificial spots are distinguished (Fig. 1-7).

Vascular spots have different shades of red. Changes in blood vessels lie in the pathogenesis of the formation of vascular spots. So, among the vascular spots, inflammatory, telangiectatic, hemorrhagic and spots caused by the growth of blood vessels are distinguished.

- Inflammatory vascular spots occur during inflammation skin process due to vasodilation. With vitropressure, the spots of this type turn pale.

Small inflammatory spots ranging in size from 2-3 mm to 2 cm are called roseola. Acute inflammatory roseola is bright pink in color, edematous, prone to fusion and peeling, usually occurs in children with allergic dermatitis, eczema, pink lichen, childhood infectious diseases (measles, rubella, scarlet fever). Neo-inflammatory roseola is hardly noticeable, has a pale pink color, clear outlines, and is not prone to fusion and peeling. Such

Rice. 1-7. Spot: a - pigmented, b - vascular, c - hemorrhagic, d - artificial

roseola, as a primary element, occurs in patients with secondary syphilis, pityriasis versicolor, leprosy.

Large vascular spots that tend to merge and occupy large areas of the skin are called erythema. Erythema is always an acute inflammatory spot and is associated with skin edema and intense itching. Erythema as a primary morphological element occurs in patients with allergic and contact dermatitis, eczema, toxidermia, erythema multiforme exudative.

A variety of inflammatory vascular spots - "stress" erythema that occurs with strong emotional experiences(anger, shame, shyness). In pathogenesis given state the main role is played by unstable vasodilation caused by neuro-reflex mechanisms.

This group of spots can also include erythema caused by venous stasis due to the expansion of venous capillaries and venules, which is called cyanosis. For children early age diffuse cyanosis of the mesh type is characteristic - marble skin.

- Hemorrhagic spots occur on the skin during hemorrhage and are due to the release of red blood cells from blood vessels into the surrounding tissues due to injury or with an increase in the permeability of the vascular wall. Hemorrhagic spots are rashes of complex origin, as they can

be both inflammatory and non-inflammatory, characterized by hemorrhages in the epidermis or papillary dermis. With an inflammatory hemorrhagic lesion, necrosis or increased permeability occurs in the vascular endothelium. Non-inflammatory damage to the integrity of blood vessels occurs as a result of bruises, toxic or mechanical effects. When blood enters the surrounding tissue, the outlines and size of hemorrhagic spots are different.

Point, single small (up to 1 cm in diameter) hemorrhages are called petechiae, larger, irregular outlines in the form of stripes - vibices, large areas of hemorrhage in the form of a "platform" - ecchymosis, and large bruises - hematomas. Hemorrhagic spots differ from inflammatory ones in the presence of a rusty hue due to the coloring of the skin with hemosiderin, as well as the absence of blanching when pressed.

A disease or syndrome characterized by a rash of hemorrhagic spots (regardless of their size and shape) is called purple. Purpura occurs in patients with vasculitis, toxidermia, scurvy, infectious diseases (typhoid and typhoid fever).

- Telangiectatic spots- spots caused by persistent expansion (dilatation) of blood vessels and (or) vascular neoplasms (hemangiomas). Vascular spots, consisting of clearly visible small blood vessels, sometimes branching tree-like, are called telangiectasias. They are formed as a result of persistent paralytic vasodilation under the influence of the irritating effect of climatic factors, as a result of vegetative neurosis in rosacea; as a side effect of the use of external glucocorticoid drugs, for example, on the face of young children with atopic dermatitis. In newborns, telangiectatic vascular spots are often found, which are localized on the back of the head (Unna's spot, "stork's bite"), in the region of the eyelids, and the bridge of the nose. These telangiectasias resolve on their own by the age of 1-2 years.

- Spots caused by vascular neoplasms, also called hemangiomas. Hemangiomas are capillary, cavernous, venous and are the cause of congenital vascular nevi: flaming nevus, port-wine stains.

Dark spots associated with a change in the amount of melanin pigment in the skin and can be congenital or acquired. With a decrease in the content of pigment in the skin, there are depigmented spots, and with an increase - hyperpigmented spots of different colors Brown.

Depending on the size of the spots and the mechanism of their occurrence, acquired hyperpigmented spots are divided into freckles, chloasma, melasma.

- Freckles- small foci of hyperpigmentation on the face, back, upper limbs, appearing under the influence of intense UV radiation, are often genetically inherited.

- Chloasma- large yellowish or dark brown spots that occur more often in women during pregnancy or liver disease after UVI.

- Melasma- hyperchromia of a common nature, for example, with Addison's disease, sunburn.

- Lentigo- a small congenital pigment spot caused by the accumulation of melanocytes in the epidermis. Congenital hyperpigmented spots include lentigo, congenital melanocytic nevi, Mongolian spots, etc.

Depigmented, or hypopigmented, congenital macules may be a manifestation of widespread or limited form of albinism.

