Novitil Usage

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Regular use of the product and light exposure is of the essence.
Repigmentation is a gradual process. Discipline and patience are key to success in any vitiligo treatment. An attitude of positive expectation helps both the repigmentation process and completion of treatment.

Three aspects need to work together in order to obtain positive results:

1) Novitil.
2) User: regular daily use.
3) Sun exposure (or an artificial source of Ultraviolet Light)
as recommended.

Sunlight Exposure

When sunlight exposure is used,
Novitil should be applied twice a day on a regular basis,
right before going in the sun. Increase direct sunlight exposure
5 minutes every day until reaching 30 minutes a day.
Alternatively, sunlight exposure can also be taken 15 minutes
twice a day (ex. morning and late in the afternoon).

Exposure time may need to be adjusted according to skin type*, age, and previous experience in regard to sunlight exposure. Particularly skin types I and II need to carefully adjust exposure time.

* I Always burn, never tan
II Always burn, but sometimes tan
III Sometimes burn, but always tan
IV Never burn, always tan
V Moderately pigmented people (Chinese, Indian)
VI Black people (West Indies, Africans)

Find a comfortable position in which you can expose the affected area(s). The rest of the body does not need to be exposed to the sun. You can cover it or use a sunscreen lotion (spf=50) as a matter of general protection (differently from psoralen Novitil does NOT make the skin more sensitive to sunlight).

Alternatively, when it is not possible to take the sun,
the areas with white spots could be exposed to infrared light,
from a distance of 18" to 20" (45 to 50 cm), for half an hour,
after each application. This should always be combined with
a sufficient amount of sunlight exposure.

Points to remember:

1. Apply the gel twice a day.

2. Have light exposure only once day for 30 minutes 
(or 15 minutes twice a day) depending on what schedule is more 
convenient for you.

3. Apply Novitil right before having your light exposure time.

4. The second time, when having sunlight exposure once a day,
(you could apply it after taking a warm shower, which helps the skin by stimulating the circulation, activating metabolism,
and opening skin pores).

Sunlight exposure plus infrared light

Another option is to combine both infrared light and sunlight exposure. You would be using Novitil twice a day, as mentioned above. The first time, you would apply Novitil right before taking sunlight, and later on, the second time, you would apply Novitil and then have infrared light exposure. On those days when there is no sunlight at all, you would use the infrared light on both occasions, right after applying Novitil.

An artificial source of Ultraviolet light

Novitil can be used in combination with an artificial source of
Ultraviolet light (instead of sunlight exposure). The benefits,
as compared to the sole use of UV light, would be a
higher degree of repigmentation in a shorter period time
(decreasing amount of UV light, and risk of side effects).
Please note that artificial ultraviolet light should only be used following directions from someone who is appropriately qualified,
and has experience regarding its use in cases of depigmentation.
Novitil should be used regularly, twice a day, including
an application 15 minutes before each UV light exposure.
The rest of the times Novitil is applied without relation
to light exposure.

The exposure time and the other aspects will depend on
a number of factors including skin type, localization,
type of equipment, manufacturer's instructions, etc.

Typically exposure time is increased gradually.
Treatment may be adjusted depending on these factors as well as based on the observed response. It is also important to review the information provided by the manufacturer of the equipment.

General information about the use of tanning beds:

1. Treatment should always start with a short exposure time, which is increased gradually and progressively, carefully following instructions provided by the manufacturer of the equipment and by a qualified individual. For example, starting with a few minutes and slowly increasing the time each session until reaching the following criterion (see number 2).

2. It should be considered not only the exposure time limits indicated by the manufacturer, etc. but also the following criterion:

The skin should not get beyond E1 according to the
grading below:

E0 No erythema (erythema is the word for a red skin)
E1 Minimally perceptible erythema (pink)
E2 Marked erythema (red)
E3 Fiery red erythema with swelling
E4 Fiery red erythema with swelling and blistering

This means that time exposure should be carefully individualized
and adjusted according to the skin response.

3. Typically tanning beds are used NO more than three times
a week. This 48 hour period give time to observe skin
response, which may take up to 48 hours to show.

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