About 2 percent of the world’s population is affected by vitiligo. This is a disease caused by lack of melanin producing cells, or melanocytes, in certain areas of the skin. Melanocytes are the cells that give color to skin, eyes and hair. When they stop functioning properly or get destroyed, white patches appear. Vitiligo is then said to have developed.
Vitiligo is not painful but appears so. It often appears before the age of 20 and sometimes before the age of 40. The incidence rate in older people is very low. Areas affected by vitiligo are more sensitive to the sun. The face, arms, lips and hands are commonly affected.
There is no cure for vitiligo. Luckily, the disease is not dangerous. It however can cause stress and other psychological problems. Available treatment options seek to restore color to affected areas. This doesn’t keep the disease from spreading or recurring.
What is vitiligo; definition, pictures, types and facts
Vitiligo is pronounced as (vit-ill-EYE-go). If melanocytes were to be removed from the skin, it would appear pale and white. This is what happens with vitiligo. Some internal or external factors can lead to destruction of melanocytes or their ability to produce melanin. In most vitiligo definitions, the disease is described as being autoimmune. This is where immune cells mistakenly attack healthy cells in the body. Vitiligo mostly occurs on the skin but can also affect inside the mouth or in the hair roots. Affected hair turns white or grey.
There are two identifiable types of vitiligo:
Segmental vitiligo – this type is more common in children but less common during later stages of development. It also referred to as localized vitiligo because it occurs on one area of the skin or body.
Non-segmental vitiligo – this type is also called generalized vitiligo. It develops symmetrically on paired body parts such as hands, arms, and around eyes. It is the most common type of vitiligo. Several subtypes of non-segmental vitiligo exist for specification:
- Acrofacial – this subtype mostly affects fingers and toes. Signs appear on the upper side of affected fingers or toes.
- Focal – it is characterized by localized white patch or patches.
- Generalized – this is the type of vitiligo that affects most people. There is no defined boundary to the affected areas.
- Mucosal – as the name suggests, it appears on mucous membranes such as inside mouth. This is also the type seen on lips.
- Universal – in this rare case, loss of pigment occurs almost all over the body.
There is no way of telling if one type will turn into another or not. For example, you can’t tell if vitiligo on lips will spread to around the eyes and so on.
Below are other vitiligo facts to know:
- White patches and depigmentation are the main signs of vitiligo. They can occur anywhere on skin and sometimes mucosal membranes or hair.
- Race, gender, sex and age are not considered predisposing factors. Anyone can get affected by vitiligo.
- The disease is not contagious. This means that it cannot be passed from one person to another such as during skin to skin contact. However, the disease may occur in different body areas, spread or recur.
- Experts are not sure what causes vitiligo. It is thought to be an autoimmune condition or caused by a virus. It may also run in families.
- Having vitiligo doesn’t indicate any serious health problem. In fact, patients lead normal healthy lives apart from the fact that affected areas are more prone to sunburns.
- Treatment may reduce severity of the disease but will most likely not completely cure it. There is no known way to prevent the disease.
- How fast does vitiligo spread? It is quite difficult to guess the long it will take for vitiligo to spread. For some people, patches take years to be big enough to cause concern. Spread and progress is very fast in other cases. But it is not always that vitiligo will spread.
Vitiligo causes and risk factors
It is known that vitiligo occurs when melanocytes die or lose the ability to produce pigment. Why this happens is only vaguely understood. Rather than vitiligo causes, let’s look at its risk factors:
Normally, immune cells identify and fight off invading pathogens. The immune system sometimes becomes overactive and ends up destroying some healthy cells. There are many autoimmune conditions which may include vitiligo. Vitiligo caused by autoimmune disorders is associated with thyroid disease.
In some cases, vitiligo is observed to be running in families. This is not always the case. Having a close family member with vitiligo doesn’t necessarily mean you will have it.
Damage to melanocytes
Melanocytes can for example be damaged by extreme sunburn or large wounds. Being exposed to some chemicals may also trigger vitiligo.
Stressful events such as childbirth can trigger vitiligo in people who already are predisposed.
Age is not considered a risk factor. However, most people develop vitiligo prior to or around the age of 20 years.
Vitiligo signs and symptoms
White patchy skin discoloration is the main sign of vitiligo. It is more noticeable in dark skinned people but doesn’t mean it is more severe. The signs often begin in body areas exposed to sun such as on upper side of hands, arms, face, lips and feet. At first, a pale spot appears which then becomes white before spreading to adjacent areas.
In some people, individual spots form but do not spread. In others, the spots spread, join and develop into large patches. This is how vitiligo spreads. The center where first signs appeared may be whiter than the areas near borders. Sometimes, blood vessels will make affected areas appear pinkish.
Vitiligo doesn’t cause common discomforts caused by skin conditions such as dryness and flaking or scaling. The edges may sometimes be itchy, slightly inflamed or with brown discoloration. Coconut oil for vitiligo can be used to reduce itchiness. Signs may appear on:
- around eyes
- back of hands
- genital region such as vitiligo scrotum symptoms
- groin region
- on top of feet
Apparently, vitiligo is not a disease for humans alone. It can also occur in animals such as cats. Vitiligo cat cases are fairly rare.
