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VITILIGO is a common, acquired pigmentary disorder of the skin. The condition has been known to exist for at least 2000 years and occurs worldwide. It affects an estimated 1% of the population. There are two significant types of vitiligo: segmental and generalized (focal). Segmental vitiligo affects only a tiny portion of the body, such as one-half of a finger or toe. Generalized vitiligo covers large portions of the body and may be associated with autoimmune diseases or other conditions affecting pigmentation, such as albinism or pernicious anaemia. Here are ten things that you must know about vitiligo:
1. What is vitiligo?
Vitiligo is a condition in which areas of skin lose their pigment. It appears most commonly as white patches on the skin, but it can affect any size, including the mouth and eyes. It may also cause hair to turn gray or white. The patches caused by vitiligo are entirely smooth and often appear on parts of the body exposed to the sun, such as the hands, feet, arms, face, and lips.
The cause of vitiligo isn’t known. It may be related to your immune system — that is, some aspect of your immune system mistakenly attacks skin cells called melanocytes. Melanocytes produce pigment (color) in the skin.
2. Who gets vitiligo?
Anyone can get vitiligo, but it’s more noticeable in people with darker skin. How evident it depends on how many pigment-producing cells the body has left. Vitiligo is most often diagnosed between ages 10 and 30, but it can occur at any age. In some cases, people first notice vitiligo patches after age 40 or even later in life. People with vitiligo may have a slightly increased risk for thyroid disease.
3. What causes vitiligo?
The cause of vitiligo isn’t known; however, it’s thought to be related to your immune system — that is, some aspect of your immune system mistakenly attacks cells called melanocytes. Melanocytes are found in the skin and produce pigment (color) that gives its tone or hue. Under normal circumstances, these damaged cells are replaced by new ones over time. But with vitiligo, the melanocytes are being destroyed faster than they can be replaced.
It’s thought that melanocyte stem cells (cells in the skin that produce melanocytes) might also be involved in this process. Stem cells may have a direct effect on vitiligo. Or it could be that something happens to stem cells due to an immune system attack on other melanocytes in the skin. There is no evidence yet suggesting whether or not this is true.
Research has shown there is a genetic component for some forms of vitiligo, meaning you’re more likely to get it if your parent or sibling has it. However, most people who develop it don’t have any family history of the disease. For most people with vitiligo, the condition seems to be triggered by something in the environment that affects them.
4. What are the signs and symptoms of vitiligo?
Vitiligo has few symptoms and usually doesn’t cause other health problems. However, some people experience changes in their vision because of an eye condition called uveitis that develops in association with vitiligo. Signs and symptoms of vitiligo include: Vitiligo commonly causes loss of color (pigment) in patches on the skin, which may enlarge or spread over time. The inside of the mouth, gums, and lips also may lose pigmentation.
Patches range in size from a pencil eraser to large areas that cover much of the body.
White patches often slowly increase in size over many years, sometimes spreading across otherwise unaffected areas of skin. In some cases, the white patches stay precisely where they started until the condition is treated. As vitiligo spreads, it can cause long-term changes to your appearance and emotional well-being.
Loss of pigment on parts of the eyes, often around their outer edges
Loss of color (pigment) in the hair, including eyelashes, eyebrows, and beard, as well as pubic hair.
5. How common is vitiligo?
According to some estimates, vitiligo is a relatively common condition — about 1 or 2 percent of people in the United States have it. The disease appears in both sexes and all races equally. Although it can develop at any age, it usually shows up before the age of 30. It’s most often diagnosed between ages 10 and 20 years old. Vitiligo may be more noticeable when your body goes through hormonal changes, such as puberty, pregnancy, menopause, or stress, because those situations increase the loss of melanocytes in your skin.
6. What are the types of vitiligo?
The types of vitiligo are determined by which skin areas are affected and how much skin is involved. Generally, there are three main kinds: focal, segmental, and generalized. Focal means only one side of your body (such as your finger) is involved. In this case, the other parts of your body will have standard pigment. Segmental means the disease affects one side of your body, such as just one arm or leg. The color loss is usually symmetrical — that is, it’s on both sides of your body, like a mirror image — but not always. Generalized involves more than half the body; it’s also known as “vitiligo Universalis.”
In rare cases where most or all of the pigment is lost in the skin, hair, and eyes, your doctor might refer to it as an “acquired oculocutaneous albinism.” This condition is serious because it can affect your eyesight.
7. What are myths associated with vitiligo?
Myth #1: Vitiligo is contagious.
Truth: Vitiligo isn’t contagious or infectious, so it can’t be passed from one person to another through casual contacts, such as touching someone with vitiligo. It’s also not caused by a skin disease, allergy, or infection.
Myth #2: People with vitiligo lack self-control and willpower.
Truth: This myth comes from the association of vitiligo with mental illness in some cultures. Because vitiligo often appears in places like your face and hands, which are visible when you interact with others — it may affect how you feel about yourself and how others treat you. That doesn’t mean that your feelings and sense of control over your life are diminished, though. Many people who have vitiligo accept their skin changes and wouldn’t want to change them if they could.
