DEAR DR. DONOHUE: I have vitiligo, and it keeps spreading over my body. My father had it on his legs. I’m an older lady of brown complexion. This vitiligo is so embarrassing. I wear slacks every day, except to church. Do you know of any cover-ups for it? —C.
ANSWER: Vitiligo is the loss of special skin cells called melanocytes, cells that produce the pigment melanin, which gives skin its color. The loss comes about because of an immune attack on those pigment cells. Genes are one of the ingredients that lead to vitiligo. Your father is an example of the genetic influence.
The skin patches devoid of melanocytes and melanin become chalky white and are most noticeable on people with dark skin. The patches appear on the face, in circles around the mouth and eyes, on the neck, trunk, arms and legs.
Stronger varieties of cortisone in creams, lotions and gels often can coax melanocytes back into the depigmented skin. Many users have enjoyed success with skin applications of pimecrolimus (Elidel cream) or tacrolimus (Protopic ointment). Ultraviolet light, along with the oral psoralen drugs, is another way of repigmenting vitiliginous skin.
Quite a few people with vitiligo find it more convenient to apply cosmetic agents to cover the white patches and make them blend with adjacent skin. Covermark (800-524-1120), Dermablend (800-662-8011) and Cover Fx (416-665-7444) are three popular products. I’ve included the phone numbers of the manufacturers in case you cannot find the products in your area.
The National Vitiligo Foundation, Inc., will provide you with information on the many ways that vitiligo is treated. The Web site is www.nvfi.org, and the phone number (not toll-free) is 513-541-3903. You’ll find the foundation to be a friend that can help you cope with vitiligo.
DEAR DR. DONOHUE: Our friend, age 86, has Alzheimer’s disease. She sees a neurologist every four months. Some days, she is lucid; other days, she’s out in left field. She lives alone and drives a car. She recently got lost, but recovered and came home safely. Her children live out of town. We, her friends, think the time has come for our friend to give up independent living. What criteria are used to make this decision? — C.F.
ANSWER: Your friend’s lapses fill the criteria that indicate a need for assisted living. Although 50 percent of people with a degree of dementia make this decision for themselves, that leaves 50 percent who do not. Giving up one’s home and one’s car has unpleasant ramifications for that half who want to continue living independently. Close relatives can convince these people that they need help. A doctor can step in and strongly advise such moves. You and your friends would do this woman a service by contacting her children and telling them exactly what you have told me.
The booklet on Alzheimer’s diseases discusses it and its treatments. Reader can obtain a copy by writing: Dr. Donohue — No. 903W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.