In last one decade we have noticed that there are mainly two kinds of challenges we face during the treatment and we end up in achieving less satisfactory outcome.
Difficult Vitiligo:
The type, site, severity, long duration, previous treatments, presence of white hairs or no hairs, age of patient, associated disease conditions, and underlying deficiencies/ derangements make a vitiligo, “difficult to treat”. However, we believe that no vitiligo is as such “difficult to treat”. There are one or the other ways to fight most of the vitiligo cases. Miracles do happen even in, most difficult vitiligo. Successful repigmentation is the sure end result in difficult vitiligo in a dedicated, determined, disciplined and involved patient. These are the ones who enjoy the journey so that they get the better destination. They are first happy with the treatment and ultimately become happy because of the treatment. They dedicate sometime for their vitiligo fight and focus on life style changes, diet modifications, stress management, skin care and be compliant in treatment and follow ups.
Difficult Patient:
This is the biggest challenge in achieving better outcome. It sounds harsh but this is the reality. Even simplest vitiligo in a difficult patients gives no expected outcome. We define difficult patients as the ones who only try to listen or understand what they want to listen or understand and do only those things which they like to do. They are least interested in listening or understanding what they need to listen and understand. They don’t do anything needed from them to fight their vitiligo. Success is like mirage to them. Such patients have high drop out rates and face more side effects. They are bothered by journey and never get the desired destination. They are never happy with the treatment and their only aim is to be happy because of treatment with unrealistic expectation, with out any dedication, determination, discipline and involvement. They are always busy and don’t have any time for their vitiligo fight and not willing to focus on life style changes, diet modifications, stress management, skin care and never compliant in treatment and follow ups.
