Therapeutic wounding - 88% phenol in idiopathic guttate hypomelanosis

CONTEXT: Therapeutic wounding includes wounding the skin to induce pigmentation of the depigmented skin patches that was earlier used for repigmenting small patches of stable vitiligo. In this study, we have used the same principle to induce pigmentation in idiopathic guttate hypomelanosis (IGH) by spot peel with 88% phenol. AIMS: To study the efficacy of phenol in causing repigmentation in IGH and its adverse effect profile. SETTINGS AND DESIGN: Open prospective study. MATERIALS AND METHODS: Twenty patients with 139 IGH macules were subjected to spot peel. Eighty-eight percent phenol was applied with an ear bud once a month for two sittings. Patients were assessed both subjectively and objectively after every session and at the end of 3 months of initiation of therapy. RESULTS: Repigmentation was noted in 64% of IGH macules. More than 75% improvement was seen in 45% of the total IGH macules, while 41.5% showed 50-75% improvement at the end of three months. Persistent scabbing was the common adverse effect noted in 17.26% of lesions. CONCLUSION: Spot peel with 88% phenol is a safe, simple, cost-effective, outpatient procedure for IGH, which can be combined with other medical therapies.