Although there are many therapies currently available for vitiligo sufferers, not every patient responds to treatment. For patients with large patches of pale skin in visible areas such as the face and hands, depigmentation may be considered as a final resort. This is a controversial treatment for some ethnic groups that view skin color as an important part of their identity. However, when repigmentation is not possible, some individuals choose this option so that they can at least have the same skin tone all over.
Skin Bleaching Isn’t for Everyone
This therapy is not prescribed by dermatologists as a cosmetic procedure to provide overall skin whitening for individuals with normal pigmentation. The results for a person with healthy melanocytes (pigment producing cells) would tend to be very uneven as the skin continues to try to restore normal coloration. Instead, depigmentation is reserved for patients who already have a compromised ability to produce melanin. For these individuals, treatment simply quickens the progression of aggressive vitiligo so it affects the skin more rapidly.
Benoquin, a powerful monobenzyl ether hydroquinone cream, is usually the medication prescribed for vitiligo patients seeking depigmentation. The treatment process is very lengthy – it can take several years to complete. Usually, mild skin irritation is the only side effect. This should subside within a few minutes after application. In the event that a patient is allergic, a rash typically develops within the first couple of days of treatment.
Some dermatologists test the cream on one area of the body first over a period of several months to determine whether the patient is likely to respond to full body treatment. Although the cream is applied topically, the results are not confined to areas that receive direct treatment with Benoquin. So, some dermatologists may recommend applying the cream to visible areas like the face and arms and allowing the rest of the body to gradually lighten as the depigmenting effects spread. This may result in uneven pigmentation on areas of the body not treated directly with Benoquin.
Patients who have their pigment producing cells destroyed are at increased risk for sunburn for the remainder of their lives. Avoiding sun exposure during the middle of the day and using a high SPF sunscreen is recommended to reduce skin damage. Sun exposure can also cause spots of repigmentation – particularly on the face. When these occur, Benoquin can typically reverse the effects and turn the skin white again.