Vitiligo (vit-ill-EYE-go) is a disorder in which white patches of skin appear on different parts of the body.
Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.
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This happens because the cells that make pigment (color) in the skin are destroyed, die or stop functioning. . These cells are called melanocytes (ma-LAN-o-sites). Vitiligo can also affect the mucous membranes (such as the tissue inside the mouth and nose) and the eye.
Vitiligo usually affects the skin, but it can develop anywhere we have pigment. Patches of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color.
There is no way to predict how much color a person will lose. Color loss can remain unchanged for years. Some people see patches enlarge and new patches appear. On a rare occasion, the skin regains its lost color. Vitiligo is chronic and can last for years or be lifelong.
Signs and Symptoms
White patches on the skin are the main sign of vitiligo. These patches are more common in areas where the skin is exposed to the sun. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:
The armpits and groin (where the leg meets the body). Around the mouth, in the mouth (especially people with darker skin), eyes, nostrils, navel, genitals, and rectal area. Your dermatologist may call this “loss of pigment” or “depigmentation.” We can lose pigment anywhere on our bodies, including our hair (scalp, eyebrow, eyelash, beard). People with vitiligo often have hair that turns gray early (premature hair whitening).
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The affected skin can lighten or turn completely white. Many people do not have any other signs or symptoms; they feel healthy.
A few people say that the skin affected by vitiligo itches or feels painful.
Will the white patches spread? There is no way to tell if vitiligo will spread. For some people, the white patches do not spread. But often the white patches will spread to other areas of the body. For some people, vitiligo spreads slowly, over many years. For other people, spreading occurs quickly. Vitiligo can progress. With time, some people see their vitiligo cover a large area.
Some people have reported more white patches after physical or emotional stress.
What Causes Vitiligo?
The cause is not known. In vitiligo, the immune system may destroy the melanocytes in the skin. It is also possible that one or more genes may make a person more likely to get the disorder.
Scientists do not completely understand why these cells die. One type of vitiligo, non-segmental vitiligo, may be an autoimmune disease. An autoimmune disease develops when the body mistakes a part of itself as foreign. If the body mistakes these cells as foreigners, it will attack and kill these cells.
Studies suggest that the other type of vitiligo, segmental vitiligo, has a different cause. This type seems to develop when something in the body’s nervous system goes awry.
Some researchers think that the melanocytes destroy themselves. Others think that a single event such as sunburn or emotional distress can cause vitiligo. But these events have not been proven to cause vitiligo.
Who Is Affected by Vitiligo?
Many people develop it in their twenties, but it can occur at any age. The disorder affects all races, ethnicities and both sexes equally, however, it is more noticeable in people with dark skin. e
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People with certain autoimmune diseases (such as hyperthyroidism) are more likely to get vitiligo than people who don’t have any autoimmune diseases. Scientists do not know why vitiligo is connected with these diseases. However, most people with vitiligo have no other autoimmune disease.
Vitiligo may also run in families. Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it. y
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How Is Vitiligo Diagnosed?
The doctor will use a family and medical history, physical exam, and tests to diagnose vitiligo. The doctor may ask questions such as:
Do you have family members with vitiligo?
Do you or family members have any autoimmune diseases? Did you have a rash, sunburn, or other skin problem before the white patches appeared? Did you have some type of stress or physical illness? Did your hair turn gray before age 35? Are you sensitive to the sun?
The doctor will do a physical exam to rule out other medical problems.
Tests might include:
Taking a small sample (biopsy) of the affected skin to be examined, blood tests and an eye exam.
How do dermatologists diagnose vitiligo?
If your dermatologist suspects that you have vitiligo, your dermatologist will:
Review your medical history, and may ask specific questions such as whether anyone in your family has vitiligo. Perform a physical exam, looking carefully at the affected skin. You also may need a blood test to check the health of your thyroid gland. People who have vitiligo often have an autoimmune thyroid disease. A blood test will tell whether your thyroid is healthy. If you have thyroid disease, treatment can successfully control it.
Treatment may help make the skin look more even. Treatment may improve the appearance of the skin but doesn’t cure the disease. The choice of treatment depends on the number of white patches, how widespread the patches are and the treatment the person prefers to use.
Some treatments are not right for everyone. Many treatments can have unwanted side effects. Treatments can take a long time, and sometimes they don’t work.
Current treatment options for vitiligo include medical, surgical, and other treatments. Most treatments are aimed at restoring color to the white patches of skin.
Medical treatments include:
Medicines (such as creams) that you put on the skin. Medicines that you take by mouth. A treatment that uses medicine plus ultraviolet A (UVA) light (PUVA). Removing the color from other areas so they match the white patches.
