Permanent skin depigmentationPermanent skin depigmentation

Barbarin M.

Faculty Hospital in Nitra, Department of Dermatology, Nitra, Slovakia

Objective:Objective:

Permanent skin depigmentation is considered in patients with generalized vitiligo />50%/

unaffected skin is lightened to achieve a more uniform appearance.

Methods:Methods:

Chemical permanent skin depigmentation uses Monobenzylether of Hydroquinone

Benoquin Cream /20% of MBEH/: - is applied topically - twice daily - 3 to 12 months

KI: pregnanancy, brestfeeding

Results:Results:

The pigment removal with 20%MBEH:

- only for vitiligo patient

- is permanent

- produces a chalk- white color

- makes the skin vulneralble to

the sunlight and needs protection

/umbrella, long sleeves, hat/

Case:Case: Michael Jackson in 1986 diagnosed with vitiligo and discoid LE FH: vitiligo+

In the early 90s: - discolorations covered most of the body - he went throught the permanent skin depigmentation /20% MBEH, it took about a year/

Chemicals effective in skin whiteningChemicals effective in skin whiteningPre-melanin synthesis: Tretinoin 0,05-0,1% crm./retinoic acid/ -makes the skin more sensitive to UVA,UVB- avoide sunlight

During melanin synthesis: Hydroquinon 2%, 4% crm./irrit./ popular for last 40 years -EU banned it from cosmetics in 2001Arbutin /safe natural source of hydroquinon in pears,berrys/Kojic acid /fungal metabolit, in fermentation process of sake/Azelaic acid 20% crm./in grains-wheat,barley, is produced by Pityrosporum ovale/Vitamin C >5%

Post-melanin synthesis:Alpha hydroxy acids /AHA/ >5O% facial peels

Other Other Laser treatmentsLaser treatments- ablative and nonablative /melasma/- ablative and nonablative /melasma/Liquid NLiquid N- excess melanin comes to the surface and peels - excess melanin comes to the surface and peels off in a few days off in a few days Oral suplementsOral suplements of pomegranate extract, ellagic acid, of pomegranate extract, ellagic acid, vit.E, ferulic acid,, soyabean /inhibit melanine production/.vit.E, ferulic acid,, soyabean /inhibit melanine production/.

Long term use of skin whitenersLong term use of skin whiteners can lead to pigmentation increasing to the joints of the can lead to pigmentation increasing to the joints of the -fingers-fingers-toes-toes-buttocks and ears.-buttocks and ears.

The skin of the face can become The skin of the face can become -thinned -thinned -the area around the eyes can have increased pigmentation causing a -the area around the eyes can have increased pigmentation causing a „bleach panda effect“.„bleach panda effect“.

Thank you