Permanent skin depigmentation

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Permanent skin depigmentation …

Permanent skin depigmentation
Martina Barbarin

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This PPT is loaded as student material "as is", from the VRF Vitiligo Master Class Barcelona November 2011; VRF does not endorse or otherwise approve it.

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  • 1. Permanent skin depigmentation Barbarin M. Faculty Hospital in Nitra, Department of Dermatology, Nitra, Slovakia
  • 2. Objective:
    • Permanent skin depigmentation is considered in patients with generalized vitiligo />50%/ unaffected skin is lightened to achieve a more uniform appearance.
  • 3. Methods:
    • Chemical permanent skin depigmentation uses Monobenzylether of Hydroquinone
    • Benoquin Cream /20% of MBEH/:
    • - is applied topically
    • - twice daily
    • - 3 to 12 months
    • KI: pregnanancy, brestfeeding
  • 4. Results:
    • The pigment removal with 20%MBEH:
    • - only for vitiligo patient
    • - is permanent
    • - produces a chalk- white color
    • - makes the skin vulneralble to
    • the sunlight and needs protection
    • /umbrella, long sleeves, hat/
  • 5. Case:
    • Michael Jackson
    • in 1986 diagnosed with
    • vitiligo and discoid LE
    • FH: vitiligo+
    • In the early 90s:
    • - discolorations covered most of the body
    • - he went throught the permanent skin
    • depigmentation /20% MBEH, it took
    • about a year/
  • 6. Chemicals effective in skin whitening
    • Pre-melanin synthesis:
    • Tretinoin 0,05-0,1% crm ./retinoic acid/
    • -makes the skin more sensitive to UVA,UVB- avoide sunlight
    • During melanin synthesis:
    • Hydroquinon 2%, 4% crm ./irrit./ popular for last 40 years
    • -EU banned it from cosmetics in 2001
    • Arbutin /safe natural source of hydroquinon in pears,berrys/
    • Kojic acid /fungal metabolit, in fermentation process of sake/
    • Azelaic acid 20% crm ./in grains-wheat,barley, is produced by Pityrosporum ovale/
    • Vitamin C >5%
    • Post-melanin synthesis:
    • Alpha hydroxy acids /AHA/ >5O% facial peels
  • 7. Other Laser treatments - ablative and nonablative /melasma/ Liquid N - excess melanin comes to the surface and peels off in a few days Oral suplements of pomegranate extract, ellagic acid, vit.E, ferulic acid,, soyabean /inhibit melanine production/. Long term use of skin whiteners can lead to pigmentation increasing to the joints of the -fingers -toes -buttocks and ears. The skin of the face can become -thinned -the area around the eyes can have increased pigmentation causing a „bleach panda effect“.
  • 8. Thank you