It sounds like you have Vitiligo. This can happen in Caucasians (my brother-in-law has it) but it's devastating to black people. Here is some information I have found and I have left you a website to go too: by Thomas B. Fitzpatrick, MD , Ph.D Three myths about the treatment of vitiligo prevail in the medical profession. The first myth is that treatment of vitiligo is "impossible." This is clearly not true and the majority of patients can achieve good results. The second myth is that oral psoralens, which form the basis for some vitiligo treatments are "toxic to the liver." Oral psoralens are not toxic to the liver. The third myth is that psoralen + UVA (PUVA) treatments for vitiligo "cause cancer of the skin." When used to treat vitiligo, PUVA therapy requires only a limited number of treatments-approximately 150 in number that has not been shown to cause skin cancer. By comparison, PUVA treatments for psoriasis can be as many as double the number for vitiligo. It has been shown that a small percentage of patients who receive more than 250 PUVA treatments can develop treatable squamous cell cancers of the skin. Four options are currently available for the treatment of vitiligo: sunscreens; cover-up; restoration of normal skin color; and bleaching of normal skin with topical creams to remove normal skin pigment to make an even color. The two goals of sunscreen treatments are: to protect unpigmented involved skin from sunburn reaction and to limit the tanning of normal pigmented skin. The sun protection factor (SPF) of sunscreens should be no less than SPF 30, as this grade blocks not only erythema, but also the affects of sunlight on the DNA of the skin cells. Sunscreen treatment skin phototypes 1, 2, and sometimes 3 (those who burn, then tan to some degree). The goal of cover-up with dyes or make-up is to hide the white macules so that the vitiligo is less visible. Self-tanning lotions and camouflage are quite helpful for some patients. Restoration of normal skin color can take the form of spot treatments or whole body treatment. Initial treatment with certain topical corticosteroid creams is practical, simple, and safe. If there is no response in 2 months, it is unlikely to be effective. Physician monitoring every 2 months for signs of early steroid atrophy (thinning of the skin) is required. Much more complicated is the use of topical Oxsoralen (8-MOP). Oxsoralen is highly phototoxic (likely to cause a sunburn), and the phototoxicity lasts for 3 days or more. This should be performed only as an office procedure, only for small spots, and only by experienced physicians on well-informed patients. As with oral psoralens, 15 or more treatments may be required to initiate a response, and 100 or more to finish. Mini grafting, which involves transplanting the patient's normal skin to vitiligo affected areas, may be a useful technique for refractory segmental vitiligo macules. PUVA may be required following the procedure to unify the color between the graft sites. The demonstrated occurrence of Koebnerization in donor sites in generalized vitiligo restricts this procedure to patients who have limited skin areas at risk for vitiligo. "Pebbling" of grafted site may occur. For more widespread vitiligo, treatment with oral psoralen + UVA (PUVA) is practical. This may be done with sunlight and trimethylpsoralen (Trisoralen) or with artificial UVA (in the doctor's office or at an approved phototherapy facility) and Trisoralen or Oxsoralen-Ultra.
Ophthalmologic examination and ANA blood tests are required before starting PUVA therapy. Outdoor therapy may be initiated with 0.6 mg/kg Trisoralen followed 2 hours later by 5 minutes of New England sunlight (less in southern regions). Treatments should be twice weekly, not 2 days in a row, and sunlight exposure should increase by 3 to 5 minutes per treatment until there is a sign of response, and in a few this causes koebnerization. Individualization is required: treatment options are either 0.4 mg/kg of Oxsoralen-Ultra (well absorbed, efficient potentially very phototoxic, significant risk of nausea) or 0.6 mg/kg of Trisoralen (variably absorbed, not very phototoxic, little nausea).
Initial UVA exposure should be 1.0 J and increments (twice weekly, not two days in a row) 0.5 (Oxsoralen-Ultra) to 1.0 (Trisoralen) J per treatment until there is evidence of response of phototoxicity. The later is the sustaining UVA dose until reasonable repigmentation has been established.
PUVA is up to 85% effective in over 70% of patients with vitiligo of the head, neck, upper arms, legs, and trunk. Distal hands and feet are poorly responsive and alone are not usually worth treating. Genital areas should be shielded and not treated. Macules that have totally repigmented usually stay in the absence of injury/sunburn (85% likelihood up to 10 years), macules less than fully repigmented will slowly reverse once treatments have been discontinued. Maintenance treatments are required.
Risks of treating vitiligo with PUVA include nausea, GI upset, sunburn, hyperpigmentation, and acute dryness. We advise against oral PUVA treatments for children under age 10. Treatment is most likely to be successful in highly motivated patients who clearly have reasonable objectives and understand the risks and benefits. While PUVA is not a cure, most patients who are responding well to treatment are not at the same time developing new vitiligo macules. www.avrf.org/treatments/treatments.htm I wish you good luck & God Bless
Surely you jest. The Beatles were from the 1960's.
Chorus: Surely, Surely, Surely, Surely He's able, to carry you thro ooo, ooo, ooo, ooo Verse: (Leader and Choir) As pilgrim we, we sometimes journey. We often know not, which way to turn But there is one, who, knows the road. Who'll help us carry, who'll help us carry Every lo-------ad 1st Refrain He's able, He's able, He's able, He's able; May gather, around you, so dark and sable Chorus: Surely, Surely, Surely, Surely He's able, to carry you thro ooo, ooo, ooo, ooo Verse: (Leader and Choir) As pilgrim we, we sometimes journey. We often know not, which way to turn But there is one, who, knows the road. Who'll help us carry, who'll help us carry Every lo-------ad 1st Refrain He's able, He's able, He's able, He's able; May gather, around you, so dark and sable Surely, Surely
Not at this time but surely in the future
YES
It surely did kinda.
Slowly but Surely was created on 2004-10-11.
I clean it up. Slowly but surely
Surely, a lot of unsolicited advice will come your way as soon as your belly started showing or as soon as they learned you are pregnant. The best way to deal with is to just smile at them and politely change the topic.
It dissolves slowly but surely, it will mix when you put your filter on!
It progressed slowly but surely, and took full form in the 1800.
First define your goals and what you want out of life, and slowly and surely you will get there step-by-step. That'll be your direction.
it started 23 Mar 2010 Surely it cannot be 2010. Please provide right answer. It should be 2001.
absolutely YES because the management of Tokyo broadcsting system said that the showing of hyd final is a worldwide showing.And surely,Philippines was included in the showing.
Newmoon, Eclipse, The runaways,and Coming slowly but surely...... ' Breaking dawn'
well, if she broke, show sympathy. then become her friend. slowly but surely, you'll get there.
Because it damages the value of the site to users. Vandalism is slowly but surely dealt with as it is discovered, and restriction is often permanent.
Moe Koffman - Days Gone Byhttp://www.youtube.com/watch?v=war-LU3kWU4