What Is Vitiligo?

Vitiligo is a condition of the skin that happens when the cells that give your skin its colour die. These cells, which are called melanocytes, no longer make melanin, which gives your skin its colour. This makes some parts of your skin lose their colour or turn white.

A 2020 survey found that between 0.76 percent and 1.11 percent of adults in the United States have been told they have vitiligo. Between 0.5 and 2% of people around the world have it.

Loss of skin colour can happen anywhere on your body, including:

• sun-exposed areas, like the hands, feet, arms, and face
• inside the mouth or other mucus membranes
• nostrils
• genitals
• back of the eye
• within the hearing system of the ear

If you have hair in the area, it may also turn grey or white.

Even though vitiligo can affect many different parts of the body, it is not contagious. Someone with vitiligo can’t give it to another person.

What are the symptoms of vitiligo?

Vitiligo can cause a number of signs, such as:

• white patches on the skin
• premature graying or whitening of the hair, eyebrows, facial hair, or eyelashes
• loss of pigment in the mucous membranes, including the inner lining of the nose and lips

One 2016 study showed that people with vitiligo lose colour in their hands and faces most often. The skin under your arms and around your groyne are two other common places.

But depending on the type of vitiligo, different parts of the body may be affected. According to a 2020 review, Some types of vitiligo are:

• Universal vitiligo. This kind of vitiligo shows up on most of the skin’s surfaces.
• Segmental vitiligo. On one side of the body, white spots show up. Often, it goes on for about a year and then stops. It also gets worse slower than vitiligo that affects the whole body.
• Generalized vitiligo. Wide white spots show up on both sides of the body in the same way. This is the most common pattern, and it can happen anywhere on the body where pigment cells are found. Over the course of a person’s life, it often starts and stops many times.
• Focal vitiligo. Most patches are smaller and only show up in a few places on the body.
• Acrofacial vitiligo. This kind of vitiligo mostly affects the face, hands, and sometimes the feet.

What increases your risk of vitiligo?

No one really knows what causes vitiligo. The disorder doesn’t seem to be passed down from parent to child, and many people who have it don’t have a family history of it. But the National Institute of Arthritis and Musculoskeletal and Skin Diseases says that your risk could be higher if someone in your family has vitiligo or other autoimmune diseases.

A 2018 review found that having genes like NLRP1 and PTPN22 that are linked to vitiligo could be another risk factor.

Most researchers think that vitiligo is an autoimmune disorder because your body is attacking its own cells. A 2016 study found that about 20% of people with vitiligo also have another autoimmune disease.

Vitiligo may be linked to many autoimmune diseases, such as:

• thyroiditis, caused by an improperly functioning thyroid
• lupus
• psoriasis
• alopecia areata, or baldness
• type 1 diabetes
• pernicious anemia, an inability to absorb vitamin B12
• Addison’s disease
• rheumatoid arthritis
• scleroderma, a disorder of the connective tissue of the body

Some experts also say that vitiligo can show up after:

• severe sunburns or cuts
• exposure to toxins and chemicals
• high levels of stress

What are the complications of vitiligo?

Most of the time, vitiligo doesn’t do much to the body. Ear and eye problems are the most dangerous, but they don’t happen very often.

The main effect on your body is that losing pigment makes you more likely to get a sunburn. You can protect your skin from the sun by putting on sunscreen with an SPF of 30 or higher and wearing clothes that block the sun.

Psychological effects

Research shows that vitiligo can have big effects on a person’s mind. A 2016 study found that more than over 50 percent of the people with vitiligo said it hurt their relationships. Some people said they thought about their condition the whole day, especially since it was hard to predict.

They also told us:

• avoiding physical activities
• withdrawing from events
• feeling like their condition is a disfigurement
• depression
• anxiety
• emotional burden

If you have vitiligo and any of these bad things are happening to you, talk to your doctor or someone who cares about you. You should also find out as much as you can about the disorder. This can help you feel less stressed about your condition or how to treat it.

When to contact a doctor

Talk to your doctor if any of the following things happen to you:

• White spots on the skin or a loss of pigmentation. Graying or whitening of the hair on the head, face, eyelashes, or eyebrows before it should.
• colour change on the inside of the mouth or nose

There is no cure for vitiligo, but early treatment can help stop the skin from getting lighter and restore pigmentation to any spots that have lost it.

Because vitiligo is often linked to other health problems, treatment can also help find and treat any other health problems that may be going on.

Diagnosis and test

During your visit, your doctor will perform a physical exam, ask about your medical history, and do lab tests.

Make sure to tell the doctor about anything that could be a cause, like a recent sunburn, greying hair, or an autoimmune disease. Tell your doctor if anyone else in your family has vitiligo or another skin diseases.

Your doctor may also ask you the following:

• Where did it start on your body?
• Does vitiligo run in your family?
• Has anyone in your family been diagnosed with an autoimmune disease?
• Have you already tried any cures?
• Are things getting better or worse in any places?

Your doctor may also look for vitiligo with an ultraviolet lamp. The lamp, which is also called a Wood’s lamp, helps your doctor look for differences between vitiligo and other skin conditions.