With a limited form - piebaldism areas of depigmentation appear on the scalp in the form of white strands, on the face. Acquired hypopigmented spots are characteristic of vitiligo, leukoderma.

True primary leukoderma characterized by the appearance of small depigmented spots and is formed with insufficient synthesis of melanin due to intoxication in patients with secondary syphilis, typhus and typhoid fever.

- Vitiligo - an autoimmune disease characterized by the appearance of depigmented spots of various sizes.

Primary leukoderma must be distinguished from secondary leukoderma, or pseudoleukoderma, which is characterized by the appearance of white spots with the resolution of primary elements in psoriasis, eczema, pityriasis versicolor and is caused by secondary pigment deficiency against the background of inflammation.

artificial stains occur when colored foreign substances are deposited in the skin. The outlines and color of the spots depend on the substance itself and the method of its administration. Tattoo- drawing on the skin, obtained by artificial introduction dyes in the skin.

Skin depigmentation (vitiligo) is a skin disease that causes white patches on the skin. Most often, it begins on those parts of the body that are exposed to solar radiation (arms, legs, face).

In clearly defined areas of the skin, the production of melanin pigment stops. Depigmented spots increase in size over time, may merge and form patterns.

One of serious pathologies skin is vitiligo. The disease has a pronounced symptomatology - white spots with clearly defined boundaries.

If you do not treat the disease, pigmentation increases, the affected skin fragments merge with each other. Further, the process may affect the hairline - it will lose its natural color.

The main places of localization of pale spots on the skin with vitiligo are:

hands, palms,
face, elbows,
neck and limbs.

The disease begins due to the strong destruction of melanocytes, but what leads to this phenomenon is still not clear. One of the medical versions is hereditary predisposition and malfunctions. immune system.

Treatment of the disease is possible, but it will be difficult and long.

Leukoderma is a violation of the pigmentation of the skin, leading to a decrease or complete disappearance of melanin. One of the varieties of this pathology is syphilitic leucoderma, which develops when a person is infected with a disease similar in name.

It has a special symptomatology, so it is easily diagnosed. Characteristic rounded rashes appear on the skin. Hyperpigmentation forms around the white spots, so that the rash becomes very noticeable.

There is the concept of "false leukoderma", when characteristic spots accompany concomitant diseases:

psoriasis;
pink lichen;
eczema.

Vitiligo (lat. Vitiligo) is a skin disease that develops as a result of the destruction of the melanin pigment, which is expressed in the formation of white or milk spots on the skin. White spots on the skin of the face, body, arms and legs in most cases are the result of the development of vitiligo.

Sometimes doctors instead of "vitiligo" use the term "leukoderma", or "leukoderma".

The melanin pigment is natural natural pigment dark color produced by melanocytes. When, under certain factors, melanocytes are destroyed, or their production of melanin is disrupted, white spots appear on those areas of the skin.

The nature of the disease, as well as its exact causes of development, are not fully understood, but the main factors that provoke the appearance of white spots on the body are considered to be a side effect from taking some medicines, various chemical substances, disturbances in the work of the endocrine, nervous, immune, lymphatic and other systems, unfavourable conditions residence.

Vitiligo can be inherited, but in most cases, this skin disease is an acquired disease. Moreover, even if the parents have this disease, it may not develop in children, since the hereditary factor alone is not enough.

Vitiligo is not transmitted by airborne droplets.

Statisticians note that the carriers of white spots in the aftermath of the development of vitiligo are up to 1% of the world's population, mainly at the age of 10-30 years. In young children, this pathology is practically not observed.

Vitiligo disease. What is the danger?

Although vitiligo is a skin disease, which at first glance brings only aesthetic troubles, but this is only at first glance. In fact, white spots on the skin may indicate the presence in the patient's body of more serious violations and diseases:

Skin diseases: psoriasis, eczema, ichthyosis, alopecia; - violations of the thyroid gland; - hypovitaminosis, beriberi; - development of myopia, diabetes, pneumonia and other diseases.

Constant psychological stress from the presence of white spots in a conspicuous place can lead to serious diseases of the nervous system. The person can close outside world and suffer from depression and loneliness.

Vitiligo. ICD

Causes of Vitiligo

Can be distinguished the following reasons that cause hyperpigmentation of the skin:

Progression in the body of various endocrine diseases.
The intake of excess iron in the body.
Impact on the dermis of sunlight.
The development of the inflammatory process on the epidermis.
Long-term use of certain drugs.
Pregnancy and hormonal changes.
The result of side effects of certain drugs and contraceptives.

Hyperpigmentation is a skin condition that develops as a result of increased melanin production.

Such a change in the color of the epidermis is usually accompanied by the appearance of the following symptoms:

People with light spots on their skin usually don't feel sick. However, it has been observed that certain autoimmune diseases increase the risk of vitiligo. It has also been noted that workers in some chemical industries are subject to similar skin pigmentation disorders, which indicates a connection between depigmentation and exposure to external factors. There is no single answer to the question of the causes and mechanisms of skin pigmentation disorders. There are a number of factors that most often provoke the development of depigmentation:

There are many reasons for pigmentation disorders. Doctors note genetic factors, autoimmune failures, negative effects ultraviolet radiation. Experts also talk about bad ecology. The dustiness of the city, difficult climatic conditions can cause pigmentation.

