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Vitiligo is a condition that causes the skin to lose its natural pigment. While people get interested in Vitiligo when they see a person with the disease, it’s not immediately apparent that such a person has Vitiligo. It takes an observant doctor and patient working together for this diagnosis to be made correctly. This is because several other conditions mimic Vitiligo:
1) Addison’s disease: This is due to hormonal loss and leads to pale skin and hair, besides many other symptoms like weight loss, vomiting, etc. However, Addison’s doesn’t affect the mucous membranes (e.g., inside of mouth or eyes). Vitiligo does.
2) Leprosy: Here, too, you get shiny spots on the skin and in eye mucous membranes. However, leprosy can be treated with a course of multidrug therapy (MDT).
3) Albinism: This, too, results in pale skin and hair, but there is no loss of pigment from the mucous membranes.
4) Carotenemia: The main symptom here is orange-yellow discoloration of the palms and soles. Carotene pigmentation doesn’t affect the mucous membrane areas.
If you have Vitiligo, it’s essential to get an accurate diagnosis to start appropriate treatment early and minimize skin damage. Here’s how to make this process go smoothly:
1) Go only to a doctor who knows about Vitiligo. It’s good to get a referral from a family physician, an endocrinologist, or a dermatologist.
2) Get a complete physical done by your primary care doctor and get the blood tests called an Autoimmune profile done. This test looks at antibodies against thyroglobulin, thyroid peroxidase antibody, vitamin B12 level, etc. If you have any autoimmune issues that may be causing Vitiligo (like diabetes, thyroid disease, etc.), this will give the doctor some clues about what is happening in your body.
3) A skin biopsy helps confirm the diagnosis. In this procedure, tissue skin samples are taken and examined under a microscope for pigment loss. There are different types of blips that can occur with Vitiligo.
4) Your doctor will also ask you about your family history and look for signs of autoimmune diseases like diabetes, thyroiditis, etc.
5) The goal of treatment should be to repigment (get back color) in the white areas
and improve quality of life. If this isn’t possible, it’s essential to keep the rest of your body protected from sun damage, too, because Vitiligo makes people photosensitive (sensitive to sunlight). This means that you need to wear sunscreen lotion every day all year round, even when it is cloudy.
Here are the techniques used to diagnose Vitiligo:
- Clinical examination: There are two types of clinical examinations. The first type is the observation of the color of the skin in different parts of the body. An expert dermatologist can diagnose Vitiligo by looking at it, even in its initial stages before depigmentation occurs. The second way is to look for the common signs and symptoms that are associated with pigmentation loss. However, many conditions might have these same signs and symptoms, which makes diagnosis difficult sometimes.
- Wood’s light examination: Under a special light called Wood’s lamp or black light, affected areas appear as white spots because they reflect less light than normal skin does. This test helps to differentiate between Vitiligo and leprosy because people suffering from leprosy glow
- Dermatoscopy: In this test, a dermatoscope is used to examine the color of the skin. In Vitiligo, there is usually a significant decrease in pigment compared to normal skin.
- Skin biopsy: In this procedure, a small piece of skin that contains pigment cells is removed and examined under a microscope. This helps determine how much melanin is present in affected areas and what stage vitiligo has reached. The earlier the disease, the easier it will be for affected people to regain their original skin tone.
- Blood tests: These are done to investigate whether other conditions might cause depigmentation or whether an autoimmune component is involved in causing Vitiligo.
- X-ray: This is done to rule out other conditions that might resemble Vitiligo, such as leprosy and tinea versicolor (fungal infection of the skin).
- Ultraviolet photography: In this test, ultraviolet rays are passed through a special filter onto skin areas where pigment has been lost. If there is any abnormality in melanocytes, it will appear as white spots under normal light.”
- Chroma diagnostic testing: This blood test looks for melanocyte antibodies in your system and can help confirm Vitiligo if positive.
- Ultraviolet photography lets the doctor takes pictures of areas with lost pigment under ultraviolet light to see how far the depigmentation has gone and calculate its extent (degree). It will also show variations in surrounding skin colour, like freckles or moles, which will give clues about whether another condition (like Addison’s) may be causing this appearance.
In children, Vitiligo is diagnosed by appearance and family history. In about 25% of cases, a blood test may help diagnose the condition.
It can sometimes be challenging to diagnose Vitiligo because it can cause white patches on anybody area, including the face, fingers, toes, and genitals. Sometimes more than one type of depigmentation occurs at a time.
What are the precautions vitiligo patients can take?
- Do not get sunburned. Sunburns cause inflammation of the skin and accelerate Vitiligo.
- When outside, wear sunglasses to protect your eyes from UV rays and sunscreen on all body parts that aren’t affected by Vitiligo.
- Tanning beds and tanning booths expose you to harmful ultraviolet (UV) radiation that can worsen Vitiligo over time and lead to skin cancer. Talk with your doctor before using a tanning bed or booth if you have Vitiligo in areas other than your face, hands, wrists, feet, ankles, lower legs, or arms.
5) Avoid smoking as it is linked with an increased risk of developing melanoma (skin cancer).
- If you experience itching, burning, or other scarring symptoms (atrophy), contact your doctor immediately.
- Try to avoid sun exposure as much as possible. This might be not easy if it is part of your job or hobby to spend time outdoors, but try to use sunscreen and protective clothing, like wide-brimmed hats and sunglasses. Keep in mind that ozone depletion (from the Earth’s surface up into the atmosphere) leads to an increase in UV radiation reaching the Earth’s surface; this means that spending less time outside during daylight hours is now more critical than ever for vitiligo patients.
9) Most importantly – do not apply corticosteroids directly onto Vitiligo patches to attempt repigmentation.
