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What is vitiligo?
Vitiligo (pronounced "vit-il-EYE-go") is a skin ailment in which the skin loses its color or pigment. This causes your skin to appear lighter or turn white. Areas of your skin that lose pigment are known as macules if they are less than 1 centimetre broad and patches if they are greater than 1 cm. If you have vitiligo on an area of your body with hair, it may turn white or silver.
The problem develops when your immune system destroys melanocytes. Melanocytes are skin cells that create melanin, the substance responsible for skin color or pigmentation.
Who does vitiligo affect?
Vitiligo affects both races and genders equally. It's more noticeable in those with darker skin tones. Vitiligo can develop at any age, however macules or patches typically appear before the age of 30.
If you have any of the following autoimmune conditions:
Addison’s disease.
Anaemia.
Diabetes (Type 1).
Lupus.
Psoriasis.
Rheumatoid arthritis.
Thyroid disease.
How common is vitiligo?
Vitiligo is a frequent condition that affects 0.5% to 1% of the global population. However, many cases may go unreported, and some researchers believe the illness could afflict up to 1.5 percent of the population.
How does vitiligo start and progress?
Vitiligo typically begins with a few little white macules or spots that eventually develop throughout your body. Vitiligo usually starts on your hands, forearms, feet, and face, but it can appear elsewhere on your body, including your mucous membranes (the moist lining of your mouth, nose, genital and rectal areas), eyes, and inner ears.
Larger patches may broaden and spread, although they often remain in the same location for years. The position of smaller macules fluctuates and changes over time as specific parts of the skin lose and regain pigmentation.
Each person with vitiligo has different amounts of afflicted skin. Some persons have a few depigmented patches, while others have a general loss of skin color.
What are the types of vitiligo?
Types of vitiligo include:
Generalised vitiligo is the most prevalent kind of vitiligo, characterized by the appearance of macules over the body.
Segmental: This form affects only one side of your body or a specific location, such as your hands or face.
Mucosal vitiligo is a condition that affects the mucous membranes of the mouth and/or genitals.
Focal vitiligo is an uncommon kind in which macules develop in a restricted area and do not spread in a predictable way over one to two years.
Trichome: This type results in a bullseye with a white or colorless center, followed by a region of lighter pigmentation and your natural skin tone.
Universal: This unusual variety of vitiligo causes more than 80% of your skin to be pigment-free.
Symptoms and Causes
What are the symptoms of vitiligo?
There are following Signs and symptoms of vitiligo :
Colourless patches on the skin or mucous membranes. These may appear whiter or lighter than your natural skin tone.
Patches of hair on your body turn silver, grey, or white.
Symptoms can range from moderate to severe, affecting a significant area of your skin. Some persons with vitiligo have itchy skin before depigmentation occurs.
Where will I have symptoms of vitiligo?
Symptoms of vitiligo can emerge anywhere on your skin. Vitiligo symptoms are most commonly seen in the following areas:
Hands.
Feet.
Arms.
Face.
Mucous membranes (inside of your mouth, lips and nose).
Genitals (penis).
What causes vitiligo?
Vitiligo is caused by a lack of melanin in your skin. The cause behind this is unknown. According to research, vitiligo can be caused by:
Autoimmune condition: Your immune system misidentifies healthy cells (melanocytes) as foreign invaders, like bacteria, which can be harmful to your body. This causes your immune system to overreact and produce antibodies that damage your melanocytes.
Genetic alterations: A genetic mutation or a change in your body's DNA can impact how your melanocytes work. There are around 30 genes that can enhance your chances of developing vitiligo.
Stress: If you suffer regular emotional or physical stress on your body, particularly following an injury, the amount of pigment produced by your melanocyte cells may alter.
Is vitiligo genetic?
While study is ongoing to discover more about the origins of vitiligo, studies show that approximately 30% of cases are inherited. This suggests that the disorder is inherited, and you may inherit vitiligo from your biological relatives. Several possible genetic alterations influence how melanocyte cells behave. Vitiligo symptoms occur when a hereditary mutation attacks the cells that provide pigment to your skin.
Is vitiligo painful?
No, vitiligo is not painful. However, unpleasant sunburns can occur on lighter spots of vitiligo-affected skin. It is critical to protect yourself from the sun by using sunscreen, avoiding exposure during peak hours, and wearing protective clothes.
Diagnosis and Tests
How is vitiligo diagnosed?
