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ASPEN, COLO. -- The relaunch of a unique tar formulation could mean a new treatment option for patients with vitiligo and other hypopigmenration disorders, according to Dr. R.W. Urbanek.
The compound, known as V-Tar, has a direct effect on melanocytes as well as a cosmetic effect, Dr. Urbanek said at a surgery seminar sponsored by the Colorado Dermatology Center.
V-tar features a 30% concentration of tar in a highly solubilized suspension that allows it to go on easily and readily penetrate the skin. "Other tars are a particulate suspension in a vehicle [and they] look like soot on the skin," said Dr. Urbanek, a dermatologist in private practice in Staten Island, N.Y. "This looks more like a watercolor."
Dr. Urbanek started using V-Tar almost 30 years ago, when it was developed and sold by Syosset Laboratories Co. Closure of the company as well as legal disputes, kept V-Tar off the market from the mid-1970s until last year, when Dermasave Labs purchased the formula and resumed its production.
Dr. Urbanek has no financial interest in either company
Patients like V-Tar because "you can make people look better the same day" Dr. Urbanek said, so they are likely to comply with treatment. He "paints on" a small amount in the center of the lesion before spreading it out toward the edges, taking care not to overlap with pigmented areas to avoid darkening that skin. He starts with a small amount and adds more gradually until he matches the patient's natural color.
Most patients apply it in the same fashion once a week, leave it on for 4-6 hours, and then wash it off of facial areas. Melanogenesis usually begins within 2 months, or after eight applications. He has followed some patients as long as 20 years who are still producing melanin in the treated areas after stopping treatment.
Facial vitiligo is the primary indication for V-Tar, but Dr. Urbanek has used it on patients who develop hypopigmentation for other reasons. He has patients apply a steroid cream on "off" days to keep any inflammation under control.
Dr. Urbanek said the major adverse effect reported by his patients who use V-Tar is a stinging sensation on their skin upon exposure to sunlight, which is especially frightening to children but has no lasting effects.
Sunlight may act synergistically with the tar preparation, so patients may darken too much unless they have protection. The synergistic sunlight effect can be used to advantage on difficult-to-repigment areas on extremities, but it generally is better not to complicate therapy with ultraviolet light on easily repigmented areas such as the face. Patients are advised to avoid the sun as much as possible and to wear hats, sunscreen, and protective clothing.
Dr. Urbanek suggests not prescribing V-Tar for patients whose vitiligo covers more than 30% of their body surface area. Treatment may be too time consuming.
Since aromatic compounds present in the tar may elicit an allergic response, he recommends patch testing if patients are known to be allergic to perfumes.
The compound, known as V-Tar, has a direct effect on melanocytes as well as a cosmetic effect, Dr. Urbanek said at a surgery seminar sponsored by the Colorado Dermatology Center.
V-tar features a 30% concentration of tar in a highly solubilized suspension that allows it to go on easily and readily penetrate the skin. "Other tars are a particulate suspension in a vehicle [and they] look like soot on the skin," said Dr. Urbanek, a dermatologist in private practice in Staten Island, N.Y. "This looks more like a watercolor."
Dr. Urbanek started using V-Tar almost 30 years ago, when it was developed and sold by Syosset Laboratories Co. Closure of the company as well as legal disputes, kept V-Tar off the market from the mid-1970s until last year, when Dermasave Labs purchased the formula and resumed its production.
Dr. Urbanek has no financial interest in either company
Patients like V-Tar because "you can make people look better the same day" Dr. Urbanek said, so they are likely to comply with treatment. He "paints on" a small amount in the center of the lesion before spreading it out toward the edges, taking care not to overlap with pigmented areas to avoid darkening that skin. He starts with a small amount and adds more gradually until he matches the patient's natural color.
Most patients apply it in the same fashion once a week, leave it on for 4-6 hours, and then wash it off of facial areas. Melanogenesis usually begins within 2 months, or after eight applications. He has followed some patients as long as 20 years who are still producing melanin in the treated areas after stopping treatment.
Facial vitiligo is the primary indication for V-Tar, but Dr. Urbanek has used it on patients who develop hypopigmentation for other reasons. He has patients apply a steroid cream on "off" days to keep any inflammation under control.
Dr. Urbanek said the major adverse effect reported by his patients who use V-Tar is a stinging sensation on their skin upon exposure to sunlight, which is especially frightening to children but has no lasting effects.
Sunlight may act synergistically with the tar preparation, so patients may darken too much unless they have protection. The synergistic sunlight effect can be used to advantage on difficult-to-repigment areas on extremities, but it generally is better not to complicate therapy with ultraviolet light on easily repigmented areas such as the face. Patients are advised to avoid the sun as much as possible and to wear hats, sunscreen, and protective clothing.
Dr. Urbanek suggests not prescribing V-Tar for patients whose vitiligo covers more than 30% of their body surface area. Treatment may be too time consuming.
Since aromatic compounds present in the tar may elicit an allergic response, he recommends patch testing if patients are known to be allergic to perfumes.