Pigment problems can also form while taking certain groups of medications. IN this case antibiotics and oral contraceptives play a special role.

Pigmentation on the face or, for example, the abdomen may appear after the inflammatory process. Often, after a bee or wasp sting, a long period of time remains on the human body. dark spot. The thing is that melanin pigment has a positive effect on tissue healing, it copes well with free radicals. Due to the fact that melanocytes often struggle with healing in a particular area of \u200b\u200bthe skin, it turns out that they also pigment it at the same time.

The main reason is the lack of melanin in a limited area of \u200b\u200bthe skin (acquired or congenital).

If a person began to notice the first symptoms of discoloration of skin areas, it is better to seek the advice of a specialist. It is recommended to do this even if the white dots do not cause any discomfort.

Only a dermatologist can find out real reason deviations through a comprehensive examination.

Experts believe that the loss of pigment by cells is caused by both internal and external causes.

TO internal reasons relate:

autoimmune processes, when for unknown reasons the body gets rid of melonocytes;
hereditary predisposition;
failure of the pituitary and hypothalamus hormonal background;
severe viral infections;
improper functioning of the thyroid gland, disruption of the endocrine system of the body;
a state of constant stress and nervous tension;
avitaminosis.

External factors are highlighted in a separate list. These include:

hypersensitivity skin to the effects of cleaning and detergents, non-natural tissues and other irritants;
skin injury;
regular interaction with toxic substances;
abuse of tanning, SPA procedures.

Fungal diseases of the skin are widespread. Severed or colored lichen - one of the forms fungal infection skin cover.

Most often the disease manifests itself in males living in warm climatic conditions. In rare cases, lichen can be found in children or older men.

Doctors identify several main causes of the onset of the disease:

vegetative-vascular dystonia;
abuse of antibiotics;
passion for sunbathing and SPA procedures;
failure of the endocrine system;
hormonal changes.

Symptoms of the disease do not cause the patient any discomfort in areas of skin lightening. Sometimes there is a slight itch.

Treatment can only be prescribed by a dermatologist, after examining a skin scraping to identify a pathogen.

State human body largely depends on the correct balanced nutrition. White spots are very frequent occurrence in violation of the normal diet.

If you do not organize a balanced diet, the process can be delayed and lead to complete skin lightening. Relying only on self-healing is not worth it.

The dermatologist will analyze the state of the body and prescribe special biological supplements, you may have to undergo some cosmetic procedures.

An integrated approach to the problem will help solve it within one to two months.

Increased skin pigmentation usually appears in places exposed to the sun: face, hands, neck, forearm and shoulders. Ultraviolet radiation plays key role in the formation of spots on the skin.

The process of excessive pigmentation of the skin can contribute to changes in the hormonal background (contraceptive pills, hormone therapy, pregnancy).

Acute and chronic inflammatory processes in organism. Photosensitizing substances present in medicines ah (for example: antibiotics), perfumes and cosmetics (with whitening properties without protective filters, containing AHAS / BHA, retinol, alcohol, essential oils).

Changes in skin color increase with age. Metabolic disorders lead to hyperpigmentation.

As already mentioned at the beginning of the article, vitiligo is an acquired disease, the cause of which is a number of internal and external factors that lead to the destruction of melanin, the pigment that essentially carries skin color.

Consider the most popular causes of vitiligo:

autoimmune disorders. It is based on violations of the immune system, when, in case of violations of the body due to various pathologies it does not produce the necessary antibodies to protect itself, or vice versa, the control over the work of antibodies is disturbed, and they begin to damage healthy tissues.

Trophic disorders of the skin. Vitiligo is formed on areas of previously damaged skin (sunburns, microtrauma, scars) under the influence of ultraviolet rays (sun), especially in the spring and summer.

genetic predisposition. seen genetic predisposition to vitiligo, i.e. this disease can be inherited. In addition, it was noted that brown-eyed people are more susceptible to this pathology than people with gray or blue eyes.

Diseases of the digestive tract. Liver diseases associated with stagnation of bile, dysbacteriosis, malabsorption syndrome - all this leads to impaired intake and absorption of microelements necessary for the production of melanin - magnesium, manganese, iron, copper, zinc and other substances.

Diseases of the thyroid gland. On average, about 10% of patients with white patches have thyroid-related diseases, including goiter (grades 1 and 2), hyperthyroidism, and hypothyroidism.

Science does not know either the exact causes or the mechanism of development of vitiligo. There is an assumption that the appearance of vitiligo disease can be explained by the following factors:

exposure to certain chemicals or drugs;
pathology of the autonomic nervous system;
diseases of the endocrine organs;
hereditary predisposition;
chronic diseases.

