Vitiligo is a skin condition that causes depigmented patches due to the loss of melanin-producing cells. It can affect any part of the body and may vary in size and shape. While its exact cause is unclear, it is believed to involve autoimmune factors.
Vitiligo is a skin condition where cells responsible for your skin colour called melanocytes, are destroyed. When melanocytes fail to produce skin pigment and melanin, it can result in areas of the skin losing pigmentation, leading to white spots and patches. The extent of colour loss varies among individuals, with some experiencing a few spots while others have widespread depigmentation. Vitiligo is not contagious but it can appear on any part of the body, potentially spreading over time.
The exact cause of vitiligo is not fully understood, but experts believe it is an autoimmune disease where the body’s immune system mistakenly attacks and destroys melanocytes. Moreover, exposure to sunlight is thought to exacerbate the condition. It has also been seen that it can start at any age and affect anyone but it is more noticeable in individuals with darker skin tones.
Currently, there is no known cure for vitiligo. But treatment options focus on managing symptoms and may include topical corticosteroids, phototherapy (UVB or PUVA), surgical procedures like skin grafting, or depigmentation therapy in extensive cases. These treatments focus on stopping the progression of vitiligo, which may take time and results may also vary.
Vitiligo occurs when melanocytes, the skin cells responsible for producing melanin, are insufficient in number or dysfunctional. Melanin provides skin and hair with their natural colouration. In individuals with vitiligo, the inadequate functioning of melanocytes leads to reduced melanin production. This results in the development of white patches on the skin and hair. Several factors contribute to the onset of vitiligo, including:
Vitiligo is often associated with autoimmune disorders, where the immune system mistakenly attacks and destroys melanocytes. This autoimmune link suggests a genetic predisposition combined with environmental triggers.
A significant risk factor for vitiligo is having a family member with the condition or other autoimmune diseases. This indicates a genetic susceptibility to autoimmune reactions that affect melanocytes.
Various environmental and physiological factors can trigger or exacerbate vitiligo:
Vitiligo can affect anyone and can develop at any age. However, for many people with vitiligo, the white patches begin to appear before age 20 and can start in early childhood. Certain factors that may increase the risk of developing vitiligo, include:
Major Symptoms |
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Necessary Health Tests |
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Treatment |
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The main symptom of vitiligo is a loss of natural skin colour or pigment, called depigmentation. The first symptom or white spot, that becomes noticeable is usually around the area of a sunburn or minor injury. Initially, patches can be small, pale spots that gradually turn white over time. These patches vary in size and shape and can occur anywhere on the body. In some cases, the edges of these patches may be inflamed and cause itchiness. Here are common symptoms of vitiligo:
While vitiligo patches can appear anywhere on the body, they commonly first appear on areas exposed to sunlight, such as the hands, face (especially around the eyes and mouth), and arms. However, they can also develop in less exposed areas like the feet and genitals. These patches are typically milky-white in colour and become more noticeable over time as the affected areas lose more pigment.
Vitiligo can also affect hair colour. In areas where the skin loses pigment, hair growing from those areas can turn white or grey. This can occur on the scalp, eyebrows, eyelashes, beard (in men), and body hair. The change in hair colour is due to a lack of melanin production in the hair follicles.
In addition to skin and hair, vitiligo can also affect mucous membranes, such as the inside of the mouth and the nose. These areas may lose pigment, resulting in patches of lighter colour. This can sometimes be one of the early signs of vitiligo.
You will often lose pigment quickly in several areas of your skin. After the white patches appear, they may stay the same for a while but get bigger later.
The diagnosis of vitiligo typically involves various options, such as a visual examination, family history, and skin biopsy.
The primary method of diagnosing vitiligo is a visual examination of the skin by a dermatologist or healthcare provider. The doctor may try to evaluate the characteristic depigmented patches on the skin. These patches are typically white or lighter than the surrounding skin due to the absence of melanin.
In some cases, a Wood’s lamp (black light) examination may be used. This special ultraviolet lamp can help detect depigmented areas that may not be easily visible under normal light.
Since vitiligo can be genetic, dermatologists often ask you about your family history. A positive family history of vitiligo increases the likelihood of an individual developing the condition. Vitiligo is associated with autoimmune disorders, so a history of other autoimmune conditions in the family may also be relevant. Apart from this, skin type (especially sensitive skin), and any injuries or trauma to areas where patches are visible are also examined to understand potential triggers or exacerbating factors.
A skin biopsy involves taking a small sample of affected skin for microscopic examination. This can help determine if there are any abnormalities in the skin structure, which can help confirm the diagnosis of vitiligo.
While a skin biopsy is not always necessary for diagnosing vitiligo, it may be performed in certain cases:
Early diagnosis is crucial for starting appropriate treatment and managing the condition.
Treatment for vitiligo aims to restore pigmentation to the areas with milky-white patches, help melanocytes grow back and slow down the progression of vitiligo. It might take some time for the treatment to work and you might get new patches during this time. Common treatments for vitiligo include:
Medical treatment
Also called light therapy, it uses UVA light treatments to slow or stop the progressions of your vitiligo. This treatment option is performed with a combination of medicines your doctor prescribes to manage vitiligo.
In cases of extensive vitiligo, depigmentation therapy may be an option to lighten unaffected skin for a more uniform appearance. Doctors usually recommend this treatment for people who have vitiligo on more than half of their bodies. During this treatment, the patient may experience swelling, redness, itching, and dry skin.
While there is no specific medicine to treat or stop vitiligo, steroid drugs may be effective in treating vitiligo.
Surgical treatments
Procedures such as skin grafting, blister grafting, and melanocyte transplantation are considered for stable vitiligo patches that are not responsive to other treatments.
If you and your healthcare provider opt for drug, surgical, or therapeutic treatment for vitiligo, it can take several months to judge its effectiveness. It is common to try multiple approaches or a combination before finding the most effective treatment. Even if initial treatment succeeds, results may not be permanent, and new patches could develop. Your healthcare provider might recommend ongoing skin applications of topical creams to help maintain results and prevent relapse.
No drug can stop the process or prevent vitiligo. The onset of the condition and its progression are influenced by a combination of genetic, autoimmune, and environmental factors that are not fully understood. Avoiding triggers such as excessive sun exposure or trauma/injury to the skin may help but even they cannot reduce or prevent the risk of vitiligo.
Vitiligo often runs in families, however, vitiligo can occur without a family history as well. Research indicates multiple genes may contribute to its development, making inheritance patterns complex and not always predictable.
The exact cause of vitiligo and why it spreads is not fully understood. It is believed to involve autoimmune factors where the body's immune system mistakenly attacks and destroys pigment-producing cells (melanocytes). Triggers such as stress, illness, or skin trauma may exacerbate this autoimmune response, leading to further depigmentation.
There is currently no known cure for vitiligo. Treatment options aim to control symptoms, reduce further depigmentation, and, in some cases, promote repigmentation. Different therapies, such as topical treatments, and light therapy, may be recommended.
Vitiligo currently has no known cure. While some patches may naturally fade over time, treatment options prescribed by doctors aim to even out skin tone. The likelihood of repigmentation is a bit difficult, and the process can take a lot of time, with low success rates.