Vitiligo is a condition that affects about one out of every 200 people in the United States, but many people have never heard of it. While not life threatening, this condition can have a significant impact on the quality of life, mental and emotional well-being of patients.
What Is It?
Vitiligo is a skin condition that causes the skin to lose pigment in patches that will slowly enlarge over time. This causes a splotchy appearance on a person’s skin. This condition is most noticeable in those with darker complexions because of the significant color difference between the white patches and the normal skin. The patches of discolored skin will maintain the same smoothness and texture, only the color will change due to lose of pigment.
While vitiligo is considered to be a skin condition, it is also a part of a deeper autoimmune problem, since the immune system of a person with vitiligo attacks the cells in the skin that make melanin, called melanocytes, which is responsible for the pigmentation of the skin. The condition stops these cells from producing melanin or kills them altogether so the skin loses melanin in those areas, resulting in the white patches.
The changing skin is the only symptom of vitiligo. It doesn’t have any other symptoms, though it is thought to be connected to other autoimmune conditions. A person may experience symptoms associated with those conditions, but not from vitiligo itself. With vitiligo, a person will experience:
- Areas of skin where the color will begin to change. This can happen suddenly or gradually over time. These areas will be flat and aside from the changing color will appear otherwise normal.
- The light patches will have a well defined, but irregular border that may be darker than the regular skin tone.
- The patches most often appear on the face, elbows, knees, hands, feet and genitals.
- It can affect both sides of the body equally.
- No other changes in the skin will be present.
The cause of vitiligo is still a bit of a mystery. What is known is that it occurs when the immune system produces cells that attack the melanocytes in the skin. These cells are responsible for producing the brown pigment that makes up a person's skin tone.
Vitiligo can appear at any age and affects both men and women equally. It can run in families as well.
About 1 in 100 people have vitiligo, but it may not be as noticeable in a person with fair skin as it is in someone with darker skin.
Ongoing studies have shown a connection between vitiligo and the following autoimmune conditions:
- Addison's disease: a condition in which the body produces too little of certain hormones in the adrenal gland. This condition can be life threatening if left untreated and can affect a number of different systems and functions in the body.
- Hyperthyroidism: a condition in which too much of the thyroid hormones are produced. This can cause problems with many different body systems as well as being life threatening if left untreated.
- Pernicious anemia: a type of anemia that occurs when the body can't properly absorb vitamin B12. This condition is linked to many other problems, but it is easily treating with high potency supplementation and a balanced diet.
Vitiligo is extremely difficult, if not impossible to treat. The earlier it is diagnosed, the better the chances are of a successful treatment outcome, but there is no way to stop it from progressing.
Phototherapy is a treatment option in which the affected areas of skin are exposed to light in such a way that the skin is forced to tan, thus returning some of the color. This can be done alone or used along with medications that make the skin more sensitive to ultraviolet light.
Medications applied to the skin that suppress the immune cells are also used. These include things like:
- Immunosuppressant creams
- Photosensitive creams
Skin grafting is an option for some, but because surgery poses some inherent risks of its own, it is usually not a first choice for treatment.
Several lines of makeup are available to help even out skin's appearance. They are specially designed for patients with vitiligo and provide much more coverage than the drug store variety does.
For those who have lost the pigment in their skin over a large area of their body, the rest of the skin can be de-pigmented. This is an extreme and permanent change, however, so it is only used as a last resort.
Skin that has been de-pigmented, whether by the condition or by a procedure to help normalize a person's appearance, should always be protected by sunscreen. De-pigmented skin is has a much higher risk of being severely sun damaged.
There are several support groups available to help those with vitiligo cope. They include:
- American Vitiligo Research Foundation
- National Vitiligo Foundation
The course that vitiligo will take is one that can't be predicted. Sometimes pigment will return and sometimes more pigment will be lost in other areas. Sometimes it continues to spread and other times it stops for no reason. But with the appropriate treatment and support, those with vitiligo can live a more normal life, without worrying about what their skin looks like.