Myth #3: Vitiligo is a type of leprosy.
Truth: Leprosy is a chronic infectious disease that has nothing to do with vitiligo. It can cause your skin and the tissue under it (nerves, fat, and muscle) to become discolored or lose their pigment. The loss of color usually begins on the face or extremities and progresses over time as an area gets affected more by the disease. Unlike in vitiligo, this discoloration is often permanent once it’s present over a large part of your body — even after treatment of the illness.
Myth #4: Vitiligo is just a cosmetic problem.
Truth: The loss of skin color in some regions of your body can affect how you feel about yourself and how others treat you. To deal with or cover up these changes, some people may use makeup or camouflage techniques to hide them. For most people, though, vitiligo isn’t something that affects their happiness and well-being because it’s outside their control (such as having dark hair when you would rather have blonde hair).
8. How is vitiligo diagnosed?
Your doctor will ask about your medical history, family history, and any symptoms you are experiencing. You may have a physical exam to look for signs of vitiligo and rule out other conditions that could be causing these changes, such as skin diseases or infections. Your doctor may also give you a blood test to check your thyroid function and vitamin levels, both of which can affect melanocyte production in the body. If you have vitiligo, the test results will be normal.
9. What treatments are available for vitiligo?
Any treatment that restores color to white patches of skin would be considered a treatment for vitiligo. Different repigmentation therapies are depending on how many areas are affected and how large they are. The goal of these therapies is to give you a more even skin tone by lightening or darkening the pigment in your skin to match the surrounding area(s).
Several medications can help repigmented (or “regenerated”) pigment stay on the skin longer. These drugs include corticosteroids (such as hydrocortisone), tacrolimus, and pimecrolimus. If you have just a few white patches, you may want to try these first before trying more aggressive and difficult treatments such as light and laser therapies or skin surgery.
There are many treatment options available for people with vitiligo. Your doctor will recommend the best one(s) depending on how much pigment loss you have, where it is and whether your condition is getting better or worse over time. Here are some examples:
- Pills – Certain drugs that affect melanocyte production in your body can cause lightening (or darkening) of skin color when they are taken daily. These include acitretin and isotretinoin (also called “Accutane”).
- Creams – These are applied to the skin daily and may include corticosteroids, tacrolimus, and pimecrolimus. Other creams that can be applied less often may include calcineurin inhibitors such as tacrolimus (Protopic) or pimecrolimus (Elidel). Some of these drugs have been associated with side effects in children under age 2. Your doctor will discuss possible risks and benefits before you use them on your child. See also: Topical Immunomodulators for Treating Vitiligo
- Light therapy – For small patches only. This treatment is usually done in a medical office every few weeks, over several months. It uses intense “violet/blue” light that penetrates the skin and has been shown to trigger pigmentation in many people with vitiligo.
- Laser therapy – For small patches only. This treatment is done at a doctor’s office or dermatology clinic every 2-4 weeks, depending on how often your doctor needs to treat you for several months. A laser works by targeting melanocytes (cells that make pigment) under the skin and stimulating them, so they start making pigment again.
- Skin surgery – Rarely needed for small patches; instead of making new pigment cells, this option is meant to move existing ones into areas where they’ve disappeared. The techniques used include Autologous (donor) melanocyte transplant — This is done in a doctor’s office and requires two procedures. First, pigment is removed from an area with lots of pigment cells (often the buttock or inner thigh). Then these pigment cells are isolated and processed to make a suspension of single cells that are then injected into your white patches. It can take up to 6 months for the new color to appear; it will fade if you receive more transplants. There is also a 10-15% risk of scarring from this procedure.
Repigmentation: The goal here isn’t to trigger pigmentation like with laser therapy, but rather move existing skin cells into the affected areas so they can start making pigment again. Your doctor will use a device called a “dermabrader” (similar to a grater) to remove the top layer of skin and expose the area where pigment cells are located. This is sometimes done in combination with other treatments.
- Topical immunomodulators – These drugs, such as tacrolimus and pimecrolimus, act by blocking a chemical messenger that tells immune system cells to attack your melanocytes (the pigment-producing cells). They can be used for vitiligo on small areas only but are often not recommended because they have been linked to side effects such as skin atrophy (thinning), burning, itching, or inflammation.
10. Homeopathy is very effective for treating vitiligo:
Homeopathic remedies work towards strengthening immunity and curing vitiligo conditions at their root cause. They help build immunity so that the body can heal itself and not give any side effects, as all homeopathic remedies are prepared from natural sources only.
Homeopathic treatment aims to stimulate the body’s immune system and boost its healing ability, rather than just treating the symptom itself(skin pigmentation). Homeopathy addresses both – the symptoms and the root cause behind them for long-term results with no side effects. Hence, they are safe to use for all ages.
You can book an appointment through OHO Homeopathy for detailed consultation with a Homeopathy doctor if you have vitiligo!