Vitiligo is the loss of skin color; it is due to the destruction of the pigment-producing cells known as melanocytes in certain areas of the skin. It can either be localized to one area or can occur in several different areas of the skin. In most of the people, these patches can spread to the other parts of the body. Sometimes vitiligo can occur in the eyes and mucous membranes. Although vitiligo is not a serious condition, it can emotionally and psychologically disturb the affected person.
The main symptom of vitiligo is white irregular patches on the skin due to the loss of color. Vitiligo is more common on the arms, hands, feet, face, and lips. However, it can also occur in the armpits, groins, nostrils, eyes, genitals, rectal areas, navel and around the mouth. Initially, vitiligo starts as a small spot that looks paler than the rest of the skin and finally becomes white over a period.
Additionally, there can be graying of the hair in early age and loss of color in the mouth especially in dark-skinned people.
Although the cause of vitiligo is not determined, it is believed to be an autoimmune response. The possible cause is due to the immune system attacking and destructing the body’s healthy melanocytes of the skin.
Vitiligo can occur at any age but is more common in people aged between 20 – 40 years of age. The other factors to develop vitiligo are:
- A family history of the condition
- Dark skin color
- Presence of certain autoimmune diseases, such as hyperthyroidism
- Exposure of the skin to sun
- Physical or emotional stress
The following complications can develop in people with vitiligo:
- Sunburn and skin cancer
- Emotional and social distress
- Eye problems, such as the inflammation of the iris
- Hearing loss
The doctor will collect the medical and family history of the patient and performs a physical examination of the patient to diagnose vitiligo. Sometimes the skin is exposed to a special lamp which generates UV light to confirm the condition. Further diagnostic testing is needed to rule out other related medical conditions, such as psoriasis and dermatitis. These procedures may include:
- Blood tests to check if any other autoimmune disorders are present
- Eye examination
- Biopsy of the affected skin
There is no cure for vitiligo; the treatment aims at delaying the discoloration process and helps to return the skin color to some extent. However, results can vary from person to person and are unpredictable.
As most of the treatments have side effects, the doctor initially suggests the patient to use self-tanning products to make the skin color even.
Other treatment options may be chosen, if the above options are not effective. These include medicines, therapies, surgery or a combination of them.
Some medicines when used alone or in combination with light therapy can restore the skin tone to some extent.
Corticosteroid creams may be prescribed to reduce the inflammation and bring back the color to some extent if used in the initial stages of the disease. However, it takes several months to notice the change in skin color. The side effects may include the formation of streaks on the skin and skin thinning.
Immune-suppressing agents may be prescribed to treat small depigmented areas, especially on the face and neck. The side effects may include lymphoma and skin cancer.
A combination of psoralen (plant-derived chemical) consumption followed by UV light exposure for 3 times a week up to 12 months is an effective approach to return the color.
Depigmentation of the remaining areas may be chosen, if vitiligo has spread majorly, and if other treatments are not effective. However, depigmentation is a permanent treatment, and the person will be highly sensitive to sunlight.
If the above therapies are not effective, then surgery may be chosen. The surgical approaches include:
- Skin grafting is the surgical removal of the small portions of the normal skin which is attached to the affected skin. This is usually chosen when there are small patches of vitiligo.
- Blister grafting involves the creation of blisters by suction which is transplanted into the affected area.
- Tattooing or micro pigmentation technique involves the use of a special device to introduce pigment in the skin. This method is effective if depigmentation has occurred around the lips in people with dark skin tone.
The patches can reappear over a period even after successful treatment.
There is no known method to prevent vitiligo.