Vitiligo is an autoimmune disorder, and depigmented macules and patches characterize this acquired pigmentary disorder. The condition occurs when the melanocyte cells, that are responsible for giving color to the skin are attacked by the immune system when considered as the foreign or abnormal body. Vitiligo can cause stress, self-consciousness, and even devastation in the affected individual. This condition also limits their daily social activities, especially when it is widespread in the exposed body areas such as hands, face, feet, and neck. Vitiligo is not a contagious disease and is also not a form of skin cancer.
The color of the skin is determined by the melanocyte cells (active cells determine the skin color). These cells produce melanin pigment that also protects the skin from the sun damage and also provides the skin with its normal color. People with dark skin produce a lot of melanin naturally, and people with light skin produce less. Vitiligo can affect people of all races and occurs when the skin suddenly stops producing melanin. The small spot is called macule, and it is lighter in appearance compared to the surrounding skin. These white patches may spread slowly or quickly, and then they remain stable for years. The vitiligo spots are more noticeable in people with darker skin tones.
The exact cause of vitiligo is unknown and can occur due to genetics, virus, and autoimmune disorders. Sometimes stress, oxidative stress, exposure to certain chemicals, sunburn can also contribute to vitiligo.
Frequently Asked Questions
Take care of the skin well and do not apply too much cosmetics and harsh soaps. Always apply sunscreen as the depigmented skin is more likely to get sunburns. Moisturize the skin often with vitamin E creams.
Vitiligo is not a life-threatening disease, but it can cause social embarrassment and psychological impact on the affected individual. This condition does not cause skin cancer, but excessive sun exposure can cause skin damage and increase the risk of cancer. One must apply sunscreen to prevent sunburn which dermatologists recommend otherwise also.
- Clinical examination (wood's lamp examination)
- Physical test- patches observation
- Skin tissue histopathology
Sometimes, medical conditions like Tuberculoid leprosy, Post-inflammatory hypo-pigmentation, and Calcium deficiency also develop white spots, so it is necessary to take help from a vitiligo specialist to rightly diagnose the problem.
There is no specific way to prevent vitiligo, but following measures are recommended to minimises the chances:
- Limit sun exposure and apply sunscreen daily
- Eat balanced and nutritious antioxidant, vitamin, and mineral-rich diet
- Do regular exercise and indulge in relaxing activities like meditation
- Avoid tattooing
- Do not eat seafood, if allergic
- Avoid artificial food colors and preservatives in diet
- Take timely help from skin experts as and when required
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Types of Vitiligo
Vitiligo is categorized depending on the patches ratio, and the body part affected with vitiligo. This includes:
1. Generalized vitiligo
- Most common type
- Affects many parts of the body
- Symmetrical pattern of patches
2. Segmental vitiligo
- This occurs in one part or side of the body
- Occurs at a younger age
- The least common type of vitiligo
3. Localized or focal vitiligo
- Occurs at one or a few parts or areas of the body
Signs and symptoms of Vitiligo
- Skin color loss in patches
- Graying or whitening of hair (premature), in areas such as beard, eyebrows, eyelashes, scalp
- Loss of color in the inner layer of the eyeball
- Loss of tissue color inside mucous membranes
Note: People with vitiligo have an increased risk of skin cancer, sunburn, hearing loss, inflammation of the iris, and social distress.
Vitiligo treatment helps to restore the color of the affected skin. Before undergoing the treatment, it is essential to find a dermatologist who specializes in skin care and is experienced in treating this condition.
Diagnosis of Vitiligo
- Physical examination
- Medical history of the patient
- Family medical history
- Blood and other laboratory tests
- Rule out medical problems such as eczema or psoriasis
- Ultraviolet light test
- Biopsy test (skin sample of affected area)
Non-surgical Treatment options
Various medical treatments help to create uniform skin by either re-pigmentation and depigmentation treatments. The common treatments include:
1. Creams to control inflammation
Certain corticosteroid creams can help the affected areas of the skin to return back to their normal color. The cream is easy and effective to use.
Certain medications are effective in treating small areas of depigmentation (face and neck).
3. Depigmentation Therapy
This therapy is provided with certain medicated drugs, and this treatment is used when the disease is extensive. The therapy is applied to the pigmented patches of the affected skin, and this makes the area to turn white to match the areas of vitiligo.
4. Phototherapy (Ultraviolet B or UVB treatment): The narrowband ultraviolet B light sessions are provided per week for several months. This treatment is effective for treating white spots across a large body area. This treatment is combined with other treatments, can provide a positive effect on vitiligo. The procedure often leads to fewer side effects.
5. Excimer laser treatment: This treatment delivers a suitable wavelength that is also effective in treating small targeted areas.
Many a time, topical immunomodulators, and various other repigmentation therapy are also useful in providing the best results.
Surgical Treatment options
If vitiligo fails to improve or clear with these treatments, then a surgical procedure is performed to treat vitiligo (stable).
1. Skin Grafting: Surgery is useful when light therapy does not provide promising results. In this procedure, the surgeon removes the small grafts of normal color pigmented skin and attaches into the area that has lost pigment.
2. Melanocyte Transplants: In this method, melanocytes are further grown in the laboratory. These cells are then transplanted to the vitiligo affected skin area.
Self-care in Vitiligo
- Do not get a tattoo to hide vitiligo as it can damage the skin, and a new patch of vitiligo can appear within a few weeks.
- Protect the skin from the sun. If someone has a light skin tone, then they must always apply a water-resistant, broad-spectrum sunscreen with more than SPF 30+. Always wear clothing that shields from the sun. Sun damage can worsen this condition, and sunscreen helps to minimize tanning.
- Concealing products may help to improve the appearance of the vitiligo affected area, especially in the exposed skin. The FDA also approves Self-tanners that contain dihydroxyacetone.
- Consult a dermatologist before applying any products and trying home remedies for vitiligo. Various medications available in the medical stores and market can worsen vitiligo.
- Avoid using sunlamps and tanning beds.
Vitiligo can cause psychological distress, and this can cause a worsening of the condition. A skin specialist suggests the best counseling and treatment manage and cure this condition effectively.