(1)Early treatment principle
Many practices shows that,in the early stage of vitiligo,treatment maybe easier.Early leucoderma of 1~2 month,usually disappears after half a month to two months treatment.
Incipient leucoderma still has incomplete damage melanin in skin lesion,so we call it “incomplete vitiligo”.It should be treated as early as possible, so there are possibilities to make melanophore in basal layer of leucoderma recover ,division grow,secrete melanin and be sent to epidermis layers by dendrite to reach the best effect.At the same time,incipient vitiligo has small area and the melanin around it can move to it, which will help to make vitiligo disappear quickly and shorten the course of treatment.
If illness exceeds one year, the course will be prolonged.If exceed over several years or decades the treatment will be quite difficult for melanophore in basal layer of leucoderma is complete destroyed and even the melanophore in hair follicle has also completely disappeared.
Therefore, incipient treatment and incipient diagnosis are important principle for vitiligo treatment.We need to know,the early skin lesion usually appears to be punctate and sheet reduce splash.Its edge is fuzzy and presents loom,which is quite difficult to distinguish with normal skin.It is easy to be misdiagnosed to pityriasis alba or sweat stain and etc. Thus, the optimal treatment time will be lost for therapeutic miss and error.On the contrary,there are also facial pityriasis alba, amelanotic nevus, nevus anemicus being misdiagnosed to vitiligo and no effect after long term treatment.Therefore, we should identify them carefully.
(2)Different times for vitiligo treatment principle
In the course of the disease,vitiligo can be divided to stationary phase and development stage.
In treatment, avoid using external drug without discrimination.For vitiligo development stage,treatment should mainly focus on endotherapy and adjust the immune function and neuroendocrine functions of body.If there are other disease of extrapyramidal motor systems
In development stage,avoid strong light radiation or ultraviolet ray in case that they will burden melanophore ,increase the virulent products from melanophore metabolism and aggravate autodestruction of melanophore.At the same time, don’t coating exterior intense thrill drug,such as fluorouracil,nitrogen mustard and psoralene and etc in case local stimulus response.These will damage melanophore and aggravate immune disturbance and then lead to vitiligo spreading and enlarging.
For development vitiligo,especially small area development vitiligo, we can consider mainly use external medicine assisting with phototherapy.
Chinese medicine thinks incipient vitiligo is pathogenic wind blocking type,mainly treat by dispel the wind.Lasting hurt ,vital energy and blood imbalance, stasisloodhinders and branches of channels blocking are so-called persistent illness entering collaterals, we should treat it by promoting blood circulation to remove blood stasis and regulate qi and dredge the collaterals.Lasting disease,deficiency of liver and kidney and essence and blood loss are so-called lasting disease involving body,we should treat it by nourishing liver and kidney and supplement spirit and blood.This dialectical ideas has great reference and guidance significance in vitiligo treatment.
(3)Comprehensive treatment principle
For pathogenic factors for vitiligo are complicated and extensive,and they interplay with each other and interact as both cause and effect.And the detail mechanism is still not clear.Therefore, any simplex treatment and medicine will be limited and the course of treatment is long ,and treat rate is low.
Therefore,at least at the present stage,we should persist comprehensive treatment.For example, as for segmental vitiligo,we should consider not only neurochemistry factors,but also immune turbulence factors.It is necessary for improvement of effect and treat rate to make systematic and comprehensive treatment program.In our country,thousands of years Chinese medicine practice have accumulated plenty of experience and prescription to treat vitiligo.If we combine Chinese and Western medicine,the effect will be better than simplex Western medicine without doubt.Therefore,we emphasize combination of internal and external,combination of Chinese and Western medicine,combination of medicine and physiotherapy or other therapies.