Vitiligo

What is Vitiligo?

Is a chronic disorder that causes depigmentation of patches of skin. It occurs when melanocytes, the cells responsible for skin pigmentation, die or are unable to function. The cause of vitiligo is unknown, but research suggests that it may arise from autoimmune, genetic, oxidative stress, neural, or viral causes.

What Causes Vitiligo?

Vitiligo occurs when immune cells destroy the cells that produce brown pigment (melanocytes). This destruction is thought to be due to an autoimmune problem, but the cause is unknown.

Vitiligo is associated with three other autoimmune diseases:

  • Addison's disease
  • Hyperthyroidism
  • Pernicious anemia

Symptoms

  • Skin that feels normal lacking in pigment may appear gradually or suddenly. These areas have a darker border, and the edges are well defined but irregular.
  • Vitiligo most often affects the face, elbows and knees, hands and feet, and genitals. It affects both sides of the body symmetrically.
  • Vitiligo is more noticeable in darker-skinned people because of the contrast of white patches against dark skin.

Signs and Tests

  • Dr. Tomi can examine your skin to confirm the diagnosis.
  • Sometimes, Dr. Tomi may use a handheld ultraviolet light that causes the areas of skin with less pigment to glow bright white.
  • Occasionally, a skin biopsy may be needed to rule out other causes of pigment loss. Dr. Tomi may also perform blood tests to check the levels of thyroid or other hormones, and vitamin B12.

Prognosis

Vitiligo varies and is unpredictable. Some areas may regain normal pigment, but other new areas of pigment loss may appear. Skin that is re-pigmented may be slightly lighter or darker than the surrounding skin. Pigment loss may worsen over time.

Treatment

Treatment options include the following:

  • Phototherapy: a medical procedure in which your skin is carefully exposed to ultraviolet light. Phototherapy may be given alone, or after you take a drug that makes your skin sensitive to light. A dermatologist performs this treatment.

Medicines applied to the skin, such as:

  • Corticosteroid creams or ointments
  • Topical ointments such as pimecrolimus (Elidel) and tacrolimus (Protopic)

Skin from normally pigmented areas may be grafted and placed onto areas where there is pigment loss.

There are make-up coverage techniques to mask the appearance of vitiligo. Alphaderm provides Avène Couvrance to correct medical imperfections.

Skin without pigment is at greater risk for sun damage. Be sure to apply a broad-spectrum (UVA and UVB), high-SPF sunscreen or sun block and use appropriate safeguards against sun exposure. Depigmented areas are more likely to sunburn and develop certain skin cancers.

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