Types of vitiligo

Depending on the degree of damage to the skin, the intensity of manifestations, there is a certain classification pathological process that accompanies the disease. The general view of the modern classification of hypopigmentation is as follows:

In normal healthy skin there are cells - melanocytes, which are responsible for the production of the required amount of a specific coloring pigment.

In the event that the epidermis contains too much melanin, the skin becomes more dark shade and this condition is called hyperpigmentation.

With any changes in the coloring pigment in the human body, skin pigmentation disorders appear on his body. With too little coloring pigment, this develops pathological condition, as hypopigmentation, and it is expressed in very light skin.

Specialists distinguish the following types of dermal pigmentation disorders:

Depending on the time period, skin depigmentation can be temporary (after lichen) or permanent (with albinism). As a result, it is possible to distinguish primary depigmentation (it includes albinism and vitiligo) and secondary depigmentation (developing after skin diseases, for example, lichen, juvenile acne, chemical burns alkali or acid).

Vitiligo is classified as follows:

According to the clinical course (vitiligo stage)

Initial stage. On the skin area, one spot of depigmentation of a rounded shape is formed.

stage of stability. The newly formed spot continues to grow in size, no other changes occur.

Progress stage. The old spot continues to grow in size, while other spots may begin to appear on the skin.

In some cases, white spots on the skin may appear, and grow very quickly to large sizes, this type of disease is called fulminant vitiligo.

repigmentation stage. White spots during treatment this disease or they can arbitrarily be painted over with melanin, gradually disappearing from the skin, although this is quite rare.

By localization

Localized form of vitiligo. Depigmentation occurs locally on one area of the skin. In turn, the localized form is subdivided into:

Focal type (focal leukoderma). It is characterized by one or more spots located in the same area, next to each other.
Segmental type (segmental leukoderma). It is characterized by several spots located along the nerve plexuses.
Mucous type (mucous leukoderma). It is characterized by spots only on the mucous membranes.

Generalized form of vitiligo. Depigmentation occurs extensively, develops in different areas of the skin. Subdivided into:

Vulgar type (vulgar leukoderma). Characterized by spots randomly scattered throughout the body.
Acrofascial type (acrofascial leukoderma). Spots appear mainly on the face and limbs.
Mixed type (mixed leukodkermia). It is a combination of vulgar and acrofascial leukoderma, or leukoderma vulgaris, acrofascial and segmental type.
Universal type (universal or total leukoderma). The process of depigmentation occupies almost the entire body, up to 80% of the skin surface.

Dermatologists distinguish three main types of pigmentation disorders:

Leucoderma. Such a violation is accompanied by hypopigmentation and is caused by a decrease or complete absence of melanin.
melasma. This pigmentation is accompanied by hyperpigmentation and is caused by excessive deposition of melanin.
Grey-blue dispigmentation. Such a violation occurs against the background of the presence of melanin in the skin and is accompanied by the deposition of melanin or non-melanin changes in the color of the skin.

Each of these pigmentation disorders is not independent disease. These terms refer to those characteristics that can be observed on the skin of patients with various diseases accompanied by changes in the color of the skin, hair or eyes.

Symptoms of hypopigmentation

The word "pigmentation" today makes not only women worry different ages but also men. They fight with it, call it a “disease”, hide it. But few people know that there is nothing frightening in the very word “pigmentation”.

According to the dictionary, pigmentation is the coloring of tissues that occurs under the influence of pigments. Unfortunately, almost every person during his life is faced with pigmentation disorders, which can be localized in the decollete, face, arms, legs and other open areas of the body.

Treatment by a dermatologist begins with an examination of the spots with a Wood's lamp. Sometimes stains cannot be completely removed, they can only be lightened and made less noticeable. Depending on the type of stain, your doctor may recommend:

The use of bleaching agents. The most famous:

- Hydroquinone at a concentration of 1.5 to 8% (arbutin, ericoline, arbutoside - ointments, alcohol solutions). Whitens on initial stage the appearance of a spot.

Visible results are achieved in a few weeks. By-effect- discoloration of the skin around the spot.

- Retinoids (tretinoin cream, synthetic vitamin A, Accutane, Retin-A) - analogues of vitamin A. The course of treatment lasts up to 3 months.

- Azelaic acid (15-20% skinoren, azelic) - removes minor inflammation and hyperpigmentation, and eliminates acne. Frequent use may cause redness and burning of the skin.

- Kojic acid (1-4% with the same name) - non-toxic, pronounced exfoliating property, inhibits the formation of melanin. - Vitamin C (not less than 5%) - Corticosteroids (prednisolone, hydrocortisone ointment, gel) - has a strong anti-inflammatory effect, reduces the activity of melanocytes.

It is good to combine with bleaching agents.

Chemical peels - the purpose of the procedure is to improve appearance skin of the face, neck and hands, cleanse and smooth the skin and restore its color.

A chemical peel consists of an acid (glycolic, trichloroacetic or kojic) that has a controlled damaging effect on the skin. Peeling can remove fine wrinkles, discolor excessive pigmentation, eliminate small scars from acne.

