Before making an appointment, arm yourself with information.
- Research current vitiligo treatments in order to decide which treatments you are comfortable with and best fit your lifestyle and budget. (You can find detailed information on the full range of vitiligo treatments and factors affecting choice of treatment at Treatments. (The specific treatments a physician may recommend will depend on the type of vitiligo and the age and health of the patient).
- Locate a vitiligo specialist or doctor willing to prescribe current treatments and be encouraging and supportive. Feel free to check beforehand if they are treating other vitiligo patients and willing to offer a choice of treatments. If the patient is a child, you’ll want to know if they have experience treating children with vitiligo and what treatments are offered for children.
Check VSI’s list of patient-recommended doctors for physicians in your area:
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Prepare formyour visit.
- Be prepared to provide basic information to the physician such as:
- When did you first notice pigment loss?
- Were there precipitating factors, such as sunburn or illness?
- Did the vitiligo begin slowly with a single depigmented area?
- Did you notice many small areas over the entire body?
- Did it begin rapidly and spread quickly?
- Be prepared to describe your experience with any previous vitiligo treatments, including:
- How long ago did you see the prescribing doctor?
- Are you currently using any type of treatment? If so, what?
- Which treatment/s have you tried?
- How did you use the treatment? For example, if it was a topical treatment, how many times a day did you apply it? How long did you leave it on? How many days a week did you apply it?
- How long did you use the treatment? (days, weeks, months)
- Did you see results?
- Did you experience side effects? If so, what were they?
- Have available information on your family’s history with any of the following:
- Early graying/white hair
- Alopecia areata
- Thyroid disease (either hypo-or hyperthyroid)
- Insulin-dependent diabetes
- Pernicious anemia
- Addison’s disease
- Celiac disease
- Other medical, surgical, environmental, social or emotional issues
Having a friend or family member along and/or taking a tape recorder on this first visit may be useful in recalling instructions or information later.
Know what to expect from your visit.
Diagnosis and evaluation procedures:
Each doctor’s protocol will differ, but the following are common procedures to expect.
- a total body skin examination
- observation with a Wood’s lamp (similar to a black light)
- photographs of representative areas in order to track progress on follow-up exams
The doctor may also order laboratory tests to assist his/her evaluation of the vitiligo. Typical lab tests for vitiligo include all or part of the following:
- Antinuclear Antibody (ANA) – This test helps determine if the patient has other autoimmune diseases.
- Thyroid peroxidase antibody (TPOAb) – Thyroid antibody testing is primarily ordered to help diagnose an autoimmune thyroid disease and to separate it from other forms of thyroiditis.
- Complete Blood Count (CBC) with differential,
- comprehensive metabolic panel,
- thyroid panel, including Free T3, Free T4 and TSH
- 25-Hydroxy-Vitamin D
Some doctors will prescribe vitamins or supplements to help stabilize the immune system. These are not so much a treatment but an adjunct therapy. The list below includes some of the more typical supplements recommended as frequently vitiligo patients have decreased levels of these vitamins:
- Multi Vitamin
- Vitamin B12
- Folic acid
- Vitamin D
While these supplements are generally considered safe, age and health may affect the dosage and appropriateness of some or all of these supplements for certain individuals.
If your doctor recommends a treatment, important questions to ask that can help you decide whether you want to go forward with the treatment are:
- How does this treatment work to help vitiligo?
- What are its possible side effects?
- How is it used and how often?
- If topical, can it be washed off? If so, after how long?
- If you want to apply sunscreen and the topical medication, which would you apply first?
- What type of results might you expect to see?
- How long will it take for me to see results?
- How long will you use this treatment?
- Does insurance normally cover the treatment? If not, can the doctor help to secure coverage?
- How much will the treatment cost?
When will you see the Doctor again?
Depending on the prescribed treatment, most doctors will want to see the patient again in around 3 months to assess progress.
You may also find the following information helpful:
How to Evaluate Effective Treatments- Reasonable Expectations
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