In patients who have extensive vitiligo, it is often more feasible to remove the existing pigment that trying to repigment the vitigo skin.
3 methods are commonly used to achieve depigmentation:
1. Monobenzyl ether of hydroquinone:
This product must be used with caution and must not be allowed to come into contact with anyone other that the patient for obvious reasons.
Depigmentation achieved with monobenzyl ether of hydroquinone (Courtesy Dr N Raboobee)
2. Liquid nitrogen
Depigmentation can be achieved by applying liquid nitrogen to spots of pigment present on a background of extensive vitiligo
Liquid nitrogen was used in this patient to remove the spots of pigment in a background of extensive vitiligo
(Courtesy Dr N Raboobee)
3. The Q-switched Alexandrite laser and he Q-switched ruby laser are able to remove pigment quite accurately. However, these devices are not widely available.