Dermabrasion (deep mechanical peeling) - exfoliation is carried out under the action of the smallest particles. This is mechanical abrasion of the upper layers of the epidermis and dermis.

Processing is carried out using a special electric device with a rotating disk - a brush. The procedure is performed under local or general anesthesia, depending on the surface area of the skin.

After the procedure, a dressing is done. Skin recovery takes several weeks.

The treatment is indicated in case of removal of acne scars, marks after smallpox, some post-traumatic scars, hyperpigmentation, wrinkles, tattoos.

Microdermabrasion is the mechanical removal of the stratum corneum using abrasive wheels.

Cryotherapy – spot freezing liquid nitrogen and then removing dead skin. The method is very effective, but sometimes scars remain.

Laser procedures - the skin pigment melanin absorbs light energy from the laser and thus burns out.

High technologies - include preparations for ultra-lightening of the skin (creams, serums, masks). The composition includes special substances from hyperpigmentation, which inhibit the formation of the tyrosinase enzyme and therefore block the formation of melanoblasts, destroy excess melanin.

— Masks from colloidal gold(golden masks) - restore correct work melanocytes. The treatment is very effective, but it costs about $1,000 per procedure, and several such procedures are needed to get the desired effect.

– Lighting compositions of resveratrol – rejuvenate the skin, effectively dissolve spots, remove melanin from cells. The disadvantage of the method is that it does not prevent the formation of melanin.

Phytotherapy and home remedies for pigmentation treatment

- Pineapple juice or puree - contains the substance bromelain (an enzyme that dissolves melanocytes) and fruit acids.

- Citrus juice - has a strong whitening and peeling property.

- Infusion of lemon skin - contains essential oils and fruit acids. Well whitens and moisturizes the skin.

- Papaya puree - contains a large number of vitamin A, improves the protective properties of the skin.

- Raspberry juice - whitening property, vitamin therapy.

- Whitening lotion: cut the cucumber into pieces with the peel and put in milk buttermilk. The infusion will be ready in 3 hours. Wipe your face with a cotton swab dipped in the infusion.

- A decoction of stains: grind with a blender or in a coffee grinder a few flowers of coltsfoot, rue grass and knotweed in equal proportions. Pour a spoonful of the mixture with a glass of water and cook for 5 minutes. Decoction to wipe the face several times a day.

- Brightening peeling mask: mix a glass of chamomile infusion and a glass of yogurt. Then add milk powder to the solution until it thickens. Apply the mask on the face, wash off after 20 minutes.

The main symptom of vitiligo is white or milky spots on the skin, with a diameter of 2-3 mm per initial stage, with clear boundaries of the affected area, which cause their wearer aesthetic discomfort, psychological stress.

Especially cosmetic defect visible when a person is sunbathing in the sun, tk. then a stronger contrast is created and the spots become more visible. Sometimes new spots form inside the vitiligo spots, which are even more pronounced with depigmentation.

In other cases, patches expanding into new areas of skin may combine with each other, forming irregularly shaped contours.

The most common areas for the appearance of white spots are the face (mouth, nose, eyes and ears), arms and legs (elbows, knees, feet, fingertips), groin area, hairy areas of the skin (moustache, beard).

Varieties of spots with vitiligo:

spots of three colors with a pigmented contour;
spots of four colors with a clear pigmented contour;
spots with a bluish tinge;
the spots have borders in the form of a slightly raised shaft.

Additional or accompanying signs of vitiligo may include:

Skin diseases: dermatitis, psoriasis, lichen planus, scleroderma; - increased sensitivity of spots to infrared radiation; - lack of tan spots when exposed to ultraviolet rays; - lack of sensitivity of affected skin areas to external stimuli (cold), as well as impaired sweating processes; - lightening or graying of hair on the affected areas of the skin; - rounded baldness; - chronic diseases of the gastrointestinal tract; - the liver is more susceptible to various intoxications - alcohol, drugs; - choreoretinitis, porphyria, Setton's nevus, white skin atrophy.

It is important to note that, despite the fact that disturbances in the work of the sweat glands occur in the places where the spots are located, depigmented skin does not dry out and does not peel off.

Diagnostic methods

The technique for diagnosing hypopigmentation is based on an external examination of the affected area, which has a less pronounced natural color.
Also, to make a more precise diagnosis, consult a dermatologist, who may prescribe an additional examination of the affected skin using the light of a Wood's lamp.
It can be prescribed in the presence of raised edges of lightened spots on the body. skin particle biopsies from the affected area.

Diagnosis of vitiligo usually involves a history and physical examination of the patches.

Additionally, they can appoint:

It is also necessary to distinguish vitiligo from:

depriving (simple, white or multi-colored);
secondary leukoderma on the background atopic dermatitis, lupus or syphilis;
leprosy (leprosy).

Vitiligo treatment

Treatment for hypopigmentation is a long process that involves the use of certain drugs that stimulate the production of melanin in the skin.

