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Treatment Effects on Quality of Life in Patients With Vitiligo

Opinion
Video

Chesahna Kindred, MD, MBA, FAAD, examines how treatment can affect the quality of life in patients with vitiligo.

Heather Woolery-Lloyd, MD: We’re going to change gears a little bit and talk about quality of life, because that is something that’s so important to me as a practicing dermatologist. I really care about my patients’ quality of life, and I wanted to talk a little bit about how treatment affects quality of life for our patients with vitiligo. [Dr Kindred], can you tell us about how treatment affects quality of life in your vitiligo patients?

Chesahna Kindred, MD, MBA, FAAD: This is very straightforward. Studies show that if a treatment works, there is improved quality of life. What we’re really talking about is repigmentation, if they get their skin back. It’s not like, for example, acne, where they have a bump added on, or psoriasis, where they have a rash. [With] vitiligo, you’ve lost something. You’ve lost your skin color. We’re talking about getting to a level of normalcy, and it really affects so much. When we repigment the patient, their social phobia dissolves, the depression improves, so on and so forth. It’s directly linked to them getting their skin back.

Heather Woolery-Lloyd, MD:I would agree. In my practice, if you can repigment a patient’s face, it changes their entire quality of life. Some women were putting on a full face of makeup, coverage makeup to cover their vitiligo—women, men, and children—for events, special events, or just to go to work if they had jobs where they did not feel comfortable and wanted to cover their vitiligo. Just that simple change of getting 20 minutes back in your morning where you don’t have to cover your entire face with makeup, and my patients will tell me that. For a lot of my male patients, the impact on quality of life is huge because a lot of those patients may not feel comfortable using coverage makeup. It’s the first time that they actually get to see the skin color that they were born with on the face. I really think repigmenting the face in my practice has a tremendous impact of quality of life. The body is very important, and repigmentation on the body is helpful also, but I find the biggest impact is when we see repigmentation on the face.

Chesahna Kindred, MD, MBA, FAAD: Yeah, I think that’s the order: face then hands then the rest of the body. That is what we see. You touched upon something. Occupation—and it makes a huge difference in my patients, patients in sales, my [male patients] who have a job where people are close up. Where I trained at Howard [University, in Washington, DC], we would actually color-match them with makeup—men and women, by the way. But if their coworkers had a job where they are close up, then the makeup and the men, that combination was very touch and go.

Heather Woolery-Lloyd, MD: I agree. Mainly because facial hair. When you have makeup over facial hair, it becomes more obvious. With men, it’s much more difficult to cover vitiligo on the lower face because the makeup would be very obvious when it’s over a 5:00 shadow, basically. Very good point.

Transcript edited for clarity.

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