A biopsy is when your doctor takes a small piece of skin to look at. These will be looked at in a lab. Biopsies of the skin can show if there are still cells in that area that make pigment.

Blood tests can help find out if you also have a thyroid condition, type 1 diabetes, or anemia if you also have vitiligo.

What are your treatment options?

Treatments for vitiligo aim to get your skin’s colour back in balance. Some treatments try to add colour to the hair, while others try to take it away. What you can do will depend on:

• how bad your condition is.
• where and how big your patches are
• how many patches you have,
• how far they spread,
• and how you react to treatment.

For vitiligo, You could get medical treatments, surgical treatments, or a mix of both for vitiligo. But not all treatments work for everyone, and some may have side effects that aren’t good.

If a treatment starts to make you feel bad, you should always tell your doctor. They may change your dose or give you other options.

Medical

Most of the time, it takes at least 3 months of treatment to see results. Based on a 2018 review, medical treatments include:

• Creams for the skin. Some creams, like corticosteroids and calcineurin inhibitors, can help white patches get their colour back in the early stages. Some people work to slow the growth. Creams that are strong enough will need a prescription, but using them for a long time can cause side effects. Some of the side effects include skin irritation, thinning, too much hair growth, and skin atrophy.
• Taken by mouth. Some drugs, like steroids, might be able to help treat vitiligo. You can only get these with a prescription.
  Treatment with psoralen and ultraviolet A (PUVA) light. You requires psoralen in the form of a pill or put it on your skin in the form of a cream. Then, your doctor puts you in UVA light to make the drugs work and help your skin get its colour back. After that, you’ll need to stay out of the sun as much as possible and wear sunglasses to protect your eyes. There are some side effects of PUVA, such as sunburn, nausea, itching, and hyperpigmentation.
• Therapy with narrowband UVB light. This is a different way to do PUVA therapy than the usual way. This treatment uses light therapy in a more targeted way, which often has fewer side effects. It can also be used at home as part of a treatment plan overseen by a doctor.
• Excimer laser treatment. This treatment helps with small patches and takes less than 4 months, two to three times a week.
• Depigmentation. A 2017 study says that your doctor may suggest depigmentation if more than 50% of your body is affected and you want to get your skin to look normal again. This is often a solution when treatments to give your skin colour back haven’t worked. The goal of Depigmentation is to make the rest of the skin fade to the same colour as the areas that have lost colour. Your doctor will tell you how to use a medicine like monobenzone. Even though it can take up to two years for this treatment to work, it usually works for good. It can also make you more sensitive to sunlight and cause inflammation.

Surgical

When medicines and light therapy don’t work, surgery is an option. If your vitiligo patches are stable and it wasn’t caused by sun damage, your doctor may suggest that you have surgery.

A 2021 review lists the following types of surgery:

• Skin grafting. Your doctor moves healthy, coloured skin to areas that don’t have enough colour. There is a chance of infection, scarring, or not repigmenting. Using blisters to Skin grafting is another option with less risk. This choice involves making blisters on skin that is not affected and moving the top of the blister to a different spot.
• Melanocyte transplants. Your doctor takes a sample of healthy tissue, grows the melanocytes in a lab, and then puts the cells where they are needed.
• Micropigmentation. Your doctor will put colour into your skin with a tattoo. This works best on the lips, but it might be hard to match the colour to your skin.

Other therapies and management options

Even if you get treatment for vitiligo, the results can take a long time to show. So, you might want to add the following:

• Sunscreen. Getting less sun can help your skin stay even. Getting a tan will give your skin more contrast, which will make any problems more obvious. It’s important to use sunscreen with a high SPF because the sun can damage skin that doesn’t have pigmentation.
• Cosmetics. Makeup or lotions that help you get a tan can help even out the colour of your skin. You might like self-tanning lotions because the colour stays on longer, even after you wash.
• Mind health management.Some 2018 research shows that medication and therapy can help you live a better life. Talk to your doctor if you feel like your mental health is getting worse.

Coping with emotional aspects of vitiligo

Researchers have found that people with vitiligo often feel emotionally stressed and have low self-esteem. One 2015 study also found that the quality of life of the parents of children with vitiligo is lower.

But vitiligo is not contagious and usually doesn’t have any bad effects on the body. People with vitiligo can lead healthy, active lives.

Find a therapist who knows about this skin condition and how it affects mental health. A 2018 review of early but small studies suggests that individual cognitive behavior therapy (CBT) can help with:

• maintaining self-esteem
• preventing depression
• improving overall quality of life

A vitiligo support group is a great way to get help, along with your family and friends. Members of these groups can say what they want and meet other people with the same condition.

You can also use the #vitiligo hashtag on social media to find stories of people who are proud of how they look. Winnie Harlow, a fashion model and activist who calls herself a “vitiligo spokesmodel,” is an example of this.

What’s new for vitiligo treatments?

In the past few years, there has been more research on vitiligo. Genetic research is getting better because of newer technology, which helps us figure out how vitiligo works.

Understanding what causes vitiligo and how it affects other parts of the body can help researchers come up with new ways to treat it.

Other studies on vitiligo look at how trauma or stress can cause it, how genes affect it, and how the immune system’s chemical signals play a role.