Last Updated on 10th March 2023 by Caroline Haye
There is still no satisfactory cure for vitiligo. But there are certainly enough re-pigmentation stories to show that it’s a condition that does respond to therapy. There are a number of different treatments that can be effective to one degree or another. It’s just that no single one works for everybody. And the precise mechanism involved in skin re-pigmentation is still a bit of a mystery. I don’t think there is even a consensus on whether the process of re-pigmentation is the same in every case. Maybe it’s a variety of different processes going on in the skin, or different ones for different people. For example, was my re-pigmentation, using nutrition together with UV light, the same mechanism as for a patient who has had success with UVb therapy alone? Probably not. (See my Nutrition Summary page.) But, regardless of that, the way that colour returns to previously de-pigmented skin often looks the same. It starts as freckles that appear around the base of hairs. Which poses the question, what is the connection between hair follicles and re-pigmentation?
How follicular re-pigmentation works
Successful UV treatment typically results in follicular re-pigmentation. If I understand it correctly, narrow band-UVb therapy works through two separate processes within the skin. Firstly, UVb radiation activates the stem cells located in the “niche” at the bulge region of the hair follicle. And secondly, it causes keratinocytes – another type of skin cell within the epidermis – to produce the hormone α-MSH. This, in turn, binds to receptors on the melanocyte and activates melanin production. Colour returns to the skin surrounding the follicles in freckles at first. And then gradually migrates outwards and joins up to produce larger “islands” of normal pigmentation.
The significance of hair follicles
The fact that re-pigmentation tends to occur mainly in those areas of skin where there are still hairs containing colour points to the significance of hair follicles. But surely this can’t be the whole story because skin (and hair) can, and do, re-pigment in areas where the hairs have lost their colour. And skin can, and does, re-pigment in areas where there is little or no hair growth at all. For example, most of my white eyelashes returned to their normal colour. Similarly, so did areas of the hair on my head that had been white. Also, the undersides of my arms where there is no visible hair whatsoever re-pigmented. (As well as the outer portions where there is some hair growth.) And this is despite having been totally white for decades. However, those parts of my hands and feet that are completely hairless have proved much slower to respond. So they are still – just like the sum of knowledge on the mechanics of re-pigmentation itself – a little patchy!
More about the re-pigmentation process in 3 Examples Of Vitiligo Recovery.
2 thoughts on “Hair follicles and re-pigmentation of vitiligo”
Sir,
How kuch time UVB takes to start re-pigmenting skin?
And how a biginner should start to NB-UVB light?
For how much time light should me taken in each session?
There is no quick answer to your question because there are so many variables. For example, your skin type, any medications you are taking that might make your skin more sensitive to UV light, and the strength of UV light being used. However, there are some guidelines that are important to know before you start. And it would be wise to check with your doctor or the manufacturer of your UV device for exact timings.
The general principle of treating vitiligo with UV light is to start with just a few seconds exposure per day, allowing at least one “rest day” between each treatment and gradually increase the exposure each time by increments of a few more seconds (referring to the user manual and/or doctor’s prescription for exact amounts). The treated area should appear pink after each treatment (a normal clinical reaction known as “erythema”) but should definitely not be sore. If soreness occurs, you should allow sufficient rest days for the skin to recover before resuming treatment at the lowest exposure once again.
I hope this helps 🙂