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Vitiligo

Vitiligo is known to be associated with social stigma and a decreased quality of life, especially when lesions are located over the face. While there are numerous treatment options for vitiligo, most of these need a long time to produce good cosmetic results. Camouflaging the skin lesions can be a useful option in such patients. The proper use of camouflage has been shown to improve the quality of life in patients with vitiligo. In this article, we discuss the different camouflage options available in vitiligo - products and techniques with their relative advantages and disadvantages.

History

The concept of skin camouflage developed during the Second World War when plastic surgeons associated with the British Royal Air Force (RAF) began searching for durable skin-colored preparations to help conceal burn scars. Sir Archibald McIndoe, a plastic surgery consultant to the RAF, established a patient support group - the "Guinea pig club," members of which were the first to try camouflage creams prepared by Thomas Blake, a chemist from the company Veil. Another pioneer in the area of skin camouflage was Joyce Allsworth who also started work in the field of skin camouflage during the post World War II period. She went on to establish the British Association of Skin Camouflage (BASC) practitioners


Importance of Camouflage in Vitiligo

Vitiligo can be associated with social stigma, especially in darker skin types. Unlike most internal illnesses, skin diseases like vitiligo are often immediately visible to others and therefore may lead to significant psychosocial consequences. Focusing on enhancing self-esteem and improving the quality of life in vitiligo patients should be an important part of the management of vitiligo. Studies have shown that cosmetic camouflage can definitely improve the quality of life in patients with vitiligo. Patients should also be helped in selecting and using a camouflage preparation that best suits their needs. The concept of specialist "camouflage therapists" has gained ground in some countries. A camouflage therapist may educate the patient about the techniques involved in using camouflage preparations to normalize their appearance. A proper knowledge of camouflage therapy can be a very good adjunct to other dermatological treatments for vitiligo.

Classification

Camouflage in vitiligo can be broadly classified into temporary camouflage and permanent camouflage. Temporary camouflage includes liquid dyes, indigenous products, foundation-based cosmetic camouflages and self-tanning products. [11] Permanent camouflage is achieved mainly by micropigmentation/medical tattooing.

Temporary Camouflage

Liquid dyes

Potassium permanganate, indigo carmine, Bismarck brown and henna pastes were commonly used to camouflage vitiligo. All these have the disadvantage of being washed away easily. Getting a color match with the surrounding skin is also very difficult.

Indigenous preparations (Traditional Indian Preparations)

Iron fillings (Loha Bhasma) and Suvarna Karini (clay mixed with henna and oils) have been used as camouflage materials. Getting a good color match is difficult with these preparations too.

Foundation-based cosmetic camouflage

These are the most common and best daily use preparations available for camouflage purposes. Camouflage preparations typically contain up to 25% more pigment compared to normal make-up foundations. They also contain fillers endowed with specific optical properties. Camouflage make-up products are also waterproof and are designed such that a single application lasts a whole day.  Camouflage preparations are essentially facial foundations. There are four basic facial foundation formulations: oil-based, water-based, oil-free and water-free forms. The most popular facial foundations are of the liquid oil-in-water emulsion types that contain a small amount of oil in which the pigment is emulsified with a relatively large quantity of water. The primary emulsifier is usually soap, such as triethanolamine or a non-ionic surfactant. The secondary emulsifier is usually glyceryl stearate or propylene glycol stearate. Facial foundations are manufactured in a variety of finishes like matte, semi-matte, moist semi-matte and shiny. Matte-finish foundations are mostly suitable for cosmetic camouflage. Foundations are also available in a variety of forms: liquid, mousse, water-containing cream, soufflι, anhydrous cream, stick, cake and shake lotion. Most camouflage preparations are formulated as creams because it is possible to incorporate increased concentrations of iron oxide into a cream formulation to provide better coverage.

The following considerations must be addressed in an ideal camouflage:

  1. Color: Camouflage make-up must match all skin tones and it should blend with the color of the area on the skin it is intended to cover evenly.

  2. Opacity: Camouflage make-up must conceal all types of skin discoloration, yielding as natural and normal an appearance as possible.

  3. Waterproof: Camouflage make-up must ideally be waterproof.

  4. Sweat resistant: The camouflage preparation should not smudge or be washed away as a result of sweating.

  5. Holding power: Camouflage make-up must adhere to the skin without sliding off.

  6. Longer wear: Camouflage make-up must provide the assurance of long wear with easy reapplication as and when needed.

  7. Ease of application: Camouflage make-up must be easy to apply. Complicated colors and steps may make it difficult for the patient to use daily. 

  8. Non-allergic/non-comedogenic/non-photosensitizing: Camouflage products should ideally be inert, without a tendency to cause allergic contact dermatitis, photodermatitis or acne.

  9. Sun-screening capacity: Any opaque substance applied on the skin will, by default, have sun-protection capacity. Ideally, a camouflage should have a good, homogenous sun-protection capacity.

  10. Ease of removal: The products should also be relatively easy to remove at the end of the day with non-alcohol-/non-acetone-based make-up removers.

  11. Cost-effective: All the desirable properties of a camouflage product need to be in the context of also being cost-effective.

Properly applied camouflage techniques can help improve the patient′s appearance considerably, thereby improving the patient′s self-esteem and quality of life. For practical purposes, the best camouflage products are the foundation-based cosmetic preparations. These can be used as daily wear creams and provide the best color match options. Permanent camouflage can be done by micropigmentation, but it has to be used understanding its limitations and disadvantages.

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TOP EXPERT IN INDIA 

EXPERT IN TREATMENT  for Vitilago

Team is highly qualified and very passionated to care for you at every step of providing care. 

