Vitiligo is a condition that affects the skin on any part of the body and causes loss of skin color in patches. Melanocytes normally occur throughout the skin, as well as in the hair follicles, mouth, and eyes. In vitiligo, it occurs when cells that produce melanin die or stop functioning.
While vitiligo affects people of all skin types, it may be more noticeable in people with brown or black skin. Around half of those with vitiligo begin to see the condition develop before age 20, but most will have seen it develop before age 40. However, the condition is not life-threatening or contagious, but it can be stressful or make people feel bad about themselves.
What Are Different Types of Vitiligo?
Below are 2 types of vitiligo on which doctors typically categorize:
- Non-segmental vitiligo, also known as vitiligo Vulgaris, bilateral vitiligo, and generalized vitiligo. This results in white patches appearing on both sides of the body and is the most common type of vitiligo. Typically, it begins around the eyes or mouth, near the hands, feet, or body area where the skin frequently rubs together. With non-segmental vitiligo, the color loss comes in spurts throughout a person’s life, spreading and becoming more noticeable as time goes on.
- Segmental vitiligo or also known as unilateral vitiligo. This type usually starts at a younger age and generally progresses for a year or so before it stops. The segmental vitiligo appears in one body area, like one arm or leg. In fact, it’s accompanied by color changes in the hair, eyebrows, or eyelashes in about 50 percent of cases, but this vitiligo type is less common than nonsegmental vitiligo and affects about 1 in 10 vitiligo patients.
In addition, below are common sites of pigment loss, including:
- Exposed areas: hands, face, the upper part of the chest
- Around body openings: eyes, nostrils, mouth, nipples, belly button, genitalia
- Body folds: armpits, groin
- Sites of injury: cuts, scrapes, burns
- Hair: early graying of hair of the scalp, beard, or other areas
- The area immediately surrounding pigmented moles
What Are Symptoms of Vitiligo?
In general, vitiligo’s main symptom is loss of natural color or pigment, called depigmentation. The depigmented patches can appear anywhere on the body, such as:
- Skin, wherein milky-white patches are developed, usually on the hands, feet, arms, and face. However, the patches can appear anywhere.
- Hair, where it can turn white in areas where the skin is losing pigment. This can happen on the scalp, eyebrows, eyelashes, and beard.
- Mucous membranes, such as the inside of the mouth or nose.
Moreover, people with vitiligo can also develop:
- Inflammation in the ear.
- Poor self-image or low self-esteem from concerns about appearance, which can affect the quality of life.
- Uveitis, which is a general term that describes inflammation or swelling in the eye.
What Causes Vitiligo?
Although the causes of vitiligo aren’t entirely understood, several different theories include:
- Autoimmune disorder. The affected immune system of the person may develop antibodies that destroy melanocytes.
- Genetic factors. Vitiligo can be inherited, part of certain factors that may increase the chance. In fact, about 30% of vitiligo cases run in families.
- Neurogenic factors. A substance that is toxic to melanocytes and may be released at the skin’s nerve endings.
- Self-destruction. Melanocyte defects can cause their own destruction.
Also, vitiligo may be triggered by certain events like physical or emotional stress. Since none of the explanations account for the condition completely, a combination of these factors may be responsible for vitiligo.
How Is Vitiligo Treated?
While there is no cure for vitiligo, medical treatment aims to create a uniform skin tone through repigmentation or depigmentation. Hence, below are common treatments, including:
Camouflage Therapy
- The use of sunscreen with an SPF of 30 or higher, which can also shield the UVB and UVA. Using sunscreens minimizes tanning, limiting the contrast between the normal and affected skin.
- Applying makeup may also help camouflage the depigmented areas. In fact, Dermablend is one well-known brand.
- Hair dyes can be used if vitiligo affects the hair.
- The help of depigmentation therapy using the drug monobenzone is used if the disease is extensive. This medication is applied to pigmented skin patches that will turn them white to match the vitiligo areas.
Repigmentation Therapy
- Corticosteroids can be taken as a pill) or as a cream put on the skin. The results may take up to 3 months, but for any side effects, the doctor will monitor the patients, including skin thinning or stretch marks, when used for a prolonged period.
- Topical immunomodulators such as calcineurin inhibitors.
- Topical vitamin D analogs.
Light Therapy
- The use of narrow-band ultraviolet B (NB-UVB), which requires two to three weekly treatment sessions for several months.
- Excimer lasers emit ultraviolet light wavelength close to that of narrow-band UVB. Additionally, this is better for those with no widespread or large lesions since it is delivered to small, targeted areas.
- The combination of oral psoralen and UVA (PUVA) treats large areas of vitiligo skin. This treatment is effective for people with vitiligo in the upper arms, legs, neck, head, and trunk.
Surgery
- Autologous (from the patient) skin grafts. This process involves taking out skin from one part of the patient and used to cover another part. However, there may be possible complications, including scarring, infection, or a failure to repigment. This might also be called mini-grafting.
- Micropigmentation. A type of tattooing is usually applied to the lips of people affected by vitiligo.
Counseling
- Vitiligo can cause psychological distress and affect the outlook and social interactions of the person. When this happens, the provider may suggest finding a counselor or attending a support group.
Who Gets Vitiligo?
While anyone can get vitiligo at any age but for many people with vitiligo, the white patches appear before age 20 and can start in early childhood. Also, this condition seems to be more common in people who have a family history of vitiligo or with certain autoimmune diseases, including:
- Addison’s disease.
- Pernicious anemia.
- Psoriasis.
- Rheumatoid arthritis.
- Systemic lupus erythematosus.
- Thyroid disease.
- Type 1 diabetes.
How To Care For The Skin?
In addition to medications and other treatments the doctor might prescribe to help manage or stop the spread of vitiligo’s physical symptoms, it’s also essential to know that certain lifestyle habits can help make it less noticeable, such as:
- Wearing sunscreen and avoiding tanning beds, as ultraviolet (UV) light can trigger a vitiligo reaction. That said, it’s recommended to look for a broad-spectrum sunscreen with an SPF of 30 or higher.
- Protecting the skin with clothing. Increase the SPF of clothing by washing the clothes with a UV-protectant treatment.
- Applying a self-tanner to the skin can add color safely. The American Academy of Dermatology suggests choosing one with dihydroxyacetone, which the U.S. Food and Drug Administration says is the ingredient responsible for darkening the skin.
- Avoiding tattoos. They can sometimes trigger another vitiligo outbreak within two weeks.
- Limiting exposure to hair dye and bleach These contain chemicals called phenols, which can trigger vitiligo to start or spread. Choose natural dyes instead.
The Bottom Line
Vitiligo is a chronic or long-lasting condition that causes patches of skin to lose pigment or color. MilfordMD Cosmetic Dermatology Surgery & Laser Center offers Omnilux Vitiligo Laser Treatment, which has achieved repigmentation after 8-12 weeks of treatment. Ultimately, it utilizes specific wavelengths of light-emitting diodes (LEDs) to help gently stimulate the skin’s natural rejuvenation process and has been proven effective in treating various skin conditions.