Vitiligo diagnosis and treatment
Diagnosis is done by examining the patient and analyzing their medical history. The patient will be asked whether there is a history of vitiligo in their family, whether they have recently been injured or sunburned and whether they have a history of autoimmune conditions.
Other related questions may also be asked. The main aim is to rule out other skin conditions such as pityriasis versicolor. A special type of lamp may be used to closely examine the affected skin. To confirm diagnosis, the following tests may be done:
- Blood test – blood test is done to check whether vitiligo is being caused by another autoimmune disease like diabetes. Signs of diabetes include being thirst and frequent urination.
- Biopsy – a small sample tissue may be taken to check for presence of pathogens such as fungi and viruses. This will not only confirm vitiligo but may also identify its cause.
Vitiligo is not dangerous. Regardless, it goes beyond being a mere cosmetic problem. Although there is no known vitiligo cure, many treatment options are available and in fact encouraged. Restoring or evening skin color is the main aim of most of the available options. This comes with the disadvantage that the disease will largely remain untreated. Your doctor may therefore choose to go with drugs or therapies. The main disadvantage with this option is that effects take long to occur. Vitiligo treatment may be done with:
- Corticosteroids – these are medications used to reduce inflammation and other symptoms such as itchiness. They mostly come in creams that are to be applied directly. Corticosteroids may help prevent skin color loss especially in early stages of vitiligo. Consult your doctor before using these medications especially for treating vitiligo baby cases.
- Light therapy – UV light is often used to promote skin healthy as well as pigmentation. In vitiligo treatment, light therapy is mostly used together with psoralen. This is a substance derived from plants that promotes skin coloration. Psoralen can be taken orally or applied directly. Using these treatments together is seen to have better results especially for mild vitiligo.
- Immunosuppressants – overactive immune system can be made mild with ointments containing calcineurin inhibitors. This treatment is not ideal for widespread vitiligo but may be effective for vitiligo on the lips, for example. The problem with immune suppressing drugs is that they may encourage other diseases to develop. Check with your doctor before using such ointments for vitiligo treatment.
- Skin grafting – skin grafting involves transplanting healthy skin from elsewhere in the body to affected areas. This requires surgery and therefore only applicable for small patches. Surgeries should be done in hospitals, mainly to reduce risk of infection. There is no guarantee that skin grafting will bring the desired results.
- Micropigmentation – here, pigment is directly implanted into affected areas. It may not be applicable for large vitiligo patches. The problem is that the process of implanting pigment may be stressful enough to trigger other vitiligo patches. Implanting the right amount of pigment to match adjacent areas is also hard. If you are at risk of developing vitiligo, it is a good idea to avoid stressful activities such as getting your skin tattooed. Such activities can trigger vitiligo.
- Depigmentation – when more than half the body is affected by vitiligo, one option is to reduce pigment in healthy areas to match the white patches. This is done with topical ointments and lotions over a period of about 1 year. Sammy Sosa vitiligo saga is a good example. Since the effects will be permanent, patients have to keep away from long exposure to sun.
Treatments on trial:
There are several treatments being tested in the hopes that they will become available in future for vitiligo treatment. One approach is using drugs to stimulate growth of more melanocytes. This may work effectively on localized vitiligo.
Treatment at home:
There are no real home remedies to treat vitiligo. Treatment at home may be done with:
- Sunscreens – vitiligo affected body areas are extremely sensitive to sun. Melanocytes among other things protect the skin from harmful sun rays. In their absence, even small doses of UV radiation can lead to severe sunburns. Sunscreens help protect the skin from sun damage.
- Camouflage – makeup and cosmetic creams may succeed in camouflaging vitiligo patches. Settling on the best vitiligo makeup combination for your skin features may take some time.
It has been suggested that Ginkgo biloba and vitamins for vitiligo such as vitamin C and B-12 may improve skin color for some people with vitiligo. Due to lack of enough data to confirm such claims, it is advisable to check with your doctor prior to using them.
Most vitiligo patients suffer from psychological problems rather than physical discomforts associated with vitiligo. Measures such as finding the right doctor and connecting with others may help a great deal. A lot of information regarding what vitiligo is, how to identify it and related topics is available online. Patients may find such information very helpful. During treatment, make sure to tell your doctor the challenges you may be going through, mostly the psychological or emotional ones. Your doctor may link you up with another professional for more help.
Even if vitiligo skin disorder patches are to spread all over the body, the disease will not develop into a more serious disease. The main possible complication is extreme sensitivity to sunlight. This can lead to agonizing sunburns if appropriate measures are not put in place.
Vitiligo is also closely related to autoimmune conditions and diseases. These include diabetes (type 1), thyroid disease (Hashimoto’s thyroiditis) and pernicious anemia. Having such conditions may make it likely for vitiligo to occur.
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