Kuldeep Raizada, Ph D BCO, BADO, FAAO

Kuldeep Raizada is a Licensed Ocularist in Hyderabad, a Board Certified Ocularist (BCO)  from National examination Board of ocularist’s, USA and a Board Approved Diplomate Ocularist (BADO) from American Society of ocularist’s, specializing in ocular prosthetics since 2001, Kuldeep places his emphasis on the satisfaction and well-being of every patient. His clinical  skill and expertise are equally matched by his personalized care for patients and attention to detail.

Kuldeep Raizada completed his basic optometry education at Gandhi Eye Hospital, Aligarh, and has his training at L V Prasad Eye Institute, Hyderabad. where he was also Founder and Head of the Department of Ocular Prosthesis services till 2009. He completed a second fellowship, in Anaplastolgy, at MD Anderson Cancer Centre, Houston. He has also been trained by the top most ocularist and anaplastologist in United States of America.

His clinical interests include ocular and facial prosthesis, particularly in pediatric patients. His research interests lie in newer advancement in development of new types of prosthesis, newer solution for ptosis corrective glasses. 

Kuldeep Raizada, is Founder & Director of the International Prosthetic Eye Center since 2010, where he is practicing since 2010.

Kuldeep Raizada has been recognized by the American Society of Ocularist, USA and American Anaplastology Association,USA and by several other professional organizations, for his excellence in research and clinical practice.

Kuldeep Raizada, have completed all requirements by American Society of Ocularist, which is hard work of 14000 working hours as well extensive study for prosthetics, Hence awarded the Diplomate Ocularist from American Society of Ocularist, USA, 2012, Chicago, USA, which is the First ever received all over Asia Pacific & throughout Middle East so ever. 

 At present he is reviewer of several journals like Contact Lens & Anterior Eye, International Journal of Anaplastology, Oculoplasty & Reconstructive  Surgery (OPRS) and Many others. He has published and presented world widely.

Fact About Kuldeep

  • CEO & Chairman of Akriti

  • Founder & Director International Prosthetic Eye Center, India

  • Founder of Healthcare India Magazine

  • Receipt of Abdul Kalam Award.

  • First ever Indian to received  Board Certifications, from National Board of examination of ocularist, USA, He was the first One all over Asia Pacific & throughout Middle East.

  • Developed First Digital Dynamic Facial Eye Prosthesis

  • Developed physiological Near Stereo test 

  • Developed physiological Distance Stereo test 

  • Developed ETDRS Log Mar Vision Charts in Hindi for 4 Meters

  • Developed ETDRS Log Mar Vision Charts in Telegu for 4 Meters 

  • Developed ETDRS Log Mar Vision Charts in Assamese  for 4 Meters 

  • Developed ETDRS Log Mar Vision Charts in Arabic for 4 Meters 

  • Developed ETDRS Log Mar Vision Charts in Bangla for 4 Meters 

  • Developed ETDRS Log Mar Vision Charts in Tamil for 4 Meters 

  • Developed ETDRS Log Mar Vision Charts in Oriya  for 4 Meters 

  • Developed ETDRS Log Mar Vision Charts in Kannada for 4 Meters

  • Developed ETDRS Log Mar Vision Charts in Malayalam for 4 Meters 


Deepa D Raizada, MS, BCA, BCO, BCCA 

Deepa completed her diploma and clinical fellowship in optometry at L V Prasad Eye Institute, India, in 2003, pursued her graduation from Madhurai Kamraj University, 2006.

She had completed her Master of Science (M Sc)  in “Maxillofacial and Craniofacial Technology” (2010-2012), King’s Collage London, UK where she was trained to work exclusively  in the field of Maxillofacial Prosthetics.

Deepa is also an associate Member of The Institute of Maxillofacial Prosthetist & Technologist, UK  (AIMPT) since 2014. & Active Member of International Anaplastology Association, (IAA) USA  since 2009.

Deepa Have make a remarkable success in becoming "Asia's First Board Certified Clinical Anaplastologist ( BCCA") and Bring glory for India as to Make India Fifth Nation to have a Board Certified  Clinical Anaplastologist.

She Did complete her Board Certification for Ocularist (BCO), By National Examination Board of ocularist, USA in March 2018 

She persued her basic training in Ocularistry from L V Prasad Eye Institute, Hyderabad and advanced training in Ocular Prosthetics (May – July, 2005) at Moorefield’s Eye Hospital, London, UK under Mr Nigel Saap. 

She worked as an Ocularist at Ocular Prosthesis Department, L V Prasad Eye Institute from 2003 – 2010. She worked with different type of techniques, developed new techniques in the fabrication and fitting of ocular & facial Prostheses. Her  work was well recognized and appreciated.

Her clinical interest include make her career in the art and science of facial prosthetics and ocular prosthetics, particularly in pediatric patients. Her research interests lie in developing new techniques in the field of facial prosthetics, and undertake research on materials used in this field.

Deepa Raizada has been recognized by the Oculoplasty Society of India, Indian Optometric Association and by several other professional organizations in India as well as Internationally, for her excellence in research and clinical practice.

Email ID: deepadraizada@gmail.com, deepaocularist@gmail.com

Fact about Deepa Raizada:

  1. She is the  First Indian Lady to be American Board Certified Ocularist  (BCO) as well as Board Certified Clinical Anaplastogist (CCA).

  2. Her credentials are unmatched with any one from Asia, Middle East, Africa &  Europe. First Ever Indian Lady to be American Board Certified Ocularist  (BCO) 2018 

  3. First Ever Indian Lady to received Her Board Certification in Clinical Anaplastology (CCA) 3rd Individual in the World to have CCA and BCO, (Other 2 in USA) 

  4. She bring the glory  to India for bringing the First Ever CCA &  made a land mark for India to 5th country in the world.