It is also necessary to eliminate the causes and manifestations of diseases that have become provoking factors in the development of the underlying disease.

Therapeutic way

The use of therapy in the diagnosis of hypopigmentation is determined by the correction of nutrition, since it is the lack of certain substances in the diet that can cause insufficient pigmentation of the skin.

For this, a sufficient amount of protein foods, fresh vegetables, especially those with a pronounced color, should be introduced into the daily diet.

It may also be necessary to analyze the working conditions: this factor can also become a provoking factor in the development of this disease. The elimination of harmful working conditions, the use of certain drugs that negatively affect the process of melanin production by the skin, are important steps in eliminating lightened skin areas.

Physiotherapy

As physiotherapeutic methods of influence, it is necessary to consider the use of treatment of the clarified parts of the skin with the help of dosed ultraviolet irradiation, stimulating the skin with a massage using drugs that stimulate the production of melanin.

medication

The use of preparations that contain a high concentration of melanin allows you to enhance the natural process of its production. Such funds are usually applied to the affected skin at the site of its lesion, left to act.

Such treatment should be carried out in courses of several consecutive procedures.

The use of medicines inside that activate the metabolism in the body, stimulate the production of melanin, also makes it possible to enhance the color of the skin. Vitamin D intake, which determines skin color, can be considered effective method therapeutic effect in the detection of hypopigmentation.

Skin pigmentation disorders are treated different ways. Therapy primarily depends on the type of disease, the age of the patient and the presence of any chronic diseases.

Cosmetics: anti-pigmentation creams

If pigmentation on the skin is not a symptom of the disease, then the doctor may recommend some cosmetic preparations. As part of effective pigmentation creams, at least one of these components must be present:

arbutin;
hydroquinone;
vitamin C;
kojic acid;
extracts of jojoba and parsley.

Before using any creams for pigmentation, a doctor's consultation is required.

Laser skin resurfacing

A good result in the elimination of pigmentation disorders is demonstrated by salon procedures, in particular laser skin resurfacing. Such complex impact on the skin allows you to get rid of various defects.

The laser affects dark spots melanin is destroyed. This method of eliminating defects allows you to eliminate pigmentation various sizes safe and fast. The main thing is to seek help only from professionals and not self-medicate.

Pigmentation removal: peeling, phototherapy

Age spots are also removed with the help of phototherapy or peeling. You can use the procedure in the cosmetology center of your city, after consulting with a dermatologist.

Peeling is deep cleaning skin, which is carried out with the help of special creams. Phototherapy is light therapy. This method works due to ultraviolet radiation, which can stimulate certain metabolic processes in the body and acts locally as an immunomodulator.

Treatment of vitiligo includes, first of all, a visit to a dermatologist, who, based on the diagnosis, will determine the form and type of this disease, and, depending on the diagnosis, determine the method of treatment and necessary drugs from vitiligo.

This point is also very important to distinguish vitiligo from other skin diseases, otherwise the possibility of erroneous treatment can only aggravate the situation.

Treatment options for vitiligo include:

Medicines for vitiligo

Important! Before using folk remedies for vitiligo, be sure to consult your doctor!

St. John's wort oil for vitiligo. St. John's wort oil stimulates melanocytes to produce melanin, which is actually responsible for skin pigmentation.

To prepare it, it is necessary to fill a small glass jar with St.

After 2 weeks, the oil must be squeezed out, and a new portion of St. John's wort flowers should be added to it, and again put the jar with the mixture in the sun for 2 weeks. This procedure must be done 6 or more times until the oil becomes red-brown and thick, which will indicate its high concentration.

St. John's wort oil is used externally as an ointment for vitiligo, tonsillitis, influenza, muscle strain, sciatica, osteochondrosis, cuts, burns, neuralgia and tumors. It is also effective in diseases of the gastrointestinal tract, if taken orally, 1 teaspoon before meals.

Black cumin oil for vitiligo. It has not only a photosensitizing property, but also a tonic effect, helps with overwork.

Before external use, the skin must be lubricated with vinegar, then applied and rubbed into it with black cumin oil. Next, you need to walk for about 30 minutes along the street - take a sunbath. Inside, you can use 2 times a day, 1 teaspoon diluted in 100 ml of water.

Marsh duckweed from vitiligo. It helps due to the iodine and bromine salts included in its composition.

Used as a tincture. To prepare a tincture of marsh duckweed, thoroughly rinse required amount duckweed under running water, then place it in a dark glass container and pour vodka (or alcohol diluted with water), in a ratio of 1 tsp.

After that, strain the remedy, and take the prepared infusion of duckweed, 15-20 drops, diluted in a quarter glass of water, 3 times a day.

Black pepper. The composition of black pepper includes a substance - piperine, which stimulates the production of melanin.

To prepare a remedy for white spots, mix black pepper and baking soda in equal parts. Rub the resulting mixture into the skin with white spots.

Over time, white areas of the skin should turn into their natural healthy color.

