Skin grafting for vitiligo moves pigment cells from skin that has them to a patch that has none. Four techniques do it: melanocyte cell transplant, punch grafting, blister grafting and follicular unit transplant. All four work only on disease that has been stable for about twelve months, and that judgement matters more than the choice of operation.
These are transplant operations, not tattoos. Healthy pigmented skin is taken from an inconspicuous donor site, usually the thigh, and the melanocytes within it are transferred to the depigmented patch, where they establish themselves and start producing pigment again.
Because the cells are your own, the colour they produce is your own. It matures over weeks to months, and a good result is one you stop noticing.
The absolute requirement is stability. Transplanted melanocytes are the same cells the immune system was attacking; put them into active disease and they are destroyed, while the donor site may develop a patch of its own. That is why the assessment is more important than the operation.
Dr. (Lt Col) Khagendra Varada
Reg. No. 10461, Hyderabad State Medical Council
Full background →“I have been going pillar to post to get my son cured of his white spot on his left side of lip and chin. It appeared 8 years back. I was told it’s special type of nerve vitiligo which has no cure. After reporting to him he told us that it is SEGMENTAL VITILIGO and unlikely and difficult to be cleared by medications alone. He suggested for surgical melanocyte transplant… I was amazed after around one month that he started rapidly getting pigmentation. I wholeheartedly suggest please do not waste time like I did.”
“Dark spots are seen in one month… Even before perticular treatment for vitiligo, great”
A thin shaving of your own pigmented skin is taken from the thigh, separated into a suspension of individual pigment cells, and applied to the patch after its surface has been prepared. A small donor area can cover a much larger one.
The colour that grows in is your own, because the cells are your own. It matures over weeks to months. None of this is worth doing while the disease is still active — the same immune system would destroy the new cells too.
Illustration, not a photograph.
All four take pigmented skin from a donor site and put its pigment cells onto the patch. They differ in how much area one donor site can cover, and in how fine the result is.
Cell suspension covers the largest area from the smallest donor site, which is why it suits extensive patches. Punch grafting is simplest but can leave a cobblestoned surface. The choice follows the site and the size, not preference.
Illustration, not a photograph.
The patch chooses the technique. Size, site and whether the hairs inside it are still dark decide it; preference does not.
| Technique | Best for | Donor site | Area per sitting | Texture and colour |
|---|---|---|---|---|
| Melanocyte transplant (cell suspension) | Larger stable patches; face, trunk, limbs | Thigh; a thin shave | Largest: many times the donor area | Smooth; colour blends over months |
| Punch grafting | Small patches; fingers, ankles, knees, elbows | Thigh or buttock; 1–2 mm plugs | Small; repeated sittings for larger patches | Durable; may cobblestone |
| Blister grafting | Lips, eyelids, small facial patches | Thigh; suction blisters | Limited by blister size | Finest match; minimal donor scarring |
| Follicular unit transplant | Patches with white hair; eyebrow, beard, scalp | Scalp | Follicle by follicle | Repigments hair and skin; the answer to leucotrichia |
Cultured techniques, where cells are multiplied in a laboratory before grafting, exist but need a facility few centres have; the four above are what is done in ordinary practice in India, and what this clinic does.
A small piece of donor skin is processed into a suspension of pigment cells, which is applied to the prepared patch. A small donor area can cover a much larger recipient area.
Tiny cores of pigmented skin are placed into matching holes in the patch, a few millimetres apart. Pigment spreads outward from each one until the areas merge.
Suction raises blisters on the donor site; the thin roofs are lifted and laid onto the patch after its surface is removed.
Follicular units are transplanted into the patch. The reservoir of pigment cells sits in the hair follicle itself, so this addresses the one problem the other three cannot. White hair growing within the patch.
One case from this clinic, photographed at fixed intervals and published with the patient’s written consent. Colour spreads outward from each plug until the islands merge; the series shows how long that takes. Results differ from person to person.
Small grafts are placed into the pale patch, and colour then spreads outwards from each one — which is why the later photograph looks speckled before it evens out. There is no before photograph for this case; the first frame is the procedure.
History, examination, Wood’s lamp and dated photographs establish whether the disease has genuinely been quiet for twelve months.
For borderline cases a small trial graft is placed and watched. It answers the stability question more reliably than any argument.
Done under local anaesthetic as a day case. The patch is prepared, the graft placed, and both sites dressed.
