Vitiligo is a skin condition that causes a loss of the brown pigmentation from areas of the skin, resulting in irregular white patches. These areas do not feel any different from other parts of the skin, they are merely affected by loss of pigmentation. Although vitiligo primarily affects the skin, it can also occur anywhere that pigmentation occurs, including hair and sometimes even eyes.
Who is at risk of vitiligo?
Vitiligo affects about one out of every hundred people in the United States, and may appear at any age. The condition can affect people of all races and ethnicities. It is believed that vitiligo occurs when immune cells destroy the cells which produce brown pigment, called melanocytes. This is thought to be an autoimmune problem, but the exact causes are unknown. It also may be linked to heredity factors, as there is an increased rate in the condition among some families.
What are the symptoms of vitiligo?
Patches of lighter-colored or white skin appear any place on the body. Some people with vitiligo develop a few patches, while others are affected in large parts of the skin area. The edges of the patches are well-defined, but irregular. There are generally not any other symptoms of the condition, and people affected otherwise feel completely healthy.
The medical community recognizes two types of vitiligo. Segmental vitiligo (also called unilateral) appears on just one segment of the body, such as a leg or the face, or just one eyebrow or patch of hair. This type often begins at an early age, may progress for a year or so and then stop.
The second type is called Non-segmental vitiligo (also called bilateral or generalized). This is the most common type, appearing on both sides of the body; for example, both hands or both knees. It often begins on the fingertips or feet, or around the eyes or mouth. Pigmentation loss tends to expand and be more noticeable, and can occur in a start-and-stop pattern throughout a person’s lifetime.
Vitiligo is not contagious, nor is it life-threatening. However, because it is so visible, it can be very life-altering. Many people with the condition develop low self-esteem and even serious depression. It is a chronic condition, meaning that most people who develop vitiligo have it for life; therefore it is important to develop coping strategies.
How can vitiligo be treated?
A dermatologist will perform a physical exam and review your medical history, including that of your family. A patient may also need a blood test to check thyroid problems, as many people with vitiligo also have an autoimmune thyroid disease. Vitiligo is difficult to treat, and some people choose not to treat it, as the only symptom is the loss of skin color in affected areas.
Some medicines that can be used to treat vitiligo include cortisteroid creams or ointments; immunosuppressant creams or ointments, such as Elidel and Protopic; or topical drugs such as Oxsoralen. Phototherapy, a procedure which exposes the skin to ultraviolet light, can also be successful in treating vitiligo and reducing the pigmentation noticeability. This treatment works best on the face, and is least effective on the hands and feet.
Many people with vitiligo simply choose to use skin dyes, self tanners or cosmetics to mask the affected areas. Some herbal remedies such as vitamins and ginkgo biloba have been found to possibly help restore skin color and stop vitiligo from worsening.
In very severe cases, when other treatment options fail to work, surgery such as skin grafts may be an option. Skin grafts can also move normally pigmented skin to areas where there is pigment loss. This should only be considered for adults whose vitiligo has been stable for at least six months and who do not scar easily. Surgery can be effective for 90-95 percent of patients.
In all cases, it is important to know that skin without pigmentation is at greater risk for sun damage. Avoiding sun exposure and always using a broad-spectrum, high SPF sunscreen should be regular practices for people affected by vitiligo.