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Vitiligo is a skin condition with loss of natural colour (pigment) in part or all skin. It occurs when the cells that produce pigment (colour) in your skin are destroyed or stop functioning. Your doctor may call vitiligo by other medical terms, such as leukoderma and depigmentation disorder.
Vitiligo can begin at any age but most often starts between 10 to 30 years old. There may be no apparent reason for vitiligo to occur, but it tends to run in families. Once you have the condition, you’re likely to develop more areas with white patches over time, although this will vary from person to person. Some people’s vitiligo may stop spreading and remain in one or two rooms. It’s not always possible to determine the cause of vitiligo by looking at the skin, but sometimes it can be helpful.
Common causes include:
- Autoimmune diseases
- Vitiligo is an autoimmune disease in which the immune system incorrectly attacks and destroys the melanocytes (cells that make pigment). As a result, white patches appear on the skin where there is no natural colour. Over time, more white patches may develop. Vitiligo may also affect hair follicles and sweat glands, causing them to become less active or stop working correctly. However, it’s not clear why this happens in some people with vitiligo but not others.
- Endocrine disorders
- Vitiligo may be associated with other endocrines (hormonal) disorders such as hypothyroidism, diabetes, and Addison’s disease. It may also occur after specific treatments for an overactive thyroid or other conditions, suggesting a link between vitiligo and the immune system. However, vitiligo itself is not usually thought of as an endocrine disorder.
- Hereditary diseases
- Vitiligo may occur if you have a family history of the condition or certain hereditary diseases such as ocular (eye) albinism. This suggests there may be some link between vitiligo and genes that control pigmentation. However, it’s not clear why this happens in some people with vitiligo but not others.
- Some medications are thought to trigger vitiligo, like high-dose steroid creams for skin conditions (such as dermatitis or eczema), methotrexate hydroxychloroquine sulfasalazine penicillamine chloroquine, and beta-blockers (used for high blood pressure, heart disease, and migraine).
Other causes include high fevers, sunburns, and psychological stress following trauma or surgery. Although these can cause depigmentation, this is usually temporary (reversible), and the pigment returns in affected areas. Vitiligo affects about 1 to 2 percent of the population worldwide. Still, it can be difficult to accurately determine how many people are concerned because some people with vitiligo may not seek treatment or see a doctor.
What are the types of vitiligo?
There are three main types of vitiligo. The location, appearance, and rate of progression vary depending on the type you have. Vitiligo can occur in one or many areas of your body, but it usually begins as white patches that grow over time.
- Non-segmental vitiligo:This is the most common type of vitiligo, affecting roughly 90 percent of all people with the condition. It usually begins in one or two areas, such as patches on your arms, legs, face, or trunk. White patches often appear on more than one area at a time and sometimes spread to other parts of your body over time.
- Segmental vitiligo:This type affects 10 percent of people with vitiligo. It tends to affect only one side of your body (one leg, one arm) and may involve large areas. Segmental vitiligo may appear later in life than non-segmental vitiligo. It tends to start in adulthood after an event that triggers depigmentation in just one part of the body.
- Unilateral vitiligo:This type affects roughly 1 percent of people with vitiligo. It causes depigmentation in only one area, like unilateral segmental vitiligo, but it may start at any age and affects no more than one side of your body.
How is the severity of vitiligo determined?
Vitiligo is classified into four types based on how widespread the patches are and whether you have any other symptoms besides pigment loss. The categories are as follows:
Type 1: involves pale skin with ten or fewer white patches no larger than 5 millimetres (mm) in diameter.
Type 2: also involves pale skin, but with more than ten white patches extending beyond 5 mm. Each patch can be any size.
Type 3: is when you have lost pigment in some areas of your skin, including more than ten white patches more significant than 5 mm and a few small areas less than 5 mm wide. It may also involve a loss of colour inside your mouth or on the genital area or around body openings such as your eyes, nose, rectum, and vagina.
Type 4: This involves any loss of pigment on parts of your body that aren’t exposed to the sun (your groin and buttocks, for example). In this case, the color loss is widespread instead of patchy.
What are the symptoms of vitiligo?
-Skin patches that consist of entirely white skin; these white patches tend to expand over time. The edges often feel numb and burn easily because there are no melanocytes in those areas to protect you from heat and pain.
-Skin patches that have more than just white skin, such as light brown or pink skin in addition to all-white skin; dark brown patches occur in 30-50 percent of people with vitiligo.
– Skin patches with all three colors, white, dark brown, and light brown or pink. This type of patch is known as an island.
-Patches of skin that lose pigment but do not change their size over time; are called flat lesions (not to be confused with macules caused by tinea versicolor.
What triggers vitiligo?
- Genetic predisposition
- Autoimmune diseases or an autoimmune disorder
- Infections that can affect the immune system, such as the human immunodeficiency virus (HIV)
- Associated with other autoimmune disorders, such as thyroid disease, pernicious anaemia, Addison’s disease, and vitiligo
- Sunburns during childhood or in one’s youth
- Severe emotional stress or trauma to the skin may also trigger depigmentation in some people with vitiligo.
When is the right time to visit a skin doctor or dermatologist?
- If you notice any new, unusual skin changes.
- If the white patches spread to other areas of your body or become more extensive.
- If you develop any symptoms that could be associated with other conditions besides vitiligo (for example, if pigment loss begins in an area that’s not exposed to sunlight).
- If you experience embarrassment due to the change in pigmentation on your face, hands, or other visible parts of your body.
