Vitiligo (pronounced vit-uh-lye-go) is a skin disease that causes patches of the skin to lose color. One of the most common pigmentation disorders, vitiligo can affect anyone, but tends to be more noticeable in people with darker complexions. According to the Vitiligo Research Foundation, somewhere between .5% and 2% of the population (65-95 million people) experience the disorder. The Vitiligo Support International Inc. cites that between 2 and 5 million Americans suffer from vitiligo.
Like many skin diseases, vitligio is not contagious or life threatening, but it is a rather complex disease. It can be embarrassing, causing people to feel self conscious about their appearance. Below, we break down everything you need to know about vitiligo.
What are the symptoms?
The primary indicator of vitiligo is patches of skin that are extremely light or white. These discolored areas usually appear on parts of the body that are frequently exposed to the sun, including the hands, feet, arms, face and lips.
Another primary indicator of vitiligo is premature whitening or graying of the hair, eyelashes, eyebrows or beard. Some experience discolored patches near their armpits, navel, or genitals, see a loss of color in the tissue inside their mouth and nose, and/or see a change in color of the retinas. Some report pain in the areas that experience pigment loss, others feel normal and otherwise healthy.
What causes vitiligo, and who gets it?
Melanin is the pigment in our bodies that gives color to our hair, skin and eyes. When melanin-producing cells, called melanocytes, stop producing the right amount of melanin (or die entirely) the area where these cells live becomes lighter and lighter, sometimes even white.
Vitiligo typically appears before people reach their 20s, but can begin at any age. It’s unknown exactly why these melanocytes die or stop production, but it’s believed that autoimmune diseases, family history and genetics, exposure to hazardous chemicals, and extensive stress may play a role.
Are there different types?
Yes, there are two types, and several subtypes, of vitiligo.
The most common, non-segmental vitiligo, is also referred to as generalized vitiligo, vitiligo vulgaris, or bilateral vitiligo. This version of the condition involves discolored patches appearing and developing symmetrically, such as on both forearms or both hands. The loss of melanin production, which can start and stop cyclically throughout a person’s life, tends to begin on the feet, fingertips, wrists or hands, or around the eyes, lips and mouth. Eventually, large patches of skin lose their color.
Segmental vitiligo affects one specific area on the body, such as the face, an arm or the knee. Also called unilateral vitiligo, it typically begins at a young age, develops for a period of time (usually a year or two) and then stops.
The amount of pigment lost due to vitiligo is categorized in three ways. Localized vitiligo refers to the condition when it’s limited to a few spots in one or two areas of the body, whereas generalized vitiligo causes scattered patches across the body. Universal vitiligo is a rare form, but occurs when almost all pigment disappears.
How do you treat it?
While no cure exists for vitiligo, there are a multitude of solutions to ease its appearance.
Cosmetic solutions such as makeup, skin camouflage products, and sunless tanners (self or professionally applied) make vitiligo less noticeable and are the simplest way to hide cases of vitiligo. These aren’t permanent, and can be time consuming, but have few risks or side effects.
Cosmetic tattooing can be an effective ways to hide vitiligo on the face or mouth, but there’s a risk that the dyes won’t match the skin’s original pigment color, and will fade with time.
There are several topical treatments that can be used on the skin’s surface to help restore pigment. These are typically prescription-only, and best for those with darker skin who only have small patches of vitiligo. Corticosteroid, the most common topical, helps almost half of those who use it regain some color after several months of consistent application. These types of topical medications do have side effects, most commonly skin atrophy, which makes the skin incredibly thin, dry, and fragile.
Light treatments can also be used to re-pigment the skin — light boxes (to treat widespread cases) and excimer laser treatments (to treat small areas) are the most common, but results can vary and even disappear. Most patients need several treatments a week for a number of weeks, but this treatment can be combined with topical solutions.
PUVA light therapy uses a combination of UVA light and psoralen to restore color to the skin. Psoralen, taken as an oral medication or applied directly to the skin, increases UVA light sensitivity, therefore making light therapy more effective. While this treatment isn’t effective for the hands or feet, it’s effective for treating widespread vitiligo. Because Psoralen can effect the eyes and our bodies are susceptible to UVA light, those undergoing PUVA require careful monitoring.
Surgery and skin grafting are other solutions for vitiligo, but those who opt for this method must have a stable (unchanging) state of the condition and must not be susceptible to scaring or keloids. These procedures typically involve removing normal skin cells and placing them on the affected areas.
A more dramatic solution for those with severe cases is depigmentation, which involves removing the pigment from the rest of the body to match the new, white skin. Few people opt for this solution, which can take years and leave the skin extremely susceptible.