Paste "Sulsena" (2%). This paste is inexpensive means from dandruff and hair loss, which can be purchased at the pharmacy. It can be rubbed into the white spots of vitiligo for 30 minutes, then rinsed. After a few applications, the spots should be gone.

Birch tar for vitiligo. Lubricate white spots with birch tar for a month, if the spots do not disappear completely, take a break and repeat the course of treatment. Usually vitiligo disappears in 1-2 courses. This tool can be purchased at a pharmacy.

Garlic and onion. Rub for 5-7 minutes daily, but in turn onion and garlic in places with white spots, one day garlic, the other - onion.

To treat a disease in a child, they use almost all the methods that are prescribed for adults. The exception is systemic hormonal therapy.

It is used only in the presence of strict indications, for a minimum time and in the lowest therapeutic doses. Children under 12 years of age are contraindicated in sessions of UV skin irradiation and PUVA therapy.

You can understand how much the skin condition can improve as a result of the treatment of vitiligo by looking at photos of people before and after the treatment of the disease. The pictures below of areas of the skin affected by vitiligo will give you an opportunity to roughly evaluate the effectiveness of therapy and help you decide on a strategy to combat this little-studied disease.

How to mask age spots?

Among modern methods of masking vitiligo spots, there are:

Cosmetical tools. At the beginning, a makeup base is applied to the spots, after which a dense layer is applied on top. Foundation or heavy powder. Also on sale there is a special foundation for vitiligo, which helps to mask this cosmetic defect, and is not washed off even with water.

Self-tanning. The convenience of this procedure is manifested in the absence of soiling clothes with it. The only difficulty lies in the correct color of self-tanning, so if you have difficulty with this, apply it in a beauty salon.

Dermabrasion. This method is the grinding of the upper layers of the skin, gradually leveling the overall skin tone.

Prevention of vitiligo

As a preventive measure, one should consider good nutrition, rich in essential substances (in particular, proteins in a form accessible to the body), the elimination of current dermatological lesions, which can be the starting point for the development of hypopimentation.

Prevention of vitiligo includes following a number of the following recommendations:

When using various chemicals, especially household or garden chemicals, be sure to use protective equipment (gloves, etc.), avoid using these substances with bare hands and their contact with your skin!

Try to eat foods enriched with vitamins and minerals, minimize consumption harmful products nutrition.

In the winter-spring period, it is advisable to additionally take vitamin complexes;

Try to lead an active lifestyle, temper your body;

Remember the rules of tanning, try to avoid prolonged exposure to open sun, thus you not only minimize the appearance of vitiligo, but also sunstroke, sunburn, and God forbid skin cancer.

Try not to allow psycho-emotional overwork.

After a successful recovery from vitiligo, it is important to follow preventive measures that will prevent the disease from returning:

carefully protect the skin from injuries, burns, cuts, insect bites;
avoid wearing tight clothing uncomfortable shoes, jewelry that can rub the neck or fingers;
refrain from long stay in the cold or under the sun, do not sunbathe, do not visit the solarium;
eat right, monitor the balance of vitamins and valuable elements;
avoid contact with chemical compounds;
undergo regular medical examinations.

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Skin pigmentation disorders. There are two types of skin pigmentation disorders: 1) hyperpigmentation resulting from excessive pigment deposition; 2) depigmentation, hypochromia as a result of a lack or complete absence of pigment. In addition, there are primary pigmentation disorders that occur on externally unaltered skin, and secondary ones that appear at the site of any resolved skin pathological processes.

According to the degree of distribution of pigmentation disorders, they are divided into limited (spotted), diffuse and generalized.

Hyperpigmentation and congenital age spots. Moles, or birthmarks, are congenital abnormalities in the development of the skin. They look like small or large spots that do not rise, and sometimes slightly or even significantly rise above the surface of the skin; sometimes they resemble warts, often covered with hair. The color of pigmented birthmarks can vary from light brown to dark brown, brown and black-brown with various shades. birthmarks are not always found immediately after birth - they can also appear during puberty and even later and exist unchanged throughout life. However, they can slowly increase.

Birthmarks are very common, and people who do not have them are an exception.

Patohistology. found in biopsied skin pieces increased amount pigment in the cells of the basal and styloid layer. In the dermis, "nevus" cells are found, filled with pigment grains. With warty nevi, there is hypertrophy of the papillae.

Treatment . Small spots are removed by electrocoagulation or surgical excision. Good results often received by cryotherapy (freezing with carbonic snow).

skin depigmentation, vitiligo. Vitiligo (pes) is a skin pigmentation disorder that is never congenital. The disease is characterized by the appearance of depigmented white spots of various sizes and outlines that appear on a hyperpigmented background. Spots of vitiligo may increase, merge and form large foci of irregular shape.

Hair and vellus hairs on depigmented patches are either discolored or retain pigment.

The etiology is unknown. There is some evidence to suggest that neuroendocrine disorders play a role in the development of vitiligo.

The diagnosis is usually not difficult. However, it is necessary to remember about leprosy, in which sensitivity is reduced in depigmented areas.