Surgical treatments include:
Skin grafts from a person’s own tissues. The doctor takes skin from one area of a patient’s body and attaches it to another area. This is sometimes used for people with small patches of vitiligo.Tattooing small areas of skin.
Other treatments include:
Sunscreens, cosmetics, such as makeup or dye, to cover the
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white patches. A person may need to try several brands of concealing cosmetics before finding the product that works best.
Steroids to the affected area: Clobetasol (Clobex), Mometasone (Elocon), Fluocinolone acetonide (Synalar), Betamethasone (Luxiq)
Other treatments: Tacrolimus to the affected area (Protopic), Pimecrolimus to the affected area (Elidel)
Hydroquinone to the affected area (Topiclear)
Lifestyle: Sunscreen and reapply often
Procedures: Photodynamic therapy
Therapies: Ultraviolet light therapy
What Can People Do to Cope With Vitiligo?
Living with vitiligo can cause other symptoms such as low self-esteem and depression that is hard to beat. This can happen regardless of the amount of color loss or type of vitiligo.
When you have vitiligo, you may be upset or depressed about the change in your appearance. There are several things you can do to cope with the disorder:
Find a doctor who knows how to treat vitiligo. The doctor should also be a good listener and be able to provide emotional support. Learn about the disorder and treatment choices. This can help you make decisions about your treatment. Knowledge often improves a person’s quality of life. It helps to know about treatment options so that you know what is possible.
Learning more about vitiligo can help you decide what feels right for you. You may want to treat it, camouflage with cosmetics, or just let it be. Some people with vitiligo have found that cosmetics that cover the white patches improve their appearance and help them feel better about themselves. Only you can decide what’s right for you.
Connect with other people who have vitiligo. Family and friends are another source of support.
Connecting with others who have vitiligo can help. A vitiligo group can help you find a support group (also check your local listings ans social media).
You will find links to support groups below:
Vitiligo Support International
Message boards for major cities, local support groups that meet monthly giving you the opportunity to meet others living with vitiligo, and the chance to share support and experiences in person.
An online community where people living with vitiligo, their family, and their friends can share information and stay in touch. Can meet people worldwide.
Celebrities with Vitiligo
Big Krizz Kaliko
Vitiligo Support Group
Discussions and articles on websites.
What Research Is Being Done on Vitiligo?
Scientists have gained a better understanding of vitiligo in recent years, especially through gene research. Current research includes studies to investigate:
How trauma or stress to the skin can trigger vitiligo or the development of new white patches. New treatments and better understanding of vitiligo using a mouse model. Genes that may cause or contribute to having vitiligo. Analysis of genes already known to be linked to vitiligo. They are studying the genes involved in vitiligo. Researchers believe that by identifying all of the genes involved in vitiligo, they will learn what destroys the cells that give skin its color. With this knowledge, it should be possible to develop better treatments. One of the key goals of this research is to develop a treatment that will permanently stop the skin from losing color.
Millions of people worldwide have vitiligo.,
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200,000 to 3 million US cases per year.
Nearly half get it before they reach 21 years of age. Most will have vitiligo for the rest of their lives.
It is very rare for vitiligo to disappear.
Vitiligo occurs about equally in people of all skin colors and races.
About half the people who get vitiligo are male and half are female.
The risk of getting vitiligo increases if a person has a close blood relative who has vitiligo or an autoimmune disease, especially Hashimoto’s disease (a thyroid disease) or alopecia areata (causes hair loss).
Vitiligo is not contagious. If you decide not to treat vitiligo, it’s still important to see a dermatologist for an accurate diagnosis and physical. Vitiligo is a medical condition, not just a cosmetic concern. It is not life-threatening. But, vitiligo can be life-altering. Some people develop low self-esteem. They may no longer want to hang out with friends or develop serious depression. The emotional aspects of having vitiligo are often overlooked, but they are real. If a child has vitiligo, other children may tease and bully. People can stare. Studies conclude that many people who have vitiligo have a decreased quality of life. Most people have vitiligo for life, so it’s important to develop coping strategies. And for those of us who do not have vitiligo, we need to learn about the condition and be more compassionate to those who are living with it. It’s ok to be curious and ask questions (per an acquaintance who has vitiligo) but the rudeness, stares and unkind remarks and treatment is mean- spirited and unnecessary. Put yourself in that person’s position. This is not anything they did or asked for and they have enough going on without ignorant people treating them less than who they are. “Treat others how you want to be treated!”
*The information in this post is for informational purposes only. Seek medical advice/ treatment from your own physician and/or medical professional.