WHAT IS VITILIGO?


Almost 1 percent of the world’s population has vitiligo; a disease that causes the loss of skin colour in blotches. The extent and rate of colour loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair and the inside of the mouth.


Normally, the colour of hair, skin and eyes is determined by melanin. Vitiligo occurs when pigment-producing cells (melanocytes) die or stop producing melanin. The involved patches of skin become lighter or white.


Most people who have vitiligo will develop the condition prior to age 40; about half develop it before age 20. Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin. The condition is not life-threatening or contagious.


Vitiligo is not painful and does not have significant health consequences; however, it can be stressful thereby causing emotional and psychological consequences, making you feel bad about yourself.

Signs and Symptoms

The main sign of vitiligo is patchy loss of skin colour. Usually, the discoloration first shows on sun-exposed areas, such as the hands, feet, arms, face and lips.


Vitiligo signs include:

  • Patchy loss of skin colour

  • Premature whitening or greying of the hair on your scalp, eyelashes, eyebrows or beard

  • Loss of colour in the tissues that line the inside of your mouth and nose (mucous membranes)

  • Loss of or change in colour of the inner layer of the eyeball (retina)

Complications

People with vitiligo may be at increased risk of:

  • Social or psychological distress

  • Sunburn and skin cancer

  • Eye problems, such as inflammation of the iris (iritis)

  • Hearing loss

Causes

The exact cause of vitiligo is unknown, although most experts believe that it is an autoimmune condition in which the body's immune system mistakenly attacks and destroys certain cells within the body.


It may also be related to:

  • Family history (heredity)

  • A trigger event, such as sunburn, stress or exposure to industrial chemicals

Types of Vitiligo

Scientists separate vitiligo into two types: non-segmental and segmental vitiligo.


1. Non-segmental vitiligo

Non-segmental vitiligo is the most common type of vitiligo and occurs in up to 90% of people who have the disorder.


In non-segmental vitiligo, the patches often appear equally on both sides of the body, with some measure of symmetry. The symmetrical patches most commonly appear on skin that is exposed daily to the sun, such as the face, neck and hands, but can also appear in other areas such as the:

  • Backs of the hands

  • Arms

  • Eyes

  • Knees

  • Elbows

  • Feet

  • Mouth.


Non-segmental vitiligo is further broken down into sub-categories:

  • Generalized vitiligo: no specific area or size of patches, this is the most common type

  • Acrofacial vitiligo: mostly on the fingers or toes

  • Mucosal vitiligo: depigmentation generally appears around the mucous membranes and lips

  • Universal vitiligo: depigmentation covers most of the body, this is very rare

  • Focal vitiligo: one, or a few, scattered white patches in a discrete area. Most often occurs in young children. Also referred to as localized vitiligo.


2. Segmental vitiligo

Segmental vitiligo has a different form; this condition spreads more rapidly but is considered more constant and stable than non-segmental. It is much less common and affects only about 10% of people with vitiligo.


Segmental vitiligo is more noticeable in early age groups, affecting about 30% of children diagnosed with vitiligo.


It is non-symmetrical and usually tends to affect areas of skin attached to nerves arising in the dorsal roots of the spine. It is more stable, less erratic and responds well to topical treatments.


It's difficult to predict how your disease will progress. Sometimes the patches stop forming without treatment. In most cases, pigment loss spreads and eventually involves most of your skin. Rarely, the skin gets its colour back.

Diagnosing Vitiligo

There is no way to determine if vitiligo will spread or remain confined to one location. Your doctor (a dermatologist) will perform a physical exam, ask about your medical history, and conduct lab tests. Be sure to report any events that could be contributing factors, like recent sunburns, premature greying of your hair, or any autoimmune diseases you may have. Also let your doctor know if anyone else in your family has vitiligo or other skin diseases.


Other questions your doctor may ask are:

  • Where on your body did it first start?

  • Does anyone in your family have vitiligo?

  • Does anyone in your family have an autoimmune disorder?

  • Have you tried any treatments already?

  • Are any areas getting better or worse?


Your doctor may also use an ultraviolet lamp to look for patches of vitiligo. The lamp, also known as Wood’s lamp, helps your doctor look for differences between vitiligo and other skin conditions.


At times your doctor may want to take a sample of skin, known as a biopsy. The lab will look at these samples. Skin biopsies can show if you still have pigment-producing cells in that area of your body. Blood tests can help diagnose other problems that may go along with vitiligo, such as thyroid problems, diabetes or anaemia.

