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Vitiligo is an acquired disorder characterized by well-defined areas of non-pigmented skin resulting from loss of melanocytes. Melanocytes are cells that produce pigment in the skin called melanin. The primary function of melanocytes is to supply melanin to surrounding tissues and maintain the normal color in the skin. The process by which melanocytes are lost is poorly understood. It has been proposed that the immune system destroys the cells, but there is no evidence for this hypothesis. Instead, current research suggests vitiligo may arise from endothelial or neural crest cell defects that cause apoptosis.
So, what are the causes of vitiligo?
Vitiligo is a long-term problem affecting the skin, in which areas of the skin lose their natural pigment. The cause of vitiligo is not known, but several factors have been associated with it.
- Autoimmune disorder –
- Autoimmunity is the failure of an organism to recognize its constituent parts as being a component of itself, thus resulting in an immune response against its cells. In vitiligo, autoimmunity directed against melanocytes within the skin may lead to their destruction. Vitiligo might have therefore been suggested to be caused by autoimmune mechanisms. Vitiligo is also frequently associated with other autoimmune disorders such as thyroid disease,
- Genetic factors
- Many genes have been implicated in the pathogenesis of vitiligo. Genes that may be responsible for susceptibility to this disease are located on several different chromosomes. Some of these are polymorphisms, variations in DNA sequence often identified by changes in restriction enzymes used during genetic analysis. Vitiligo also has a sizeable hereditary factor as more than 50% of cases occur either within families or individuals who know another person with vitiligo will develop it themselves at a point throughout their lives.
- Neurochemical factors
- Some research suggests that abnormalities in neurotransmitters (chemical messengers in the nervous system) may affect pigmentation. Neurotransmitters are involved in cell communication throughout the body; they also regulate bodily processes such as stress reaction and blood pressure. A recent study suggests that people with vitiligo produce less dopamine, a neurotransmitter associated with control of melanin production.
- Industrial Chemical Exposure
- A link has been suggested between exposure to industrial chemicals such as rubber and certain dyes used in textile and leather industries and the development of vitiligo. However, this association remains unproven.
- Stress is an essential variable in the development of vitiligo. For example, people afflicted with this problem often experience a worsening of symptoms associated with illness or surgery and improve when under less stress.
- Vitamin B12 deficiency
- A deficiency of vitamin B12 (cobalamin) has been associated with the development of vitiligo. Since not all individuals with low cobalamin levels develop vitiligo, this relationship is likely more complex than simple cause and effect.
- Sun exposure
- Exposure to ultraviolet light from the sun may play a role in some cases of vitiligo, particularly those on non-sun-exposed areas such as the soles or palms. Sunburn also appears to increase pigment loss in people affected by vitiligo. However, lack of adequate sunlight does not appear to be a risk for
- Environment Exposure
- Exposure to certain chemicals in our environment may play a role in causing vitiligo. These include pesticides and the industrial solvent phenol, which has been reported to cause depigmentation of the skin in workers exposed to this chemical.
- Loss of Nerve Cells
- Researchers have proposed that apoptosis (programmed cell death) is involved in vitiligo. The loss of melanocytes from areas of skin affected by vitiligo. Apoptosis is a normal process by which cells die after being damaged or under stress.
- Multi-Vitamin Deficiencies
- A few studies have reported that the blood levels of specific vitamins are lower in people with vitiligo than those without it. This suggests a possible link between vitamin deficiency and the development of vitiligo. However, this study needs to be repeated with more participants before any conclusions can be drawn. To date, no conclusive evidence suggests that nutritional deficiencies play an important role in causing or preventing vitiligo.
Symptoms of vitiligo:
Most people develop symptoms after areas of their skin first lose color, which may take months or years. The pigment loss eventually spreads to larger areas of skin on the body and face, but often not beyond midsection. Symptoms vary depending on which parts of your body are affected by vitiligo.
- Depigmentation of skin
- Premature whitening or greying of hair, eyelashes, eyebrows, or beard.
- Appearance of milia (tiny white bumps) on the skin where pigment has been lost.
- Development of small, pigmented spots called ‘Mongolian spots’ at sites of the previous injury to the skin, such as the back of the knees, elbows, or forehead.
- Loss of color in the retina (the light-sensitive layer lining the back of your eye) leads to reduced visual acuity.
- Change the white part of your eyes, becoming blue or hazel instead of its standard brown color.
- Stretch marks on areas where pigment has been lost because skin no longer offers the same degree of elasticity as before vitiligo developed.
- Skin injury due to ultraviolet light exposure or trauma can cause lesion activity in people with vitiligo even though their skin color has returned.
- Development of milia-like cysts filled with keratin (a protein that helps keep skin smooth). These cysts are small round bumps that are yellowish or pinkish in color and become progressively more prominent and more numerous.
- Itchiness or burning sensation where skin pigment is not there.
- The hair follicles and the sweat glands over the affected area may shrink and produce fine, light hairs and less sweat than usual.
- Loss of ability to tan (tanning occurs when melanin is produced by cells called melanocytes).
How do skin doctors diagnose vitiligo?
- Immunofluorescence (DIF) test: Your skin doctor may take a sample of your skin for laboratory testing. The laboratory will then examine the samples to determine if there is melanocyte destruction, which would confirm vitiligo. This test is called a direct immunofluorescence (DIF) test.
