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Advice for Treating Vitiligo


Nada Elbuluk, MD, and David Rosmarin, MD, provide advice to physicians on the management of vitiligo.

David Rosmarin, MD: Do you have any other advice you would give to primary care physicians or to dermatologists out there, who are treating vitiligo?

Nada Elbuluk, MD: Yes. For primary care physicians or even dermatologists who may see vitiligo and don’t feel that they have enough specialization in it, it’s important—No. 1—to give patients hope and let them know there are treatment options. If they don’t feel equipped or comfortable to start those, get them to somebody who can. Now, with the Global Vitiligo Foundation and several other organizations, it’s easy enough to go and look at the physician directories and try to see who is within the local region, does specialize in vitiligo, and can see the patients. As we’ve just talked about, there’s a lot of unpacking, a lot that goes into the visit, and a lot that goes into figuring out the tailored treatment plan, if that’s what the patient wants. If they don’t feel comfortable doing it themselves, they can best serve the patient by getting them into the care of somebody who can. A lot of patients with vitiligo patients are willing to travel, too. I’ve had patients—and I’m sure you have, as well—come from far distances to see someone who specializes in vitiligo because they’re motivated to have a deeper conversation and know what all their options are. That’s important, because it is disappointing when patients come in and say they were told previously there was not much that could be done. Patients live with that answer for a long time; they don’t see any physician for years. Giving them hope, giving them the right treatment options, or getting them to see somebody who can do that for them is best.

David Rosmarin, MD: I agree. There’s a lot we can do to help patients. Unfortunately, some are discouraged, but there is a lot we can do. We can offer them hope, educate them, then there are these different treatment options and strategies. And often, even in combination, they could be synergistic. We’ll have more data about that coming out in the near future.

Nada Elbuluk, MD: Yes, I agree. The last nugget that I would add is I do like to give my patients information they can take home with them. I often give them some websites, including the Global Vitiligo Foundation and some of the other national foundations that have credible information. There’s so much misinformation out there on the Internet and social media, and sometimes patients can go down a rabbit hole on the wrong things. Giving them good resources they can use over time, after their visit with you and up until they see you again, is important. It’s also important to make sure you see the patient back at intervals that allow for enough treatment response but also allow you to check in with them. Everyone probably does it a little differently, but I try to see my patients every couple of months to check in, make sure they’re able to be adherent, and that things are going OK. Even if I don’t expect that they’d have a dramatic change between some of those visits.

Transcript edited for clarity

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