How do skin doctors treat Vitiligo?
- Medicines: Corticosteroid creams can reduce the appearance of Vitiligo patches for a short period. They also relieve itching and inflammation, which may be associated with this condition.
- Photo(chemo)therapy: This approach involves exposing affected areas to controlled doses of artificial light or UVA/UVB radiation, either alone or combined with taking medications called psoralens by mouth. Psoralens increase the effects of UV radiation on the skin and stimulate repigmentation in people with limited areas of Vitiligo. However, this therapy can cause blistering and burning of the skin.
- Topical Immunomodulators: For patients with limited areas of Vitiligo, applying calcineurin inhibitors to affected areas daily might improve the appearance of the patches over time. Be aware that this treatment worsens Vitiligo in people who are not affected or have only a few small spots.
- Systemic Treatments: Psoralens combined with Ultraviolet A (PUVA) Therapy: PUVA is a radiation treatment used to treat chronic skin diseases like psoriasis, eczema, and Vitiligo therapies aren’t working for you. The most common side effects from PUVA treatment include redness, dryness, itching, and burning of the treated skin. Infrequently, PUVA treatment may cause nausea or an increased risk of certain types of skin cancer.
- Melanocyte-stimulating hormone (MSH): Injections of MSH may help treat Vitiligo. This medication is a naturally occurring chemical that can affect melanocytes, cells that make the pigment melanin. When given as a shot, it has been shown to cause repigmentation of Vitiligo patches in some cases. However, since MSH can raise blood pressure and cause other side effects, it’s only used when other treatment options haven’t worked for you or if your patches are on your face.
- Surgical Procedures: Skin grafts for Vitiligo may use pieces of healthy skin taken from another part of your body (autologous) or cadavers (allogenic). Although surgical procedures work well in some areas like the hands, they don’t work well near joints where creases form because the skin doesn’t heal properly after surgery.
- Micropigmentation: Micropigmentation uses tiny ink deposits to mask Vitiligo spots by providing artificial colors that match normal skin tones. However, micro-pigmentation works best when Vitiligo is limited to a few spots and in fair skin people. Sometimes, this procedure can cause scarring when the ink spreads outside of the pigmented spot.
- Depigmentation: In a minimal number of cases, some people with Vitiligo notice that their patches get bigger over time. This might be a sign of another health problem called generalized edema, which is fluid retention in your body that may require treatment by a doctor. In rare cases, people who get Vitiligo also lose their natural skin color (depigmentation). In these cases, doctors sometimes remove healthy pigment from areas affected by Vitiligo using laser treatments or chemicals applied directly on the skin to help even out skin color.
What are some home remedies one can try if diagnosed with Vitiligo?
There are several home remedies for Vitiligo, but none of them can work alone. You can try:
1) Aloe vera gel: Apply aloe vera gel twice daily on the affected areas. You can also mix lemon juice or honey in it to increase its effectiveness.
2) Turmeric: Mix turmeric powder in olive oil and apply it to the affected areas. Turmeric is an antioxidant, anti-inflammatory & antiseptic which helps to treat skin disorders effectively.
3) Honey: Honey can be combined with almost everything to improve its effectiveness. Apply honey on the affected areas 2-3 times daily for four months continuously.
4) Lemon juice: To lighten skin spots, mix lemon juice with gram flour & egg white and apply it on the affected areas regularly for at least one month or more, depending upon your skin’s sensitivity to the sun after each application. However, this remedy may not work for everyone as every individual has a different skin type.
5) Neem extract: Soak neem leaves in water overnight, mash them to make a fine paste, and apply daily.
6) Multani mitti: Mix some turmeric powder in Multani mitti for a thick paste and apply it daily.
7) Oatmeal bath: Add some oatmeal to your regular bathing water to reduce skin spots.
8) Vitamin E oil or capsules: Apply vitamin E oil or take vitamin E capsules orally every day.
9) Castor oil: Mix castor oil with almond or olive oil and massage it on the affected areas 2-3 times a day. This will help to reduce skin spots gradually within a few months.
10) Almond: Soak some almonds overnight in water and grind them to make a fine paste. Apply this paste on the white patches for about half an hour & then wash it off with cold water.
When it comes to natural treatment, homeopathy is also another good treatment option as it uses natural ingredients such as sulphur, iodine, etc., to treat skin problems. Homeopathy can address both causes and symptoms of Vitiligo with proper guidance from an experienced homeopathic doctor.
Benefits of using the homeopathic treatment for Vitiligo:
- It is a 100% natural treatment & has no side effects.
- It addresses both the cause and symptoms of Vitiligo, thus ensuring complete recovery from the disease.
- Homeopathic remedies are prepared from pure minerals, metals & herbs that have undergone several tests for their purity and potency.
- Homeopathy does not just treat Vitiligo but also treats other problems associated with it, such as stress, anxiety, etc., which in turn helps to reduce or completely get rid of skin spots plus any other disorders too at the same time!
- One does not need to take multiple medications and can lead an everyday healthy life while treating Vitiligo with homeopathic treatment.
Homeopathic treatment helps restore proper skin pigmentation by stimulating the skin cells, gradually improving one’s immunity to disease, and restoring normal body functions such as digestion, metabolism, etc., making it easier for the body to fight infections, including Vitiligo. The homeopathic remedies can be combined with any other medication or home remedy that you may already be using to yield better results. Consult an experienced homeopath before starting on them since they will give you specific instructions regarding their use and dosage. Homeopathic medicines treat both early & advanced stages of Vitiligo effectively without leaving behind scars or side effects after recovery. You can book an appointment through OHO Homeopathy for more information.