- Skin biopsy: Your doctor may also suggest taking a small sample of normal-appearing skin and observing it under the microscope for signs of melanocyte loss or pigment granules outside the cells (extracellular). This is known as the indirect immunofluorescence (IIF) test. Since this requires removal of some normal skin, it is mainly done when lesions are widespread or cannot be easily sampled by DIF testing.
- Wood’s lamp examination: A Wood’s lamp is a unique ultraviolet lamp that can help reveal the presence of pigment in your skin. Whether you have vitiligo or not, it can be challenging to see pigmented areas with this test, and false positives and false negatives may occur.
- Others: A skin biopsy may also be used to measure the melanocyte stem cell population and look for other evidence of hormonal changes using immunohistochemistry (IHC). Melanocyte-stem-cell count is one indicator of disease activity; however, there are some problems with its interpretation.
- Genetic studies:If doctors suspect that you might have an autosomal dominant genetic disorder such as Waardenburg syndrome, they will order blood tests to test for these gene changes.
- Melanocyte-Keratinocyte Autografts:In cases of extensive vitiligo, doctors may do a skin graft from a natural part of your body and transplant it to the area with pigment loss. The melanocytes in this graft will migrate into the existing skin and repigment it over time. This technique is mainly used when there are few areas unaffected by vitiligo.’
What are the treatments available for vitiligo?
Treatment for vitiligo aims to restore your standard color or provide cosmetic camouflage, depending on how widespread the patches of discolored skin are. Treatment options include phototherapy (light therapy), topical creams, oral medications, surgical procedures, and tattooing.
- Phototherapy: A treatment that involves regularly exposing your skin to controlled amounts of ultraviolet (UV) radiation, which may help repigment or lighten the discolored patches of skin.
- Topical creams: These products are applied directly onto the white areas of your skin as prescribed by your doctor and can help mask some types of vitiligo as well as repigment some areas that have lost colour.
- Oral medications: Prescription pills such as those containing corticosteroids or tacrolimus may be taken orally, but their effectiveness is often limited, and they produce unwanted side effects in most people with vitiligo.’
- Surgical procedures: Your doctor may suggest surgical procedures to remove the white skin areas and replace them with normal skin, usually taken from an inconspicuous area of your body.
- Tattooing: Using special dyes injected into the affected areas can repigment your skin by mimicking its natural coloration. This procedure is often used in combination with other therapies.’
What are the complications of vitiligo?
- Negative impact on self-esteem: The main complication of vitiligo is the psychological stress and emotional trauma for those affected and their family members.’
- Other psychological disorders: There is also evidence to suggest that patients with vitiligo are at risk of developing other psychological disorders, such as paranoia or schizophrenia.’
- Chloasma: Some women report the development of melasma-like patches of skin due to ultraviolet (UV) light exposure during sunlight therapy sessions. This condition has been called “vitiligo solar roughened,” “phototoxic vitiligo,” or “pseudovitiligo.”‘
- Scars called contraction scars: It may form in areas where there is significant skin pigmentation loss, which can lead to skin contracture and result in changes in the shape of affected body parts.”
5 Skin cancer: People with white patches on their skin may be at increased risk of developing melanoma, an aggressive type of skin cancer that can spread to other parts of the body.’
Alternative vitiligo treatment:
Treatment for vitiligo aims to restore your standard colour or provide cosmetic camouflage, depending on how widespread the patches of discoloured skin are.
- Ginkgo Biloba:
- Ginkgo biloba is an herb that has been used in traditional Chinese medicine for thousands of years. The ginkgo tree leaf contains two substances called flavonoids and terpenes, which may strengthen blood vessels and improve blood flow to your skin, helping with the repigmentation of the white patches of vitiligo.
- In traditional Chinese medicine, the treatment for many conditions involves mixtures of herbs. Ginseng is one herb that may be effective in treating vitiligo. One study reported a reduction in the size and number of white patches on patients with widespread chronic vitiligo who took Korean red ginseng extract daily for 16 weeks compared to those who did not take it.
- Vitamin B12:
- Vitamin B12 is an essential nutrient that your body requires to produce healthy red blood cells responsible for carrying oxygen throughout your body. There have been cases in which people with vitiligo improved after receiving vitamin B 12 injections.
- Aloe vera:
- Aloe vera is a medicinal plant and has been used worldwide for multiple applications. Aloe vera may have a beneficial effect on wound healing and regeneration of skin cells, inhibition of melanin production, and prevention of DNA damage; all activities may contribute to repigmentation treatment of vitiligo. Combination therapy with aloe vera gel and narrowband UVB has been reported to accelerate repigmentation in people with stable vitiligo. We present our cases showing the efficacy of this combination treatment for these populations.
- Homeopathic treatment for vitiligo:
- Homeopathic treatment for vitiligo is one of the best treatments. Homeopathy works wonderfully in treating vitiligo by removing external blotches from the skin while curing internal problems simultaneously through therapy by taking a few medicines orally to change the patient’s whole system towards healthy living. Homeopathic treatment for vitiligo focuses on stopping further destruction of cells from any part and nourishing them for their healthy growth. Homeopathic treatment also works by removing patches from skin and curing skin problems permanently. And taking all these benefits, this is one of the best treatments for vitiligo.
Homeopathic treatment for vitiligo through the systemic way gives satisfactory results to many patients in treating vitiligo because homeopathy takes care of the patient’s system as a whole rather than only focusing on areas affected by it directly. You should visit a registered homeopathic doctor if you want to get rid of vitiligo. You can book an appointment through OHO Homeopathy and get the homeopathic treatment for vitiligo.