Vitiligo (often known as leucoderma or fulvary) is a cosmetic disorder where the skin loses its color in patches of irregular shapes and sizes. This is a pigmentation disorder which means that melanocytes (the pigment producing cells) in the skin get destroyed. Melanin dictates the color of our skin, eyes and hair. If melanin is no longer produced by your skin cells white patches start appearing on your skin. Vitiligo symptoms usually appear first as white patches in small areas of the skin. This "may" eventually spread and become larger over time. Vitiligo is never present at birth. More than 30% of people with vitiligo have a family history of the disorder, pointing to the presence of genetic factors capable of contributing to the condition. People with vitiligo must protect their skin from exposure to the sun. Affected areas of skin can become seriously sunburned while the surrounding skin tans. Affected people must be vigilant about using sunscreen with a high sun protection factor (an SPF of 30 or above) on exposed skin. During long periods outdoors, they should wear long sleeves, pants and wide-brimmed hats. Vitiligo Treatment Most commonly a remedy called PUVA for those seeking to darken white skin patches, especially when the condition is extensive. PUVA involves taking a drug called psoralen, which makes the skin very sensitive to light, followed by exposure of the affected skin to a special lamp chamber. Occasionally, when the vitiligo patches are very limited, psoralen can be applied directly to the skin before ultraviolet rays exposure. If ultraviolet chambers are not available, sun exposure can also be recommended by your doctor. At least a year of twice-weekly treatments is usually needed to restore melanin production. The treatments are 50 to 70% successful in restoring color on the face, trunk and upper arms and legs. The goal of PUVA therapy in vitiligo is to reverse the effects of the disease and re-pigment the white patches. Additional Therapies • Cosmetically Camouflage • Topical Steroid Therapy : Steriod creams are the simplest and safest treatment for vitiligo. • Punch Grafts • Suction Blister Grafting is a vitiligo treatment that seeks to promote the growth of blisters in a normal skin area by means of suction. The blisters are then cut and transplanted to the cut blister area of the affected site. It is considered as social taboo in India. Though it is just cosmetic in nature but because of social pressure it gives sleepless nights to patient & family.