Treating Vitiligo in Kids: Your Ultimate Guide!
Did you know that approximately half of all people with vitiligo develop it before they turn 20? In fact, 25 percent of cases occur even before the age of 8! But fret not, because there are various treatment options available for children with vitiligo. From topical medications to systemic treatments and phototherapy, the aim is to bring back color to the skin. Surgical treatments are also an option, but they are recommended only in stable, localized cases where other therapies have failed.
To delve into the topic of treating vitiligo in children, we reached out to the incredible Dr. Pearl Grimes, director of the Vitiligo and Pigmentation Institute of Southern California and a clinical professor of dermatology at the University of California, Los Angeles.
Should Vitiligo in Children Be Treated?
Here's the thing: vitiligo itself is not life-threatening nor does it cause severe health problems. However, it is often associated with other conditions like autoimmune thyroid disorders, alopecia areata, and diabetes mellitus. On top of that, vitiligo can make kids self-conscious, reduce their self-esteem, and cause emotional stress. In fact, a study found that more than half of the people with vitiligo surveyed said they experience people staring at them, while 25 percent mentioned facing challenges while interacting with strangers.
In a 2018 Nature article, vitiligo researcher Dr. John Harris wrote, "Some people with the condition are demanding that it be accepted as part of everyday diversity."That being said, parents may still choose to seek
treatment for their children, and Dr. Grimes pointed out that numerous options are available. She emphasized the importance of starting treatment as early as possible.
At What Age Should Treatment Begin?
"I absolutely love treating kids," exclaimed Dr. Grimes. "If we compare the outcomes of children to those of adults in our database, one thing becomes clear: kids have better outcomes. That's why it's crucial to start therapy as soon as vitiligo is diagnosed in children. There's a much greater likelihood of better results over time."
Dr. Grimes revealed that it's not uncommon for parents to request vitiligo treatment for their children, sometimes as young as 2 years old. While it might seem early, she believes that it could enhance the child's outcomes.
"If the onset occurs at age 2, the data suggests that the prognosis may not be as good," she explained. "There's a higher chance that the condition will progress, potentially leading to more severe involvement over time."
When evaluating young children, many factors will be considered such as their immune system status, disease progression, and the severity or affected body surface area. "The advantages of treatment should always outweigh the disadvantages," she asserted. Assuming the criteria are met, Dr. Grimes would recommend treating a child with vitiligo.
Which Treatments Are Used for Kids with Vitiligo?
Dr. Grimes follows a therapeutic approach with three primary objectives:
1. Stabilizing rapidly progressive vitiligo.
2. Achieving repigmentation (bringing back color to affected skin).
3.Maintaining consistent follow-up with the child and their family to preserve repigmentation.
By adopting this approach, Dr. Grimes has been able to determine the long-term success of treatments.
Stabilization:
When vitiligo in children is on the fast track, Dr. Grimes taps into her bag of tricks, which might include a two-week course of oral corticosteroids. These superheroes swoop in to save the day, slowing down or even halting the spread of vitiligo.
Repigmentation:
The ultimate goal? Repigmentation! Dr. Grimes works her magic, summoning the powerful calcineurin inhibitors like Protopic (Tacrolimus). These enchanting allies perform wonders, especially on the face, a key concern for our brave youngsters and adults alike. Alternatively, topical corticosteroids come to the rescue, showcasing comparable results. When vitiligo takes a wider stance,
narrowband UVB phototherapy steps onto the scene, ready to illuminate the path. And for those stubborn, localized areas, Dr. Grimes reveals the secret weapon:
targeted phototherapy, wielded by the mighty excimer laser.
While complete and permanent reversal may not always be within reach, Dr. Grimes always strives for the best outcome tailored to each individual. She chases after the optimal level of repigmentation, pushing boundaries to achieve as much as possible. If her patient reaches 50 percent at six months, she won't rest until they've reached 75 percent or more of their color's grand return.
Determining when to ease off can be quite the puzzle, as outcomes vary for each child. Once treatments have plateaued and multiple therapies have been adjusted, she gently backs away, allowing her patients to continue their vibrant journey. For some, maintenance treatments may be necessary to preserve the hard-earned repigmentation. Dr. Grimes keeps a watchful eye, providing intermittent support or twice-a-week calcineurin inhibitors, adapting to each child's unique needs.
Maintenance:
Just like a thrilling adventure, maintenance varies for each young explorer. Some may triumph over their condition and bid farewell to treatments altogether. However, even if the journey concludes, regular follow-ups are essential. After all, vitiligo is an autoimmune disorder with its fair share of companions, and our adventurers need to stay vigilant.
The Future Beckons:
One remarkable trial took center stage, featuring the topical JAK inhibitor Jakafi (Ruxolitinib). Dr. Grimes excitedly revealed that the outcomes were nothing short of excellent. While the initial phase 2 study didn't involve children, the ongoing phase 3 trial is now enrolling brave adventurers aged 12 and above.
Parental Support on the Journey of vitiligo treatment:
As our young heroes embark on their vitiligo treatment journey, their parents become their steadfast allies. Encouragement plays a vital role, motivating children to actively participate in their treatments. Dr. Grimes advises parents to assist their kids in following their prescribed regimens.
Even in the face of disruptions caused by the pandemic. For example, phototherapy sessions may have experienced a temporary lapse, but a structured approach remains key to achieving the best outcomes. Ideally, two to three sessions per week keep the adventure on track. To overcome obstacles, home phototherapy becomes a valuable ally, enabling children to continue their colorful quest from the comfort of their own homes.
In addition to treatment adherence, parents can safeguard their little explorers by protecting them from sunburns, a potential trigger for vitiligo. Dr. Grimes recommends instilling stress-management strategies, ensuring that kids have a joyful and well-rounded life throughout their journey.
So, gear up and join us on this fantastic voyage of vitiligo treatment for our young adventurers! Together, we'll unlock the secrets of repigmentation and create a vibrant future filled with laughter, courage, and boundless possibilities. Let the fun and professionalism intertwine as we conquer vitiligo, one colorful step at a time!