When therapies for repigmentation have failed and/or the vitiligo has become extensive (generally over 50% coverage), some opt for depigmentation of the remaining 'normal' pigment. Monobenzyl ether of hydroquinone, commonly called monobenzone or mono, is used to kill the remaining pigment cells, leaving the entire body fair. Like treatments for repigmentation, use of monobenzone requires patience and consistency. The process can take up to 2 years to complete, though some are done sooner depending on the initial amount of remaining pigmentation and the strength of the medication used. This medication is only available in compounding pharmacies, and can be ordered in a 20%, 30% or 40% strength. Typically, people start with a lower percentage and work up to stronger levels as their skin adjusts to the monobenzone. Potential side effects are dry skin, itching, or a rash. Because of the possibility of these side effects, it is not recommended to use monobenzone on the face. This medication has a systemic effect, so even areas where it is not applied will still depigment. Since no pigment will be left in the skin, people who have depigmented must be very cautious about sun exposure due to the risk of burning. According to doctors, however, since the melanocytes are gone, there is very little risk of melanoma, which is a dangerous cancer of the melanocytes.
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