A visual examination by a healthcare provider typically yields an accurate diagnosis of vitiligo. Your provider may examine your skin using a Wood's lamp. This lamp shines an ultraviolet (UV) light over your skin, assisting your provider in distinguishing vitiligo from other skin diseases. In addition, your provider may inquire about your medical history and family history.
What other conditions look like vitiligo?
There are other conditions that make your skin change or lose pigmentation, including:
Chemical leukoderma: When exposed to certain industrial chemicals, skin cells are damaged, resulting in linear or splotchy white skin.
Tinea versicolor: This yeast infection can cause dark patches on light skin and light spots on darker skin.
Albinism is a hereditary disorder characterized by low levels of melanin in the skin, hair, and/or eyes.
Pityriasis alba: This condition begins with red and scaly skin that gradually fades into scaly, lighter regions.
Management and Treatment
How is vitiligo treated?
Vitiligo does not require treatment because it is not detrimental to the body and is only cosmetic. If you have widespread vitiligo or your physical symptoms are interfering with your mental well-being, your healthcare practitioner can assist you in determining a treatment choice to achieve a uniform skin tone by either restoring color (repigmentation) or eradicating the remaining color (depigmentation) in your skin. Common treatments for Vitiligo include:
Medications.
Light therapy.
Depigmentation therapy.
Surgery.
Counselling.
Medications
There is no single medication that will prevent vitiligo from harming your skin, but there are some that can decrease the rate of pigmentation loss, stimulate melanocyte regeneration, or restore color to your skin. Medications to treat vitiligo may include
Corticosteroids.
Topical Janus kinase inhibitors (ruxolitinib).
Calcineurin inhibitors.
Light therapy
Light therapy or phototherapy is a treatment that can help restore color to your skin. Your practitioner will utilize light boxes, ultraviolet B (UVB) lamps, or medical-grade lasers to treat your skin for a brief period of time. It may take a few light treatment sessions to observe improvements on your skin.
The combination of oral psoralen medicine with ultraviolet light (PUVA) effectively heals huge areas of vitiligo-affected skin. This treatment works for persons who have vitiligo on their head, neck, torso, upper arms, and legs.
Depigmentation therapy
Depigmentation therapy involves removing the hue of your normal skin tone to match portions of your skin affected by vitiligo. Monobenzone is a medication used in depigmentation therapy. You can use this medication on pigmented areas of your skin. This will cause your skin to turn white, matching the areas affected by vitiligo.
Surgery
Surgery is a treatment option for people diagnosed with vitiligo. Surgical treatment could include:
Skin grafts: Skin is taken from one part of your body and used to cover another part. Possible complications include scarring, infection or a failure to repigment. This might also be called mini grafting.
Blister grafting: Blister grafting uses suction to create a blister on your skin and your provider will then remove the top of the blister to attach it to an area of your skin affected by vitiligo.
Your healthcare provider might not recommend surgery if you:
Have quickly spreading vitiligo.
Scar easily.
Develop raised scars that grow larger than a wound (keloids).
Counselling
Some persons with vitiligo find that counselling or seeing a mental health expert can help them improve their self-esteem, anxiety, or sadness, which can be linked to skin changes. Vitiligo can induce psychological suffering, influencing a person's worldview and social interactions. If this happens, your caregiver may recommend that you see a counsellor or join a support group.
Prevention
How can I prevent vitiligo?
There is no known technique to avoid vitiligo because it might have a variety of causes. You can decrease your chances of acquiring vitiligo by:
Practising safe sun exposure habits.
Taking care of your skin by using a moisturiser daily.
Avoiding stress or injury to your body.
Managing any underlying autoimmune conditions.
Additional Common Questions
What’s the difference between tinea versicolor and vitiligo?
Tinea versicolor and vitiligo are two disorders that affect the color of your skin. Tinea versicolor is a fungal illness in which your skin develops white, yellow, red, pink, or brown spots. Vitiligo is an autoimmune disorder in which you lose pigment. It causes your skin to become lighter than its natural tone, or white.
Is piebaldism the same as vitiligo?
No. Both illnesses result in white or light spots of skin or hair. Piebaldism occurs when a section of your skin lacks melanocytes, which generate pigment (melanin). You are born with pibaldism. Vitiligo occurs when the body's melanocytes are damaged. Vitiligo develops over one's lifespan.
How many types of vitiligo therapy ?
There are two type of vitiligo therapy
Light therapy.
Depigmentation therapy.
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