Vitiligo treatment little success. In some cases, favorable results are obtained from drugs from the group of psoralens (meladinin, ammifurin, beroxan, etc.). These drugs are used orally in tablets and externally in the form of lubrication of depigmented areas. At the same time, ultraviolet irradiation of affected areas is performed with suberythemal doses. Such treatment should be carried out for a long time - for months.

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Limited discoloration of the skin or mucous membranes. Spots come in various sizes and shapes, in most cases their surface does not rise above the level surrounding skin. According to the mechanism of occurrence, vascular and pigment spots are distinguished. Vascular spots, in turn, are divided into inflammatory, edematous and proliferative - hemorrhagic.

Inflammatory vascular spots that occur as a result of vasodilation, the size of a three-kopeck coin, are called roseola. Acute inflammatory roseola with a bright pink color, edematous, prone to fusion and peeling, is usually observed in children with allergic dermatitis, eczema, pink lichen, childhood infectious diseases (measles, rubella, scarlet fever). Neo-inflammatory roseola is hardly noticeable, has a pale pink color, clear outlines, and is not prone to fusion and peeling. Such roseola as a primary element occurs in patients with secondary syphilis, pityriasis versicolor, erythradma, leprosy. Large vascular spots can be localized on large areas of the skin. They tend to merge, have irregular outlines, clear boundaries and are called erythema. Erythema is always an acute inflammatory spot, therefore it can be combined with edema and be accompanied by intense itching. Erythema is formed as a primary morphological element in patients with allergic and contact dermatitis, eczema, toxidermia, erythema multiforme exudative and dermatosis herpetiformis.

Non-inflammatory vascular spots, formed as a result of reflex vasodilation during emotional stress, are characterized by the absence of swelling and peeling. They most often present as extensive, confluent pinkish-bluish patches on the face, neck, and chest and are called anger, embarrassment, or shame erythema.

Hemorrhagic vascular spots are rashes of complex origin, since they can be both inflammatory and non-inflammatory and are most often formed as a result of hemorrhage into the epidermis or papillary dermis. With an inflammatory hemorrhagic lesion, necrosis or increased permeability occurs in the vascular endothelium. Non-inflammatory damage to the integrity of blood vessels occurs as a result of bruises, toxic or mechanical effects. When blood enters the surrounding tissue, the outlines and size of hemorrhagic spots are different. Point, single small (up to 1 cm in diameter) hemorrhages are called petechiae, larger irregular outlines in the form of stripes - vibices, large areas of hemorrhages in the form of a "platform" - ecchymosis, and large bruises - hematomas and sigulations. Hemorrhagic spots differ from ordinary inflammatory, edematous ones in the presence of a rusty tint due to hemosiderin dye, as well as the absence of blanching when pressed. A disease or syndrome characterized by a rash of hemorrhagic spots (regardless of their size and shape) is called purpura, and it occurs in patients vasculitis, toxidermia, with hypovitaminosis C (scorbut), with infectious diseases (typhus, typhoid fever, scarlet fever).

Vascular spots formed due to persistent vasodilation, consisting of clearly distinguishable small blood vessels, sometimes branching tree-like, are called telangiectasias. They are formed as a result of persistent paralytic vasodilation, under the influence of the irritating effect of climatic factors, or as a result of neuroreflex excitation in adolescents during puberty.

With a decrease or increase in the content of pigment in the skin, depigmented or hyperpigmented spots appear. With an increase in the amount of pigment, spots of various shades of brown are formed. Depending on the size of the spots and the mechanism of their occurrence, hyperpigmented spots are divided into freckles, lentigo, chloasma.

Freckles - small foci of hyperpigmentation from the size of a millet grain to lentils, located on the face, chest, upper limbs under the influence of intense ultraviolet radiation, are often genetically inherited.

Lentigo - congenital nevoid foci of hyperpigmentation of various sizes and shapes, often with the presence of hyperkeratosis.

Chloasma - large dark brown or grayish-brown spots occur more often on the face, but can appear on any part of the skin. Hyperproduction of melanin can be caused by liver disease, hypofunction of the adrenal glands (Addison's disease), hyperfunction of the thyroid gland (Bazedow's disease), as well as various inflammations of the genitourinary organs in the prepubertal and pubertal period.

The spots formed as a result of the complete disappearance of the pigment, depending on the size of the defect, are called vitiligo or leukoderma.

Depigmented small spots are called leukoderma. True primary leukoderma is formed with insufficient synthesis of melanin due to intoxication in patients with secondary recurrent syphilis, typhus and typhoid fever.

Secondary pigment deficiency occurs in patients with psoriasis, eczema, pink or pityriasis versicolor in place of the primary elements, when sunburned areas form on the sites of the skin surrounding them under the influence of ultraviolet radiation. In the area of \u200b\u200bthe foci of inflammation, the ability of melanocytes to produce pigment is weakened. Such areas of depigmentation are called secondary leukoderma, or pseudoleukoderma.