- When just one patch is present, and it does not appear to increase or decrease in size even after 8-12 months without treatment, then the condition is probably stable, and no further action is required at this point.”
When should I see my doctor for vitiligo if it runs in my family?
If it runs in your family, you can become more proactive about managing your condition by asking your physician to conduct regular check-ups every three months. This way, you’ll have visual proof that depigmentation worsens over time, which may prompt doctors to begin treatment sooner rather than later. Be aware that even though pigment changes may be temporary (such as after getting a sunburn), this does not mean you have a mild case of vitiligo. Later photos can help show that pigment loss is increasing more rapidly than it did the year before.
What are the main vitiligo treatments suggested by a skin doctor?
- Skin Camouflage:
Skin camouflage is a cosmetic covering solution used to hide vitiligo patches. It can be very effective, but it’s expensive and sometimes tends to peel off.
- Topical Medications:
Topical medications are another option for people who have mild cases of vitiligo. The goal of this treatment is to stop the immune system from destroying the melanocytes. There are two types of medications:
(1) Corticosteroids: These weaken your immune system and block the production of chemicals that trigger depigmentation. Side effects include stretch marks and an increased chance of basal cell carcinoma (cancer), especially if you’re also taking ultraviolet light therapy treatments.
(2) Psoralen plus Ultraviolet A (PUVA) therapy: This treatment uses psoralens and ultraviolet A light to suppress the immune system. Psoralens make your skin more sensitive to ultraviolet light, and they can be found in medications such as Furocoumarin, Trioxsalen, Methoxsalen, and Xanthotoxin. One possible side effect of PUVA treatment is skin cancer, but your risk of developing this disease will depend on the strength and duration of UV exposure.
- Narrowband (TL-01) ultraviolet B light therapy:This treatment involves exposing your depigmented patches to narrowband ultraviolet B (UVB) light, which slows down the production of chemicals that cause depigmentation. If you have a mild case of vitiligo, this treatment can achieve excellent results within 12 to 15 sessions over six months. The risk of skin cancer with narrowband UVB therapy is lower than PUVA, but it’s still possible, so people are typically advised to stay out of the sun during and for a few months after treatment.
- Immunomodulators: These medications have been used successfully to treat vitiligo in the United States by restoring pigment production in melanocytes. However, they’re mainly FDA-approved for psoriasis (a different skin condition). The downside of immunomodulators is that they usually need to be taken over a long period, which means you’ll experience significant side effects such as nausea and fatigue.
- Other Potential Treatments: Other possible treatments include: Topical tacrolimus (Protopic) and pimecrolimus (Elidel), narrowband ultraviolet A light therapy, skin grafting, injection of botulinum toxin into affected areas, or application of chemical peels.
What is the natural vitiligo treatment suggested by skin doctors or dermatologists?
- Sunscreens:You’ll be tempted to tan your skin, but this is a bad idea. Instead, use sunscreens with an SPF of at least 30 to protect your patches from the sunlight’s harmful UVA and UVB rays.
- Vitamin B12 supplements: This nutrient can help stimulate pigment production in melanocytes. Keep in mind that it may take up to 3 months for results to become visible.
- Melatonin: This hormone is naturally produced by the pineal gland in your brain, and it’s been shown to inhibit depigmentation when applied topically or taken orally. One study published in the Journal of Investigative Dermatology found that using melatonin and narrowband ultraviolet A light therapy resulted in more significant improvements than narrowband ultraviolet A light therapy alone.
- Vitamin C cream: According to a study published in the Journal of Cosmetic Science, applying vitamin C topically can help restore skin pigmentation by stimulating the production of tyrosinase, an enzyme responsible for melanin production.
- Acupuncture: Some people have reported good results from acupuncture treatments. Still, there’s very little research to back this up, so speak with your doctor or dermatologist before trying it out.
- Stress Reduction:Living with skin patches can have an emotional impact on your life, which may interfere with your ability to handle stress effectively. In some cases, it may be necessary to deal with stress before getting better results from vitiligo treatment.
- Avoiding Smoking: According to a study published in the European Journal of Dermatology, smokers have a lower level of dopamine than non-smokers, and dopamine plays a role in regulating melanin production, so smokers are more likely to experience depigmentation.
- L-Tyrosine: This amino acid has been proven to reduce the duration and intensity of vitiligo in mice by preventing pigment loss, but research on its usefulness in humans is limited, and it’s unclear whether this treatment will be effective for people with darker skin types.
- Avobenzone: Avobenzone functions as a chemical sunscreen that can protect your skin from harmful ultraviolet rays, which means you’ll want to apply it before heading outside with clothing or sunscreen.
- Homeopathic Treatment: Homeopathic treatment has been used successfully to treat vitiligo by restoring pigment production in melanocytes. It would help if you took homeopathic treatment under the guidance of a qualified practitioner who is educated and well trained in this form of medicine.
- Homeopathic medicine for vitiligo is prepared from plant, shrub, or tree extracts. It helps to stimulate melanocytes to produce pigment and restore skin colour.
- Homeopathic medicine works well with both children and adults suffering from vitiligo. It treats the root cause and helps to improve the overall health condition of the patient. It is one of the best and side-effect-free treatments for vitiligo.
- Homeopathic medicines for vitiligo help to restore the lost colour and make the skin as normal as before. It effectively removes pigmentary blotches such as macules, patches, spots, and other discolorations caused due to vitiligo. For more information and vitiligo treatment, you can book an appointment with a homeopathy doctor through OHO Homeopathy!