Dressings stay undisturbed for several days. Pigment appears over weeks and continues to spread and blend for months.
A significant proportion of people who ask about vitiligo surgery are told to wait, and that is a clinical decision rather than a scheduling one. Operating on unstable disease produces a failed graft, a disappointed patient, and sometimes a new patch where the donor skin was taken.
If you are told to wait, the interval is used: the disease is treated medically to bring it under control, and photographs are taken so the twelve-month clock can be judged properly rather than remembered.
How stability is assessedIt burns out reliably, which is why it produces the most durable surgical results.
These sites barely respond to light. Surgery is not the fallback there. It is the appropriate first choice.
A graft is quoted as a procedure with its own consent and its own costing, in writing, after the assessment. The figure depends on the area to be covered, the technique the patch needs, the theatre time and, for punch grafting, the number of sittings. Those are not known until you have been examined, which is why no rupee figure appears on this page.
The consultation fee: ₹1,499 in person, ₹1,299 by video. If a video consultation leads to an examination in person, only the difference is charged.
How many sittings, what is included, what the reviews cost, and what happens if the graft does not take. The cost page lists them.
At the Secunderabad clinic, by the dermatosurgeon who assesses you.
Patients in the United Kingdom and the Gulf write to this clinic because grafting is hard to obtain where they live. The Vitiligo Society describes surgical treatment as rarely used in the UK and mostly available privately; the same is true across much of Europe and the Gulf, where the techniques are known but few dermatologists perform them.
The assessment rule does not change for distance. Photographs and a video consultation come first, so that nobody flies for an operation they would be refused at the door. A visit is then staged: assessment in person, the procedure on a separate day, a dressing check before you leave, and colour reviews by photograph afterwards.
What you are not offered is a package. A course of surgery sold to a traveller before anyone has judged stability is the wrong way round, wherever the clinic is.
It repigments the patch it treats. It does not cure vitiligo, does not stop new patches appearing elsewhere, and does not remove the need for ongoing review. Anyone describing it as a permanent cure is overstating it.
Only if your disease has been stable for about twelve months: no new patches, no expansion of existing ones, and no depigmentation appearing where skin has been cut or scratched.
Segmental vitiligo that has burnt out is the classic good candidate. Patches on the lips, fingertips and other sites that light cannot reach are the usual reason for choosing surgery.
Pigment cells are taken from skin that still has them, usually the thigh, and moved to the patch that has none, as a suspension of cells, as tiny plugs, as the roof of a suction blister, or as hair follicles. They settle into the prepared patch and begin producing pigment again over the following weeks.
Neither, in general. Cell transplant covers the most area from the smallest donor site and blends smoothly, so it suits larger patches. Punch grafting is simple and durable and suits small patches on fingers, ankles and knees, at the risk of a cobblestoned surface. Blister grafting gives the finest match on the lips and eyelids. The patch chooses.
The transplanted pigment cells generally persist, and results in stable segmental disease are durable over years. But vitiligo can reactivate, and a graft does not protect against new patches elsewhere.
Usually well, because the pigment is your own. It matures over months. Punch grafting can leave a slightly uneven texture; melanocyte transplant and blister grafting generally blend better.
Blister grafting leaves very little. Punch grafting leaves small marks in a concealed area. The donor site is chosen so that anything visible is hidden by clothing.
No. Local anaesthetic, as a day procedure. You go home the same day.
Pigment usually starts appearing within a few weeks and continues to spread and even out for several months. Judging the result before three months is premature.
It is quoted per procedure, in writing, after the assessment, because the price depends on the area, the technique and the number of sittings. The consultation fee is the only figure that is fixed, and it is published on the cost page. Be wary of any clinic that prices a graft before it has examined you.
Rarely, and mostly privately: the Vitiligo Society’s own guidance describes surgical treatment as seldom used in the UK. Patients from the UK and the Gulf do travel to India for it. The assessment rule is identical wherever you come from, and a video consultation before travel is how you find out whether the trip is worth making.
Then surgery is deferred and the disease is treated medically first. The waiting period is not wasted. It is used to stop the spread and to build the photographic record that establishes when the clock started.
The clinical statements on this page follow the guidance and evidence below. They are independent sources. None of them is connected to this clinic, and none of them sells the treatments described here.
Not a treatment plan sold on the spot. Message the clinic and bring your history.