Vitiligo

This is the patchy loss of skin coloring (pigmentation disorder) that develops when melanocytes become lost or destroyed. Therefore, the white patches appear on the skin which can either occur as one section or all over the body that could join together (coalesce). Vitiligo tends to progress over time and some of the cases can also have patches of pigment loss affecting the hair and the scalp. This is considered an autoimmune disorder when the body’s immune system attacks its own tissue and organs. In around 15 – 25 percent of the affected cases, they also have one other autoimmune disorder particularly rheumatoid arthritis, type 1 diabetes, psoriasis and autoimmune thyroid. Although it can develop at any age, the average onset of the condition appears to be around the mid-twenties. Vitiligo does not affect the overall health of the individual, but the physical appearance can cause serious psychological and emotional difficulties. There are several forms of vitiligo that are identified. The generalized vitiligo is considered the common form presenting loss of pigments in patches of skin all over the body. It affects the face, neck, scalp, the mouth and the genitals. It can also occur in the mucous membranes such as the lips. Segmental vitiligo is another form presenting patches of depigment skin affecting one side of the body in a limited area.

How is it identified? The most obvious sign is the loss of pigmentation resulting in irregularly-shaped patches on the skin. Usually, the discoloration appears on the sun-exposed areas such as the hands, feet, arms and the face. It can also include premature graying of the hair on the scalp, eyebrows, eyelash, the beard and the loss of color of the retina. It is not possible to predict the progression of the disease and in most cases, the condition continues to involve majority of the skin and in rare cases, the color may return back.

Treatment Options There are many treatment options for vitiligo which can be discussed with the dermatologist. The treatment for vitiligo is based on the overall health, age and the location of vitiligo. The options can include;

  • No medical treatment but the use of cosmetics such as makeup and self-tanners to make the condition less noticeable.
  • Medication used on the skin can help add color such as potent or super-potent corticosteroid and around 45% of the cases regain the skin color.
  • Light treatment can be used to restore the lost color. Individuals need to sit in a lightbox for the treatment of widespread vitiligo. Also, around 70% of individuals receiving excimer laser treatment can see effective results but in some cases, the results can disappear within a year of stopping the treatment.
  • UVA light treatment can be used and with a medication called psoralen which can either be applied on the skin or taken as a pill. This is used to treat widespread vitiligo and is 75% effective for restoring pigments.
  • Different surgical procedures are possible and can be effective for around 90% of the cases but possible side effects could include infection and cobblestone-like skin.

References https://ghr.nlm.nih.gov/condition/vitiligo https://www.mayoclinic.org/diseases-conditions/vitiligo/symptoms-causes/syc-20355912 https://www.aad.org/public/diseases/color-problems/vitiligo#treatment https://www.vitiligosupport.org/vitiligo/symptoms.cfm