Vitiligo is a pigmentation disorder characterized by the appearance of white patches on the surface of the skin in various parts of the body. The discolorations are formed due to the destruction of melanocytes, the cells responsible for the skin’s pigmentation, eye and hair color. These patches of discoloration may appear not only on the surface of the skin, but on the tissue of mucous membranes (inside the mouth and nose) and on the retina as well. Hair growing on affected areas may also turn white.

Causes

Doctors believe that vitiligo might be caused by a failure in a person’s immune system that reacts by attacking and destroying the body’s own reserves of melanocytes

 

It may (but not necessarily) be related to family history

 

Other possible causes: sunburn, stress, or exposure to industrial chemicals

Symptoms and signs

First signs of vitiligo develop especially in areas exposed to sunlight: face, lips, hands, arms and feet

Other common areas include: armpits, the area around the mouth, eyes, nostrils, navel, genitals and rectal areas

The disorder usually manifests in one of three patterns:

Focal pattern – the discoloration is especially concentrated in one or just a limited few areas

Segmental pattern – depigmentation occurs on only one side of the body

Generalized pattern – it occurs on both sides of the body, symmetrically (the most common)

Some people may experience a premature graying of the hair, while others experience a graying of eyelashes, eyebrows and even beard

Advice

Medical therapies:

Topical therapy: creams containing corticosteroids that may improve the appearance of depigmentation, but due to the hormone-like action of the creams they may cause skin shrinkage or streaks

Light treatment, though results may not be permanent

Psoralen photochemotherapy used for repigmentation of white patches, though the treatment can sometimes cause skin sensitivity in terms of the chemicals contained by the drugs, which can produce a darkening of the skin when coming into contact with ultraviolet light

Depigmentation: the process of fading the color of the rest of the skin on the body to match the whiteness of the patches, but it is recommended only in cases where at least 50% of the body is affected; major side-effects consist in redness and swelling of the skin, itchiness or dry skin, and unusual sensitivity to sunlight

Surgical therapies:

Autologous skin grafts: the process of removing skin from one area of the body onto places where vitiligo has already left visible marks of discoloration, and it is usually recommended to people with small patches of skin being affected by the disorder; possible side-effects include: development of infections, scarring, spotty pigmentation or no pigmentation at all

Skin grafts using blisters: the process of creating blisters via heat, suction or freezing in order to cut out the top of the blisters and place them onto discolored areas, a major advantage of this procedure being a lesser risk of developing scarring

Micropigmentation: implanting skin-matching pigment with a special surgical instrument, similar to a process of tattooing. It is a procedure that works best for people with dark skin and especially around the lip area, though it may increase chances of herpes outbreaks

Autologous melanocyte transplants: a procedure that works on the principle of collecting a sample of normal skin and placing it in a special dish so as to facilitate a growth of the melanocytes, which will be later transplanted onto affected areas

Additional therapies:

Sunscreens used for minimizing exposure to UVA and ultraviolet B light and to reduce the risk of developing a higher contrast between affected areas and tanned skin

Cosmetics

Counseling and support groups

MISCONCEPTIONS
  • Fear of contagion, especially via skin-to-skin contact

    Deodorants or perfumes can trigger vitiligo

    The disease is transmittable from patting dogs displaying white patches on their heads

    Some people believe that by having eaten raw meat as a child or by donating blood, vitiligo may develop

    The white patches turn cancerous

Statistics

Approximately 0.5 to 1% of the world’s population have vitiligo

 

The average age of onset is during the mid-twenties, but it may occur at any time

 

Vitiligo may manifest alongside other autoimmune disorders such as hyperthyroidism, adrenocortical insufficiency (not enough production of corticosteroids), alopecia areata (bald patches) and pernicious anemia (low levels of red blood cells due to the body’s inability to absorb sufficient quantities of B12 )

Did you know?

Melanocytes found in the skin are long-living cells, while hair melanocytes live as long as a duration of the hair cycle lasts (median 3-5 years)*

After 30 years of age 10-20% of epidermal melanocytes are lost every decade*

Diversity of hair color is given by the quantity and ratio of the brown-black type of melanocytes and the yellow-red ones

Mistaking vitiligo for leprosy in the Old Testament may account for the social stigma related to this disease**

Famous people with vitiligo: Michael Jackson, top model Winnie Harlow, Emmy Award Nominee Lee Thomas, Irish comic presenter Graham Norton, Top Gear host Richard Hammond, Mad Men’s Jon Hamm