Treatment

Vitiligo has no cure. But treatment may help to stop or slow the discolouring process and return some colour to your skin.


Many treatments are available to help restore skin colour or even out skin tone. Results vary and are unpredictable. Some treatments have serious side effects. So your doctor may suggest that you first try improving the appearance of your skin by applying self-tanning products or makeup.


If you and your doctor decide to treat your condition with a drug, surgery or therapy, the process may take many months to judge its effectiveness. And you may have to try more than one approach or a combination of approaches before you find the treatment that works best for you.


Even if treatment is successful for a while, the results may not last or new patches may appear.


Potential future treatments

Treatments being studied include:

  • A drug to stimulate colour-producing cells (melanocytes). Called afamelanotide, this potential treatment is implanted under the skin to promote the growth of melanocytes.

  • A drug that helps control melanoctyes. Prostaglandin E2 is being tested as a way to restore skin colour in people with localized vitiligo that isn't spreading. It's applied to the skin as a gel.

  • A drug that reverses loss of colour. Tofacitinib, an oral drug typically used to treat rheumatoid arthritis, has shown some potential as a treatment for vitiligo.

Prevention

There is no known way to prevent vitiligo, but you can reduce your chances of having it by protecting your skin from sunburn, exposure to industrial chemicals or reducing stress.


Lifestyle and Home Remedies

The following self-care tactics may help you care for your skin and improve its appearance:


1. Protect your skin from the sun and artificial sources of UV light. If you have vitiligo, particularly if you have light skin, use a broad-spectrum, water-resistant sunscreen with an SPF of at least 30. Apply sunscreen generously and reapply every two hours or more often if you're swimming or sweating.


You can also seek shade and wear clothing that shields your skin from the sun. Don't use tanning beds and sunlamps.


Protecting your skin from the sun helps prevent sunburn and long-term damage. Bad sunburn can make your condition worse. Sunscreen also minimizes tanning, which makes the contrast between normal and discoloured skin less noticeable.


2. Conceal affected skin. Concealing products may improve the appearance of the skin and help you feel better about yourself, especially if your vitiligo patches are on exposed skin. You may need to try several brands of makeup or self-tanners to find one that blends well with your normal skin tone. The colouring of self-tanning products doesn't wash off, but it gradually fades over several days. If you use a self-tanner, select one that contains dihydroxyacetone, as it is approved by the Food and Drug Administration.


3. Don't get a tattoo. Avoid tattooing that's not related to treating your vitiligo. Damage to your skin, such as that caused by a tattoo, may cause a new patch of vitiligo to appear within two weeks.

Coping and Support

You may feel stressed, self-conscious, sad, ashamed or even devastated by the change in your appearance caused by vitiligo. You may feel that the condition limits your ability to go about your daily activities, especially if it's widespread or affects visible areas of your body, such as the face, hands, arms and feet.


These tips may help you cope with vitiligo:

  • Make a good connection. Find a doctor who knows a lot about the condition. A dermatologist is a doctor who specializes in the care of skin.

  • Learn all about it. Find out as much as you can about the condition and your treatment options so that you can help decide what steps to take.

  • Communicate your feelings. Let your doctor know if you're feeling depressed. He or she can refer you to a mental health provider who specializes in helping people with depression.

  • Talk with others. Ask your doctor about psychotherapy or support groups in your area for people with vitiligo.

  • Confide in loved ones. Seek understanding and support from your family and friends.

....making effort to "STAY WELL"

REFERENCE:

https://www.medicalnewstoday.com/articles/245081.php

https://www.aad.org/public/diseases/color-problems/vitiligo

http://www.nhs.uk/conditions/Vitiligo/Pages/Introduction.aspx

http://www.healthline.com/health/skin-disorders/vitiligo-pictures#overview1

http://www.webmd.com/skin-problems-and-treatments/guide/vitiligo-common-cause-loss-skin-pigment

http://www.mayoclinic.org/diseases-conditions/vitiligo/home/ovc-20319041

http://www.medicinenet.com/vitiligo/article.htm

https://en.wikipedia.org/wiki/Vitiligo

https://www.niams.nih.gov/health_info/vitiligo/vitiligo_ff.asp


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The contents herein are for informational purposes only, therefore, should not be used as an alternative to seeking independent medical advice, and we cannot take responsibility for an individual’s decision to use them as such. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.