Vitiligo

You may have seen people with skin patches lighter than their natural skin and wondered what it is. What you notice is a skin condition known as "Vitiligo," where people are referred to as "colorful"! This is due to the loss of pigmentation (melanin) resulting from an abnormal destruction of melanocytes (melanin-forming cells). It causes discolored spots and patches on your skin on any part of your body. As an autoimmune condition, several risk factors could be involved in developing vitiligo. Though there is no cure, treatment options like light therapy and cosmetic procedures can help regain pigment. Vitiligo can negatively impact your psychological well-being, and the journey of self-acceptance can be long and difficult, especially in a world that equates beauty with uniformity. 

Learn about vitiligo, its types, causes, risk factors, symptoms, diagnosis, and treatment to understand the condition better! 

What is Vitiligo?

Vitiligo is an autoimmune skin condition (when your body's immune system mistakenly attacks healthy cells) characterized by loss of pigmentation. This often appears as white scattered areas over your body, including your face, eyes, and mouth. Areas of your skin that lose pigmentation are macules (if less than 1 cm wide) or patches (if larger than 1 cm). 

Although vitiligo can develop at any stage, affecting any gender or race, it is apparent in people with darker skin and before age 30.

What Are the Types of Vitiligo?

According to the American Academy of Dermatology, there are several types of vitiligo based on the location and extent of the patches or macules. These include:

Localized Vitiligo

• There are only a few patches that cover a small area.
• These patches develop only in a few places in your body.

Non Segmental Vitiligo

• Patches develop on both sides of your body and appear symmetrical
• They often appear on sun-exposed areas like the face, neck, and hands. 
• The following are subtypes of non-segmental vitiligo:

Acrofacial

This occurs on your face, scalp, genitals, fingers, or toes. 

Mucosal

These patches or macules appear around your lips and mucous membranes. 

GeneralizedThe patches are scattered on different areas of your body without any specific size. 

Universal

This is a rare type of vitiligo where the depigmented patches cover most of the body.

Mixed 

You may have both non-segmental and segmental vitiligo.

Segmental Vitiligo

• This type of vitiligo causes rapid color loss only on one side of your body. 
• After some time, the color loss halts and becomes less erratic. 
• This appears at a younger age and affects one side of your body area, such as the face, one leg, or one arm. 

Why Do You Get Vitiligo?

Vitiligo in scientific terms is caused by an abnormal destruction of melanocytes, resulting in a lack of pigmentation (depigmentation). While the exact cause of Vitiligo is still not fully understood, but several risk factors are believed to contribute to this conditions, they are as follows:

Risk factors 

Genetics 

• A genetic mutation or a change in your body's DNA can lead to depigmentation. 
• You may develop vitiligo if your parents suffer from it since it runs in the family. 

Oxidative Stress

• Increased stress levels cause free radical damage and destroy melanocytes. 
• Poor nutrition can increase oxidative stress. 

Environmental Factors 

• Factors like UV (ultraviolet) radiation and toxic chemical exposure can increase your likelihood of developing vitiligo.

What Are the Signs and Symptoms of Vitiligo?

The most obvious and classic sign of vitiligo is having painless white or pale patches on your skin. The white areas have a clear border without any signs of inflammation. 

Some may experience the following symptoms: 

• Hearing loss 
• Loss of eye pigmentation
• Other autoimmune disorders like thyroid disease 
• Itchy skin before pigmentation starts 
• Patches of hair on the body may turn silver, gray, or white

Vitiligo often negatively impacts your psychological well-being, resulting in the following: 

• Mood swings 
• Anxiety
• Depression 
• Low self-esteem 
• A feeling of detachment  

Does Vitiligo Cause Complications?

Vitiligo can be a cause of concern, often due to cosmetic reasons. However, it may cause complications like: 

Sensitive Skin

• Depigmented areas that lack melanin can cause your skin to quickly burn instead of tanning.  

Eye Abnormalities 

• You may suffer from retinal (inner layer of your eye consisting of light-sensitive cells) abnormalities and color variation in your iris (the colored part of your eye). 

Predisposition to Autoimmune Conditions

• Vitiligo may increase your susceptibility to other autoimmune conditions like diabetes, anemia, and hypothyroidism.

How is Vitiligo Diagnosed?

Your dermatologist (a doctor specializing in the diagnosis and treatment of conditions related to the skin, hair, or nails) can accurately diagnose vitiligo by: 

• Recording your medical history
• Assessing your family history
• Conducting a visual examination using a "Wood's Lamp" to evaluate your skin, the lamp uses UV light that shines when focused on your skin to differentiate vitiligo from other skin conditions.

How is Vitiligo Treated?

Unless vitiligo leads to cosmetic concerns, treatment is generally not required. However, your doctor may recommend the following treatment options: 

Medications

Certain drugs slow the speed of pigmentation loss or help melanocytes regrow. 

These include:

• Corticosteroids
• Topical Janus kinase inhibitors
• Calcineurin inhibitors 

Light Therapy

• UV light or medical-grade lasers are targeted at your skin for a specific duration to help return color to your skin. 

Depigmentation Therapy 

• This therapy uses a drug called monobenzone that is applied to the patches to match the color of your natural skin.

Surgery 

• This involves skin grafting, where the skin is extracted from one area and transplanted over the vitiligo patches. 
• An alternative surgical method called blister grafting can also help eliminate vitiligo patches.

Counseling 

• Your doctor can refer you to a mental health professional for counseling to cope with symptoms like anxiety and depression.

Summary

Vitiligo is an autoimmune skin condition that leads to scattered, painless white or pale patches on your skin. You do not require any treatment since vitiligo is not dangerous. However, if the patches are taking a toll on your appearance and psychological well-being, reach out to your dermatologist for further evaluation. There is no cure for vitiligo, but treatment can help you feel comfortable, and counseling can help you cope with the condition.