Vitiligo

What is vitiligo?

Vitiligo is a type of skin-coloring disorder. It produces white patches on your skin. It mostly occurs in areas that are exposed to the sun. This includes your face, neck, arms, hands, legs, and feet. It can affect your mouth, nose, and eyes. It also can affect unexposed parts, like your genitals. People of any age and race can get vitiligo.

Symptoms of vitiligo

The main sign of vitiligo is the white patches of skin. It is more common to have patches that are symmetric on both sides of your body. Or you may have white patches on only one side of your body. Vitiligo may or may not spread over time.

Other symptoms of vitiligo can include:

  • white skin hairs where your skin is white
  • early onset of gray or white hair on your head (less than 35 years of age)
  • white eyebrows, eyelashes, or beard
  • white patches in your mouth (mainly in people who have a darker skin color to begin).

What causes vitiligo?

Vitiligo occurs when skin cells that produce pigment (color) die. It causes white patches on areas of your skin. There is no exact cause of what kills the skin cells. Most doctors believe that it is caused by genetics. People who have an autoimmune disorder may have an increased risk of vitiligo. An example of this is hyperthyroidism. You also can inherit vitiligo from your parents.

How is vitiligo diagnosed?

See your doctor if you think you have vitiligo. They will do a physical exam and review your symptoms. They will ask about your health and family history. Your doctor may do a biopsy on your skin. This consists of sending a sample of skin cells to a lab to look at the cells. It can confirm the disease if your cells lack melanocytes, which produce pigment. Your doctor also may do a blood test. This can check for the presence of an autoimmune disorder.

Can vitiligo be prevented or avoided?

It is hard to avoid or remove vitiligo, since the cause is unknown. However, you should take care of your skin to protect it from the sun. This includes using SPF and covering up. You should limit sun exposure (both natural and artificial).

Vitiligo treatment

There are treatment options for vitiligo. They depend on how severe your condition is. This includes the size, location, and number of white patches. The goal of treatment is largely cosmetic. Most people do it to improve their appearance and feel better about themselves.

Medical forms of treatment are time consuming. It is not guaranteed to work or last, though it can be permanent. It also does not prevent new white patches.

  • Topical: This involves applying a cream to the white patches. It contains corticosteroids. The topical cream may return color, or pigment, to your white patches. It may not return full color, depending on your natural skin tone. Possible side effects include skin lines, wrinkles, or shrinkage.
  • Repigmentation: This is a type of light therapy. Psoralen is a chemical that primes your skin. You can take pills by mouth or apply cream to your skin. Then, you receive monitored exposure to ultraviolet A (UVA) light. The psoralen and UVA react to stimulate new skin cells. The goal is to return color to your white patches. This type of treatment has a lot of side effects. The psoralen can cause nausea, vomiting, itching, a rash, or abnormal hair growth. The exposure can cause sunburn or hyperpigmentation (too much color). It also can increase your risk of skin cancer.
  • Depigmentation: This treatment is most common for people who have white patches on more than 50% of their bodies. It involves coloring, or fading, your natural skin tone to match your white patches. Treatment consists of applying cream to your skin 1 to 2 times a day. You can do this until all of your skin is similar in color. The main side effect is swollen skin, known as eczema. The symptoms are red, itchy, and dry skin.

In addition to medical options, you can use cosmetics to cover your skin. This includes makeup, creams, dyes, or self-tanning lotions.

Living with vitiligo

Vitiligo is not physically harmful, but it can have emotional and mental effects. Talk to your doctor about joining a support group or getting counseling. This can help you cope and manage possible depression.

Be careful about exposing your skin in the sun. Your white patches are extra sensitive because the skin cells are dead. Other parts of your body may become sensitive to the sun with treatment. Sun exposure can increase the contrast between your skin colors. Take caution to reduce your risk of sunburn and skin cancer. Use a high SPF that protects against UVA and UVB. Do not use tanning beds. They will not help return color to your white patches.

Questions to ask your doctor

  • Once I have vitiligo, can it spread or get worse?
  • What are the chances that my children will get vitiligo?
  • Is there a certain cosmetic that you recommend for my skin color?
  • Is there a support group that you recommend?
  • Do I need ongoing screening to check for autoimmune disorders?