Vitiligo

What is vitiligo?

Vitiligo is a 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 are white patches of skin. It’s 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 naturally darker skin color).

What causes vitiligo?

Vitiligo occurs when skin cells that produce pigment (color) die. It causes white patches on areas of your skin. No one knows exactly why these skin cells die. Most scientists believe it is caused by an autoimmune disorder. This means the body’s immune system attacks and causes the death of the skin pigment cells. People who have other autoimmune disorders, such as certain types of hyperthyroidism, may have an increased risk of vitiligo. There is some evidence that genetics plays a role in this process. Some people may inherit an increased risk of developing vitiligo from their parents.

How is vitiligo diagnosed?

See your doctor if you think you have vitiligo. He or she will do a physical exam and review your symptoms. He or she 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’s 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 a sunscreen with an SPF (sun protection factor) of 30 or more. You should also cover your skin and limit sun exposure.

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

Forms of treatment are time consuming. They’re not guaranteed to work or last, though they can be permanent. They also don’t prevent new patches from appearing.

Treatment options come in the following forms:

  • 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 de-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.
  • Surgery. This can be used if other treatments don’t work. During surgery, your doctor removes skin from an area of your body that still has color. That skin is then transplanted (grafted) on the white patches. This option works best if you have small white patches.

In addition to medical options, you can use cosmetics to cover your skin. This includes makeup, creams, dyes, or self-tanning lotions. Talk with your doctor about which treatment is best for you.

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. Use a sunscreen with an SPF of at least 30 that protects against UVA and UVB. Wear sunscreen every time you’re in the sun to try to reduce your risk of sunburn and skin cancer.

Stay away from tanning beds. They won’t help return color to your white patches.

Questions to ask your doctor

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