Vitiligo: Reconstructing Pigmentation Using Camouflage Techniques

Yes, indeed, micropigmentation specialists can help people with aesthetic skin problems return to normal life with the help of a camouflage procedure. However, I would like to focus on some very important aspects. We think that the article will arouse great interest among professionals and will give an idea of the knowledge in the field of reconstructive micropigmentation in the treatment of vitiligo.

Not sure - don't take it!

The process of pigment loss, the rate of its progression or regression proceeds very individually. Despite some advances in research, the causes of this disease are not fully understood, just as the possibility of disease progression after reconstructive micropigmentation is not always known. Therefore, it is rather difficult to assess the correctness of the actions of even the most recognized expert in micropigmentation.

Working in the field of reconstructive pigmentation requires great skill, intuition, experience and responsibility. Unfortunately, the practice is such that the emergence of any new trends in the permanent makeup industry and their active discussion leads, as a rule, to the emergence of a huge number of non-professional works in this area.

Before you declare in your resume that you are ready to provide dermapigmentation services, you must definitely remember: “enter” the area of professional activity in which the quality of life of people largely depends on our work (we are talking about people suffering from vitiligo and other forms of hyper- or hypopigmentation). Very often these are people who are not socially adapted, suffering from chronic depression, having difficulties in their careers and communication, often under severe stress. As a rule, their psychological attitude plays an important role during this long illness. Vitiligo camouflage is the work of specialists of the highest standard.
All the recommended techniques and the obligatory layering of the pigment make it possible to bring the pigmentation as close as possible to the skin color. The color of the skin of each person depends on the ratio in which the four colors - white, yellow, black and red - are combined with each other. Plus, the difficulty of a perfect match is the constant color change due to chemical processes, such as exposure to ultraviolet rays. Mismatching the color, unfortunately, and further non-professional corrections lead to the loss of the naturalness of the watercolor camouflage and the impossibility of correcting it in the correct version.

Unfortunately, in modern realities, the presence of a certificate and diplomas on training in masking and camouflage pigmentation technologies is not a guarantee of a decent job. And clinics that deal with the application of camouflage on a scientific basis are not always available. Of course, it is necessary to sign an information consent, which can protect us in case of unsuccessful work, but you must first of all be a professional of the highest level.

What kind of vitiligo can be corrected?

Despite the fact that the procedure for pigmentation of large areas with a universal and generalized type of vitiligo is considered standard, it is necessary to re-confirm the need for the procedure itself. Rather, it could be a classic tattoo camouflage on the appropriate equipment.
Application of the pigment by application gives absorption into the upper layers of the epidermis, but as such there is no need for such a procedure, since it will be eliminated from the skin (as the epidermis layer is renewed - once every 28 days) and does not affect the final result at all.
Pigmentation in central and acrofacial types of vitiligo gives the most pronounced aesthetic changes. The combination of permanent make-up and camouflage pigmentation in the area of the eyelids and mouth is especially effective.
As a rule, patients with dark skin color have more winning results than people with a light color type.

History taking is an important part of the procedure.

The collection of anamnesis deserves special attention. Discussing and deciding on pigmentation always requires honest questions and honest answers. At the same time, it is important to decide at what stage - progressive, stationary or regressing the disease is. The question of the stage of the disease is resolved by analyzing the history data and assessing the clinical picture. At the same time, specialists take into account the appearance of new elements, as well as the peripheral growth of existing foci.
Not all white spots on the skin are a symptom of vitiligo. There are a large number of skin diseases that look similar to vitiligo, but have a completely different origin and require different methods of treatment and correction. Among such diseases, it is necessary to designate postparasitic and syphilic leukoderma, white lichen, some skin congenital diseases, including anemic nevus, scleroderma, secondary depigmentation after burns, injuries and chronic skin diseases (psoriasis, atopic dermatitis, etc.), depigmented cicatricial changes. and many others. That is why it is so important to consult a dermatologist for the correct diagnosis and treatment. Self-identification of white spots on the skin by PM specialists, of course, is prohibited. As well as the procedure for stimulating melanocytes.
Specialists dealing with reconstructive pigmentation of vitiligo should only work in collaboration with a dermatologist who has experience in dealing with pigmented skin disorders.

Manifestation of the Koebner phenomenon

The manifestation of the disease and the use of techniques

It is believed that camouflage dermopigmentation techniques can be combined with any active treatment of vitiligo (therapeutic and surgical).

In the progressive stage, the procedure of reconstructive pigmentation is highly undesirable due to the high risk of the Koebner phenomenon - the appearance of fresh rashes at the site of an injury of any kind. If an advanced stage of vitiligo is detected or if the process is widespread, alternative methods of masking the foci are recommended with appropriate general treatment. These include artificial staining of the skin with various dyes (potassium permanganate, indigo carmine, henna, bismarck brown, etc.), periodic applications of products containing dihydroxyacetone (DHA), dermatological camouflage using masking cosmetics with a high concentration of pigments, ingestion of products containing betacarotene , and others.
The passive period of the course of the disease is different and depends on the type of distribution of vitiligo. Localized vitiligo usually stops progressing 1-2 years after onset.
Generalized vitiligo tends to slow progression only when it starts on the skin of the face (52% of cases).
Side effects of the pigmentation method are known: exacerbation of genetic infection, chronic granulomatous reactions to injected pigments, allergic reactions, positive Koebner phenomenon, skin pseudolymphomas, secondary infection and, of course, poor color matching.
Thus, unprofessional actions of a specialist can lead to an unstable internal state of the patient, which often aggravates the situation and is the cause of further progression of the disease.
Reconstructive pigmentation of vitiligo is a work without the right to make mistakes and a huge responsibility to people with their desperate attempts to hide their skin manifestations.