GPs have access to a wide range of resources to help you manage your vitiligo – but with most appointments only lasting about 10 minutes it’s really important that you are aware of the ways in which your doctor can help. During your appointment you can request different kinds of support form your GP, and we hope this will give you an insight into what you can ask for, and help you prioritise your time during your appointment.
Here are the 7 ways in which your GP can help you, at any stage in your vitiligo journey:
1: Provide information about vitiligo
GPs can provide you with lots of useful information, the key important things we advise you ask about include:
The Knoeber Phenomenon and how it may affect your daily life and routines. Avoiding trigger factors such as friction and trauma may help to reduce new depigmentation, so it’s important to understand how your environment may be affecting your vitiligo.
A number of treatments are available, and we are beginning to see more and more treatments undergo clinical trials – so as these (hopefully) become available, it’s important for you to understand what is available to you. Your doctor is the best source of information for this, or our Society can help advise you on what’s available for you to research ahead of your appointment..
They should tell you about charities that can help you. The Vitiligo Society provides support and education for people with vitiligo and their families/carers, and raises awareness about the condition. It has an online community and local support groups. The patient information About vitiligo may be helpful.. The UK charity Changing Faces (website available at www.changingfaces.org.uk) provides details of local skin camouflage services, a telephone helpline, and online support forum; both are recommended for referral by the NHS to its practitioners.
2: Advise on the importance of effective sun protection and vitamin D supplementation
Most of us know that sun protection is very important. Some NHS Trusts may still provide sunscreen on prescription, but not all. High-factor sunscreen with protection against ultraviolet A and B (for example Uvistat® or Sunsense®) can be prescribed (these are classified as ‘borderline substances’ and the prescription must be endorsed ‘ACBS’). Your GP can advise on this and also provide advice on the need for 4-star or 5-star UVA rating and sun protection factor 50 to people with vitiligo. They can help you understand the importance of application to affected patches and surrounding skin before going outdoors into the sun.
In addition you may consider asking your GP about your vitamin D requirement. The body creates vitamin D from direct sunlight on the skin when outdoors, so when people living with vitiligo avoid the sun or use High SPSF sun protection, this can lead to a deficiency in vitamin D. Your doctor can advise on supplements and diet to help address this.
3: Offer referral to a skin camouflage service
Skin Camouflage can be a powerful tool in helping you live happily with your vitiligo. Highly pigmented cover creams and powders are available in a range of shades and colours that can be colour matched to the person’s skin tone. They are lightweight, waterproof, and easy to apply to the face and anywhere on the body after training. They may remain on the face for 12–18 hours, and on the body for up to 4 days.
A local skin camouflage service may be available through your local dermatology service – your GP can advise on this and make this referral for you. They may also suggest that you self-refer to the charity Changing Faces, which provides education from skin camouflage practitioners on the use and application of cosmetic camouflage creams and powders. The website (available at www.changingfaces.org.uk) provides patient information on Skin camouflage, details of local skin camouflage services, a telephone helpline, and online support forum.
Your GP can also talk to you about alternative options to camouflage such as self-tanning products that provide lasting colour for up to several days. Cosmetic micropigmentation and tattooing which is a more permanent option.
4: Offer support for any psychological symptoms or conditions that have resulted from your vitiligo
Vitiligo is more than a cosmetic condition, and it can seriously affect your self esteem and confidence. This in term can have a dramatic affect on your mental wellbeing. Your doctor should be asking questions about the impact of vitiligo on your daily life, and whether it’s making you feel anxious or depressed in any way. Never feel you have to down-play how vitiligo is affecting you psychologically and socially., and if you need support for this then make it clear to your GP. They have the ability to refer you for emotional and psychological support – don’t be afraid to push to get access to this help at any point in your vitiligo journey.
5: Offer treatment options
Currently the first treatment you may be offered is a potent topical corticosteroid once daily for up to 2 months. You will likely be prescribed this if you meet all of the following criteria: An adult with non-segmental vitiligo that is localized or limited (affecting less than 10% of the body surface area); Treatment is not applied to the face; For women, they are not pregnant; There are no contraindications to corticosteroid treatment. If you are given this you should also be scheduled for a review after one and two months to monitor your body’s response to it.
6: Arrange referral to a dermatologist
If you do not meet the above criteria or you do and have not had success with the prescribed treatment then your GP can arrange a referral to a dermatologist where other treatment options may be discussed. We hear that a lot of people get referred but never hear from a dermatologist – don’t give up! If you need this help then keep following it up until you get the help you need. You GP may also be able to help you explore other treatment options whilst you wait for your referral – they can do this by seeing specialist advice on treatment options
7: Check for, and arrange an investigation on any potential coexisting autoimmune conditions
There are a number of conditions that seem to be common in people with vitiligo. Vitiligo might share certain genetic or environmental risk factors with other conditions. Certain immune cells and processes that trigger inflammation in vitiligo also play a role in some other conditions. Your GP can check for these conditions and arrange a further investigation if they suspect you may have one.
if you have any questions before or after your GP appointment then please don’t hesitate to get in touch with us, we’re here to help: email@example.com