The technique consists of taking small 3-5 mm grafts of hair-bearing skin from the occipital and retro-auricular areas of the scalp, with a biopsy punch and grafting them onto similar holes produced by the punch on the bald area.
Since the excised skin tends to contract, while the wound tends to become wider due to the elasticity of the skin, it has been recommended to take the donor grafts with a larger punch (3mm) and prepare the recipient sites with a smaller punch (2mm).
Moreover, since the hair follicles are situated obliquely in the skin, an oblique punch biopsy oriented in the direction of the hair will avoid cutting through the hair follicles and thus provide a larger number of available hairs.
Further still, it is important to properly orient the grafts while placing them at the recipient sites in such a manner that all the hairs which grow subsequently have the proper direction of the hair in that area of skin. [Read more...]
When the drug is given through oral or via injections so that it reaches the diseased part after getting into blood circulation, this mode of therapy is called systemic therapy.
Areas of vitiligo which do not respond to medicinal treatment can also be subjected to punch grafting in a similar way, taking 3 mm punch grafts of the pigmented skin from a comparable donor site and transplanting these on the recipient sites in the vitiligo patch.
One of the limitations of topically applied medicines is their restricted ability to cross the epidermal barrier. In specialized circumstances therefore, one of the following procedures can be used to enhance the effect of locally applied medicines.
Inflammatory in the skin may be produced due to the local application of primary irritants or as a result of antigen-antibody reactions. Infectious agents are also associated with inflammatory reactions.