Immediate Post Laser Care CO2 Laser Treatment Beachwood Plastic Surgery

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http://www.lasersandlifts.com.au • For much more on vitiligo treatments and phototherapy • / drdavinlim • For lots of up to date procedures and videos • Realself reviews: • http://www.realself.com/find/Australi... • • Google + for up to date info. Posted daily. • https://plus.google.com/u/0/b/1139391... • • Vitiligo is a common autoimmune disorder affecting the pigment producing • cells. In Brisbane, up to 2% of the population will have vitiligo. • Frequently involved sites include the face, including the • perioral and periocular areas, flexural areas, acral areas of the hands and • feet, and around naevi. Hair roots may also be involved, a condition known as • ‘poliosis.’ One third of vitiligo patients have a family history of autoimmune • disorders including thyroid disease, diabetes and pernicious anaemia. • The primary aim of management is to halt the progression of depigmentation, • and if possible obtain repigmentation of effected areas. • Conservative management: It is appropriate to consider whether initial • treatment maybe to use no active treatment other than a high factor • sunscreen and camouflage cosmetics. This especially applies to stable, nonprogressive • vitiligo in fair skin patients. • Topical treatment: Trial of a potent topical corticosertoid for 8-10 weeks. • Consider Diprosone ointment for trunk and body, Advantan ointment for • facial areas. Topical corticosteroids must be used with caution, monitor for • skin atrophy.Topical steroid sparing agents such as Tacrolimus should be considered as adjunctive treatment,or alternatives to steroids. These preparations are not associated with skin • atrophy, however skin irritation maybe commonly encountered. • Phototherapy: The use of narrowband phototherapy has replaced PUVA • due to the superior efficacy and improved safety profile. Narrowband • phototherapy should be considered if vitiligo is widespread, progressive • or in patients who fail topical modalities. It should also be considered in • patients with a significant impact on their quality of life. A minimum of 30-50 • phototherapy sessions are needed to determine efficacy. • Lasers in Vitiligo treatment: The role of lasers in the treatment of • vitiligo is limited. Clinical trials using fractional lasers for stable vitiligo are • currently being undertaken in various International centers and at Westside • Dermatology. The laser of choice is the Eximer 308- however in most cases this is not covered under insurance, unlike phototherapy. • Psychological treatments and support groups: The impact of this condition • is often underestimated. Consider psychological and support group referral. • Support groups can be arranged via vitiligo.org • Investigations for vitiligo: Given the strong association with autoimmune • conditions, screening thyroid function tests, glucose level and B12 levels • should be conducted at baseline, and repeated every 2 years, earlier if there • are clinical indications. Diet can play a role in the treatment of vitligo. I supplement my patients with Vitamin D and Gingo at 40-60 mg daily. • Thanks for watching- please do not ask me if I know anyone else around the World who owns a phototherapy device, as I really do not know of other dermatologist who may or may not treat vitligo. • Dr Davin Lim, Vitligo expert. Dermatologist. Brisbane Australia • For bookings to see if you are suitable for phototherapy, call reception on 07 38713437. A referral is needed as I am a Specialist Dermatologist.

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