Heal House Vitiligo Research 30 · Original article
Vitiligo on hands and feet — when pigment doesn’t return, can a tattoo match the color?
Micropigmentation for Acral Vitiligo: An Open-label Pilot Study of 12 Patients
In short
Micropigmentation (medical tattooing) was performed for vitiligo on areas like the hands and feet where treatment is not very effective. Among 20 lesions, color matched the surrounding skin in 17—more than eight out of ten.
Among vitiligo, pigment returns particularly poorly on fingertips and toes. Light therapy and lasers also show slow response in these areas, so both patients and I have long struggled with them. Therefore, I thought of a method to “match” the color instead of “restoring” it. We tried medical tattooing, i.e., micropigmentation, which directly implants pigment into the skin, on the hand and foot lesions of 12 patients to see if it could be an alternative.
Q1 How effective was it?
Seventeen out of 20 treated lesions achieved a color that matched the surrounding skin very well — a rate of over eight out of ten. The number of sessions needed was generally not high: typically 2 sessions (range 1–5). Right after the procedure, the color appeared slightly darker than the surrounding skin, but it naturally lightened and settled over time. The advantage of this method is that it can relatively quickly fill areas where pigment hardly returns.
Q2 Was it painful or were there side effects?
The pain during the procedure was not mild, but it was tolerable without anesthetic injections. After the procedure, redness and swelling occurred but subsided within a few days. There were no allergic reactions to the pigment and no Koebner phenomenon (spread of vitiligo due to irritation). However, for good results, it is important to precisely select the pigment color and the depth of implantation.
Closing remarks
We found that micropigmentation can be a realistic alternative for vitiligo on the hands and feet, where color is particularly slow to return. Patients also welcome the fact that no anesthesia is needed and that color is filled in right after the procedure. Of course, it is closer to a “complement” that matches the color than to a “treatment.” That is why I think it is important to assess carefully which patients it suits before recommending it.
