Treatment methods in children
Treatment in children
Help, my child has vitiligo!
Vitiligo can manifest itself at any age. That has to do with genetic predisposition Half of people with a predisposition to vitiligo see the first spots before the age of 20e year of life appear. This means that there are many children and young people with vitiligo. Sometimes it starts as early as toddler or preschool age. What can you do then? Below is an overview of the treatment options.
Screening for thyroid problems
In any case, take your child to a dermatologist. Children with vitiligo should be screened for possible thyroid problems. Research has shown that vitiligo is sometimes associated with a thyroid disorder. This mainly concerns women over 35 with vitiligo. The risk is small in children, but because an undetected thyroid problem in a child can have major consequences (for example, growth retardation or learning problems), children with vitiligo are routinely examined for this.
Treatment options for children
There are several treatment options for people with vitiligo. For children, the dermatologist takes a slightly different approach.
The dermatologist (skin doctor) usually starts the treatment of a child with vitiligo with creams. Children usually receive a non-hormonal ointment, often Protopic. This has the advantage that even with long-term use there is less chance of side effects such as thinning skin, which can occur with hormone ointments (corticosteroids).
The other side is that you shouldn't expect too much from Protopic. This product mainly has a supplementary value to light therapy, but children under the age of 8 should not undergo light therapy yet. It is true that the cream can also have an effect in combination with normal sunlight. That is the basic idea of this treatment. The sun can also activate any pigment residues.
Never forget the sunscreen
The dermatologist's ointment (often Protopic) should be applied to the white spots in the evening so that it can be properly absorbed into the skin. The next day the child can play in the sun, but always be careful not to get burned. Always use sunscreen, because white spots burn approximately 30 percent faster than healthy skin. Apply protection factor 30 to those areas. A higher protection factor is not necessary, because then sunlight no longer has a stimulating effect on the pigment.
Light therapy
From the age of 8 it is generally possible for children to follow light therapy. This means that the white spots on the body are illuminated in a light booth with special UVB light (not tanning bed light!). The purpose of lighting is to stimulate and activate any pigment reserves that may still be in hair follicles. That is why dermatologists first look very carefully to see whether there are indeed still pigment reserves. If all the hairs in a white spot are also white, then the pigment has really run out and repigmentation is no longer possible. People with a darker skin type have a greater chance of success with light treatment.
Mixed success
A light treatment is intensive and time-consuming, a treatment takes a long time and the success varies.
For one light treatment, the skin must be illuminated for a few seconds three times a week for several months in a light booth or (for the face) with a light box. Those seconds slowly increase to several minutes. There must be at least 48 hours of rest between exposures.
Lighting at home
A complete treatment consists of 80 to 100 sessions. It is often possible to have one light booth at home available through health insurance for home lighting. That saves a lot of driving back and forth to a hospital.
Blacklight
Sometimes the effect does not last for a long time, but a doctor can still observe some growth of new pigment cells with a black light in a darkened room. There are cases where the effect is completely absent. Sometimes combustion does occur. In many others, the pigment does return, but it also happens that it slowly disappears after the treatment and white spots appear again. You can then follow a light treatment again, but this is not allowed indefinitely. Doctors consider three to five light treatments in your life responsible: three for people with light skin, five for people with dark skin. It is better to leave it at that to avoid damage.
Don't start too early
Specialists do not yet fully agree on what a good minimum age is to start light therapy. Also because the number of light treatments in your life must be limited, doctors do not want to start them too early in children. On average, a minimum age of eight years is currently assumed to start light therapy. But the dermatologist may deviate from this, based on considerations related to skin type, location of the spots and development of the child.
In recent years, it has become increasingly clear that people who use lighting do not run an increased risk of skin cancer. On the contrary: research shows that people with vitiligo actually have a slightly smaller chance of skin cancer than others. But: it is always important to prevent burns.
Pigment transplantation
Another treatment is pigment transplantation, for which there are several methods. These are not used in young children. It may be an option as children get older.
Help with bullying
It happens that children and young people with vitiligo are bullied because of their spots. This mainly happens in the summer when the spots become more visible because the unaffected parts of the skin turn brown, but those who have dark skin experience this all year round. Especially if the spots are in visible places and especially on the face. It can make children insecure. Sometimes they no longer dare to wear shorts in the summer or they no longer want to swim, for fear of critical looks or swear words.
What can you do as parents if you notice this in your child? Below are some tips.
- Help your child with a speech to explain vitiligo.
Experience shows that bullying quickly decreases when children understand what kind of stains they are. You can get one for free on the Vitiligo.nl website Request a speaking package. - Register your child with the Vitiligo.nl association, which brings together (parents of) children with vitiligo. The association organizes a members day at least once a year where children can meet each other and follow a targeted program to strengthen their self-confidence. The children also have fun on such a day and often keep in touch with each other afterwards via social media. As a member of Vitiligo.nl you will receive the members magazine four times a year Spotlight!, including a youth section and regularly updated information for parents. It membership of Vitiligo.nl costs 28 euros per year (as of 2022) and this amount is to be declared to some health insurers.
- Make one or more prints of the information card for your child kids book, which Vitiligo.nl gave to all members as a gift a few years ago.
- Join the closed Facebook group of Vitiligo.nl, where people with vitiligo and parents of children with vitiligo exchange experiences.
- Consider a foundation holiday camp The star. These holiday weeks are aimed at making children resilient and increasing their self-confidence in a fun week. Read the article in that Spotlight! No. 1 of 2018 was standing.
- In serious cases: ask your GP for help or a referral for psychological help. If necessary: speak to the school about the bullying policy.
