Vitiligo

Vitiligo is a disease manifested by loss of pigment in the skin. It is an acquired disorder that often runs in families. It is characterized by depigmentation or total lack of melanin pigment. It can occur in small localized areas or be widespread. Fifty percent of individuals develop the disease before the age of 20 and 25% develop the disease before the age of 10. The cause is unknown but is believed to autoimmune in nature. It is more commonly seen in individuals with endocrine disorders such as thyroid disease.

DIAGNOSIS

The diagnosis can be made clinically in the presence of well demarcated areas of depigmentation found symmetrically over boney prominences such as the knees or around body orifices such as the mouth, eyes and perianal or periurethral area. When the diagnosis is unclear, a skin biopsy may need to be done.

MANAGEMENT

Patients with vitiligo must be advised to follow strict sun protection. The areas of skin affected by vitiligo cannot tan and will burn with sun exposure. Sunburns raise the risk of skin cancer. Also, when normal surrounding skin is tan the loss of pigment is more noticeable. Also, since vitiligo can be associated with endocrine disorders such as thyroid disease, blood tests to rule out an underlying disorder may need to be performed.

TREATMENT AND MEDICATION

Treatment options are influenced by the amount of skin involved and the location. Often a trial of treatment with a topical corticosteroid is the initial treatment choice. Topical immunomodulators such as Protopic Ointment or Elidel Cream have also been shown to be effective and are more appropriate for extended use on delicate areas. A series of narrowband ultraviolet light treatments (NB-UVB) have also been found to be very effective. The excimer laser delivers NB-UVB directly to specific skin areas without affecting normal surrounding skin. Ringpfeil Advanced Dermatology has an excimer laser and is proud to be able to offer excimer laser treatment to our patients. Excimer has come to be preferred over older light treatment modalities such as PUVA (psoralens plus ultraviolet A). The advantage of excimer over PUVA is shorter treatment times, decreased risk of phototoxic reactions, and the ability to use excimer in children, pregnant women and in individuals with kidney or liver disease since no oral medication is utilized. In cases where depigmentation due to vitiligo is very extensive, permanently removing all remaining pigment can be offered for cosmetic reasons.

COPING

For individuals who are self-conscious about vitiligo involving visible areas such as the face and hands, cosmetic products under the brand names of Covermark or Dermablend are available for camouflage. The National Vitiligo Foundation is an organization that can be a resource for educational materials and support groups.

Online Consulation

Get treatment plan from Dr. Ringpfeil or Dr. Abraham by tomorrow evening without visiting the office.

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    SKIN

Uncensored Patient Reviews

Performance Report

(Based on 3675 surveys)
Would you recommend us?
definitely
93.1%
probably
6.16%
maybe
0.58%
not likely
0.08%
no
0.02%
Compare our service to other similar practices
excellent
87.9%
very good
10.1%
good
1.8%
poor
0.06%
very poor
0%
Overall doctor performance
excellent
94.2%
very good
4.89%
good
0.80%
poor
0.03%
very poor
0%
The doctor listened to you attentively
excellent
93.9%
very good
4.97%
good
1.05%
poor
0.05%
very poor
0%
The doctor took time to answer your questions
excellent
94.0%
very good
4.66%
good
1.27%
poor
0.02%
very poor
0%
The doctor explained treatment options
excellent
94.3%
very good
4.16%
good
1.25%
poor
0.14%
very poor
0.02%
The doctor explained treatment options
excellent
92.0%
very good
5.69%
good
2.18%
poor
0.11%
very poor
0.0%
Front desk performance
excellent
85.6%
very good
10.2%
good
3.66%
poor
0.31%
very poor
0.08%
Aesthetician performance
excellent
88.6%
very good
7.61%
good
3.39%
poor
0.24%
very poor
0.08%
Office comfort
excellent
90.9%
very good
6.93%
good
2.08%
poor
0.05%
very poor
0.05%
Parking
excellent
66.4%
very good
14.4%
good
15.7%
poor
2.49%
very poor
0.9%
Friendliness of the staff during appointment
excellent
90.9%
very good
7.23%
good
1.85%
poor
0.05%
very poor
0%

What did we do Well?

(answers:674)
#1
2013-09-24
I appreciated that Dr. Ringpfeil took the time to thoroughly explain everything we spoke about. She did not simply provide a professional opinion, she provided her opinion and supplemented it with an explanation that made everything clear to me. I felt like I was listened to and interacted with, rather than just spoken at (which has often been my experience with other dermatologists). Thank you!
#2
2011-05-18 16:40:00
The doctor explained things thoroughly to me. She was able to treat a couple of skin growths on site today. I was given a couple of sample products as well as a coupon toward the purchase of one of the prescribed products that I am to use.
#3
2013-08-27
Thought Dr. Ringpfeil was very nice and professional!
#4
2013-05-08
The doctor was very nice!
#5
2013-10-08
Didn't have to wait long to see to get into the room, or for the doctor to come in. The doctor & medical assistant took the time to explain the medications, when I should take them, how much I should use and what they would do to my skin.
#6
2013-07-29
Friendly, well educated
#7
2011-05-09 10:24:13
VERY efficient.I loved that.
#8
2014-03-17
the swiftness and kindness of the staff, felt very comfortable
#9
2010-12-22 11:56:01
Knowledgeable and friendly staff...very short wait
#10
2011-01-27 16:47:12
I felt at ease and well informed.

What can we do better?

(answers:373)
#1
2013-07-22
more relaxing music
#2
2014-01-06
Everything was well above my expecatations.
#3
2011-03-24 10:10:11
While I totally understand the late policy, unfortunately my daughter and I drove 1.5 hrs to the facility and given the weather and errorous directions, we ended up being 7 mins late. I immediately called the office while on route to explain that we were lost and sought correct directions. The receptionist was very curt, short and condesending. Upon our arrival, there was no warm greeting and very limited eye contact. Again,as a heath care provider myself, I appreciate the need to follow a schedule, however, our appointments were in direct succession and I do not think it would have had a significant impact on the work schedule, given our special circumstance.
#4
2013-08-28
No recommendations - very satisfied/pleased with everything about the visit and the office and the Doctor and her assistants. thank you to everybody for makinng me feel so comfortable (i was verrrrrry nerous)!!
#5
2011-11-17 12:08:50
The only downside is parking!
#6
2013-12-24
Nothing that I could think of would be better.
#7
2014-03-03
just keep giving me good news and no cancer.
#8
2013-08-14
Try to get enrolled as a provider in Tricare Prime!
#9
2013-11-06
fantastic service
#10
2013-05-31
not sure yet