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Vitiligo

Vitiligo

Vitiligo is a disorder in which white patches develop on the skin. The patches may also appear in the hair, eyes, and mouth. They may appear on any part of the body.

Causes of Vitiligo

The white patches are due to the destruction of melanocytes cells. These cells in the skin make pigment. Loss of pigment causes the skin to become lighter. It looks especially lighter compared to normal skin nearby. This is why vitiligo is more visible in darker-skinned people.

The exact cause of the pigment loss is not known. Possible causes include:

  • The body’s immune system may destroy the melanocytes
  • Melanocytes may destroy themselves
  • Defective nerve cells may make toxic substances that harm the melanocytes

It is likely that a genetic defect makes the cells more vulnerable to damage.

Factors that increase your chance for vitiligo include:

  • Family members with vitiligo or hair turning gray early
  • Age: 10 to 30
  • Certain autoimmune diseases such as thyroid disease

Symptoms

The main symptom is white patches on the skin. These patches may be clumped together or all over the body. Some common sites of pigment loss include:

  • Areas exposed to the sun such as the face, hands, arms, and upper part of the chest
  • Areas around body openings such as the eyes, nostrils, mouth, navel and genitals
  • Body folds such as the groin and armpits
  • Sites of chronic minor injury such as knuckles and elbows
  • Sites of injury such as scrapes, cuts and burns
  • The area around moles

White or prematurely graying hair and hair loss may also occur.

Vitiligo often begins with a rapid loss of skin color. This is followed by a long period without any change. Cycles of pigment loss and stability may occur again later. The cycle can continue throughout life.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam and eye exam will be done. The diagnosis is usually made by the appearance of the skin. A skin biopsy may be done to confirm. Special UV lamps may be used during the skin exam. Blood tests are often taken to look for signs of autoimmune diseases.

Vitiligo Treatments

There is no known cure for vitiligo. Often, the longer the patches exist, the harder it is to repigment the area. Treatment is geared to decreasing the appearance of patches by:

  • Repigmentation — replace skin color in patches
  • Slowing loss of color
  • Decreasing the difference between affected and unaffected skin

Repigmentation

This treatment involves two steps:

  1. You apply a psoralen cream or take psoralen medication orally. 
  2. You then activate the medicine by exposing yourself to UV light A (UV-A) from the sun or an artificial source.  
This treatment may repigment white patches, but takes months, can cause sunburn-type reactions, nausea and an increased risk of skin cancer.

Excimer Laser

This is a special UV laser. It is shown to be effective in localized cases.

Skin Creams

  • Corticosteroid skin cream — can sometimes slow the loss of color. It may also help return color to small areas. It may cause thinning of the skin.
  • Tacrolimus or pimecrolimus skin creams — can sometimes slow the loss of color. They can help return color to small areas. They may also cause thinning of the skin.
  • Skin grafting — done if the condition is not widespread and stable. It may be possible to graft areas of normal pigmentation to the patches.

Skin Graft

Skin Graft

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Depigmentation

This involves removing the remaining pigment from your normal skin. This treatment makes your whole body the same white color. It is only done if you have already lost a large amount of your normal skin color and repigmentation has not been successful. The medicine used is called monobenzyl ether of hydroquinone 20 percent. This treatment takes about one year to complete. It can cause side effects, such as redness and swelling of your skin.

Cosmetics

You can make your white patches less noticeable. Makeup, dyes, stains, or self-tanning lotions can work as a cover. However, the color from dyes, stains, and lotions slowly wears off.

Sunscreen

The purpose of sunscreen is to:

  • Protect the depigmented area from the damaging effects of sun exposure
  • Prevent increased pigmentation of other areas

Depigmented areas are at much higher risk for skin cancer.

 

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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