What Is Vitiligo?

Vitiligo is a skin condition in which the skin’s pigmentation is lost. Smooth white areas emerge on a person’s skin which are called “macules” if they are less than 5mm in diameter, or “patches” if they are 5mm or greater. The hair on your body may turn white if you have vitiligo in an area where there is hair. This disorder arises when the body’s immune system destroys melanocytes (skin cells that create melanin, the chemical that gives skin its color or pigmentation).

Vitiligo affects roughly 1% or slightly more of the world’s population and affects people of all races and genders, however, it is more evident in those with darker skin. Vitiligo can affect anyone at any age, however, it is most frequent in persons between the ages of 10 and 30. It is uncommon among the extremely young and old.

Vitiligo commonly affects the hands, forearms, feet, and face, but it can also affect the mucous membranes (wet lining of the mouth, nose, genital, and rectal areas), the eyes, and the inner ears.

Types of Vitiligo

Non-Segmental Vitiligo

The more prevalent type of vitiligo is non-segmental vitiligo, which accounts for up to 90% of cases. If the first white patches are symmetrical, it’s likely that you have non-segmental vitiligo. If the patches are only on one side of the body, the progression will be slower. The patches are frequently symmetrical and occur equally on both sides of the body. They are most typically found on sun-exposed skin, such as the face, neck, and hands. Non-segmental vitiligo is grouped into sub-categories:

• Generalized: This is the most common type and patches do not have defined sizes or areas
• Acrofacial: This normally occurs on the fingers or toes
• Universal: This is a very rare type in which depigmentation covers most part of the body
• Mucosal: This usually occurs where the lips and mucous membranes meet.
• Focal: This is common in young children and one or more dispersed white patches appear in a discrete area.

Some common areas non-segmental vitiligo affects include:

• Arms
• Eyes
• Knees
• Nose
• Armpit
• Back of the hands
• Armpit
• Groin
• The genital and rectal area
• Navel

Segmental Vitiligo

Although segmental vitiligo spreads faster, it is regarded as more consistent, stable, and less unpredictable than non-segmental vitiligo. It is far less prevalent, affecting just approximately 10% of vitiligo patients. It’s asymmetrical and affects roughly 30% of children diagnosed with vitiligo. It is particularly visible in the younger age groups. Segmental vitiligo affects the skin around nerves that originate in the dorsal roots of the spine. Topical therapies work effectively for it.

Causes of Vitiligo

Vitiligo occurs when pigment-producing cells (melanocytes) die or stop producing melanin (the pigment that gives your skin, hair, and eyes color). Skin patches that are affected lighten or turn white. It’s unclear what causes these pigment cells to fail or die, however, it could be linked to:

• Immune-system dysfunction (an autoimmune condition)
• Family history (heredity)
• Trigger events such as severe sunburn, stress, or skin trauma, such as contact with a chemical

Complications of Vitiligo

Vitiligo patients may be more vulnerable to:

• Distress on the social or psychological level
• Sunburn
• Problems with the eyes
• Hearing loss

Symptoms of Vitiligo

The appearance of flat white spots or patches on the skin is the only sign of vitiligo. The first white spot to appear is usually at an area that is frequently exposed to the sun. It begins as a simple area that is somewhat lighter than the rest of the skin, but as time goes, the spot becomes paler and paler until it is completely white. The patches are shaped in an uneven pattern. The borders of the skin can become somewhat irritated with a slight red tone, causing itching. In most cases, however, it causes no discomfort, irritation, inflammation, or skin dryness. Vitiligo has different effects on various individuals. Some people may simply have a few white dots that don’t spread, while others may acquire larger white patches that connect and damage wider sections of skin.

How to Treat Vitiligo

The treatment you receive is determined by your age, the amount of skin involved, where it is located, how quickly the condition is advancing, and how it is affecting your life. Here are some treatment procedures one can undergo:

Medications for Vitiligo

Vitiligo can’t be cured with medications, however, some medications can help restore skin tone when used alone, in combination with light therapy.

Drugs that Control Inflammation

A corticosteroid cream applied to the afflicted skin may help to restore color. When vitiligo is still in its early stages, this is the most effective treatment. Although this sort of cream is effective and simple to use, you may not notice any changes in the color of your skin for several months. Skin thinning or the formation of streaks or lines on your skin are possible side effects. For patients whose conditions are rapidly worsening, corticosteroid pills or injections may be an option.

Medications that Affect the Immune System

Calcineurin inhibitor ointments such as tacrolimus (Protopic) or pimecrolimus (Elidel) may help persons with minor patches of depigmentation, notably on the face and neck, however, there is a warning concerning a potential link between these medications and lymphoma and skin cancer.

Therapies for Vitiligo

Some therapy procedures such as light therapy, depigmentation, combining psoralen and light therapy can be used to treat vitiligo.

Light Therapy

Active vitiligo can be treated with narrow-band ultraviolet B (UVB) phototherapy, which has been shown to stop or delay disease progression. It may be more effective when combined with corticosteroids or calcineurin inhibitors. This therapy is needed two or three times a week. It could take one to three months to detect any changes, and six months or longer to see the entire effect. Also note that there are possible side effects such as redness, itching and burning, with risk of skin cancer.

Combining Psoralen and Light Therapy

To restore color to the light patches, this treatment combines a plant-derived chemical called psoralen with light therapy (photochemotherapy).

Depigmentation

If your vitiligo is severe and other treatments have failed, this therapy may be an alternative. Unaffected portions of the skin are treated with a depigmenting chemical. This lightens the skin over time, blending it in with the discolored parts. For nine months or longer, the therapy is done once or twice a day. Redness, swelling, itching, and extremely dry skin are all possible side effects.

Surgery

If medications and therapy options don’t work, surgery is the next step. Some surgical procedures are used to even out skin tone by restoring color; they include:

• Skin grafting
• Blister grafting
• Cellular suspension transplant

Lifestyle Remedies for Vitiligo

• Protect yourself from sunlight and other artificial sources of ultraviolet light by making use of at least an SPF of 30 broad-spectrum, water-resistant sunscreen.
• Apply plenty of sunscreens and reapply every two hours or more frequently if you’re swimming or sweating.
• You can also seek shade and protect your skin by wearing clothing that blocks the sun. Sun protection helps prevent discolored skin from getting sunburned.
• Sunscreen also helps to prevent tanning, which can enhance vitiligo patches.
• A fresh patch of vitiligo may form within two weeks if your skin is damaged, such as by a tattoo. It is essential that you avoid getting a tattoo.
• Covering your skin by making use of makeup and self-tanning solutions can help to hide skin color differences.
• To discover cosmetics or a self-tanner that blends nicely with your natural skin tone, you may need to try a few different kinds. Self-tanning products’ coloration does not wash off, although it fades over several days.

Now that you Know…

Approximately 10% to 20% of persons with vitiligo restore their skin color completely. Young people with vitiligo that peaks in less than six months and is mostly on the face have the best chance of restoring skin color. Those who develop vitiligo later in life on their lips and limbs, particularly the hands, are less likely to regain their color.

Although vitiligo isn’t life-threatening, it can be life-altering. Many societies believe that appearance is key, and if you are different, you will be avoided completely. It is important to know your skin and take overall control of your health. You should also educate yourself about vitiligo and find a doctor who is knowledgeable about the disease and treatment alternatives. Speak up if you notice any symptoms.