Prednisone for Vitiligo

[Shahmatt]

I'm a dermatologist and see patients with Vitiligo frequently. I want to say I treat them, but I have not found a really good treatment, so I work out how bothered they are and try to use the safest treatments possible and see how it goes. Topical steroids are helpful, but obviously limited by their cutaneous adverse effects. UVB to me seems fairly poor- I have never had anyone respond particularly well. Probably the most effective treatment are the calcineurin inhibitors - topical tacrolimus and pimecrolimus of which 0.1% tacrolimus (Protopic in UK) is most likely to help. It can be used much longer term without the side effects of steroids and can be used safely on the face (not necessary in your case). If a patient said they preferred not to treat I would say that was perfectly reasonable.

As for the cause- we don't know. There seems to be a tsunami of interrelated autoimmune disease in the developed world. It will be a combination of genetics/triggers but no one is really clear in the case of vitiligo.

Good luck

Thanks for your comment.

I have actually been prescribed with Protopic and Vizomet (Mometasone Furoate which I believe is a steroid). I have been told to alternate the application of these, e.g. Vizomet in the morning and Protopic in the evening. Protopic is pretty expensive, but I managed to find an alternative 0.1% tacrolimus ointment that was much cheaper.

Since my situation seems stable, and seemingly getting better, I thought I would stop the steroid and replace it with black seed oil.

Question: If I stop Vizomet cold turkey would it be a problem? For Prednisone there was a weaning off period from 2 tablets a day to 1 a day for two weeks. I apply Vizomet once a day, should I reduce to alternate days before stopping?

I came across a Youtube video of an eye doctor who suffered from dry eyes. He tried supplementing with Omega 3 for three months, and this improved his situation significantly. Omega 3 appears to also have some impact on skin health.

I have an unlikely theory, but I'll throw it out there just in case. The Vitiligo first began to appear when I was getting heavy on my lifts last November (330lb squat). Due to travel, family and work related interruptions I have not yet regained that weight, though I am getting there. The lesions first appeared just above my shoulder blades, very close to where the bar might rest while doing a squat.

My guess is that as the weights got heavier my body did not have the necessary nutrients to support muscle growth and everything else. Somehow the immune system got out of whack, leading to the Vitiligo first appearing on my back, maybe where most muscle growth was taking place.

I plan to supplement with Omega 3, Vit D, Multivitamins and also get as much sun as I possibly can over the next few months. The Omega 3s I ordered come today, 90 tablets, so 3 months from now I should know if it worked.

[Shahmatt]

It's now 3 months since I began with the plan. Amazingly the vitiligo lesions, particularly the oldest ones, have repigmented substantially.

Furthermore the lichen planuspilaris, which affects my scalp, is also showing a significant reduction in activity.

It seems amazing that these common autoimmune diseases could simply be the result of inadequate nutrition and sunlight.