Learn more about this condition in which your skin loses pigment cells, resulting in very light or white patches on parts of your body.
Vitiligo (vit-ih-LIE-go) is a disease that causes loss of skin color in patches. The discolored areas usually get bigger with time. The condition can affect the skin on any part of the body. It can also affect hair and the inside of the mouth.
Normally, the color of hair and skin is determined by melanin. Vitiligo occurs when cells that produce melanin die or stop functioning. 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. It can be stressful or make you feel bad about yourself.
Treatment for vitiligo may restore color to the affected skin. But it doesn't prevent continued loss of skin color or a recurrence.
Vitiligo signs include:
Vitiligo can start at any age, but usually appears before age 30.
Depending on the type of vitiligo you have, it may affect:
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. Occasionally, the skin gets its color back.
See your doctor if areas of your skin, hair or mucous membranes lose coloring. Vitiligo has no cure. But treatment might stop or slow the discoloring process and return some color to your skin.
Vitiligo occurs when pigment-producing cells (melanocytes) die or stop producing melanin — the pigment that gives your skin, hair and eyes color. The involved patches of skin become lighter or white. It's unclear exactly what causes these pigment cells to fail or die. It may be related to:
People with vitiligo may be at increased risk of:
Your doctor will ask about your medical history and examine your skin, possibly with a special lamp. Your evaluation might also include a skin biopsy and blood tests.
The choice of treatment depends on your age, how much skin is involved and where, how quickly the disease is progressing, and how it's affecting your life.
Medications and light-based therapies are available to help restore skin color or even out skin tone, though results vary and are unpredictable. And some treatments have serious side effects. So your doctor might suggest that you first try changing the appearance of your skin by applying a self-tanning product 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. Your doctor might recommend a medication applied to the skin as maintenance therapy to help prevent relapse.
No drug can stop the process of vitiligo — the loss of pigment cells (melanocytes). But some drugs, used alone, in combination or with light therapy, can help restore some skin tone.
Drugs that control inflammation. Applying a corticosteroid cream to affected skin might return color. This is most effective when vitiligo is still in its early stages. This type of cream is effective and easy to use, but you might not see changes in your skin's color for several months. Possible side effects include skin thinning or the appearance of streaks or lines on your skin.
Milder forms of the drug may be prescribed for children and for people who have large areas of discolored skin.
Corticosteroid pills or injections might be an option for people whose condition is progressing rapidly.
Light therapy. Phototherapy with narrow band ultraviolet B (UVB) has been shown to stop or slow the progression of active vitiligo. It might be more effective when used with corticosteroids or calcineurin inhibitors. You'll need therapy two to three times a week. It could take one to three months before you notice any change, and it could take six months or longer to get the full effect.
Given the FDA warning regarding possible risk of skin cancer with use of calcineurin inhibitors, talk with your doctor about the risks and benefits of using these drugs with phototherapy.
For people who can't go to a doctor's office for treatment, smaller portable or handheld devices for narrow band ultraviolet B therapy are available for home use. Talk with your doctor about this option as well if needed.
Possible side effects of narrow band ultraviolet B therapy include redness, itching and burning. These side effects usually clear up within a few hours after treatment.
Removing the remaining color (depigmentation). This therapy may be an option if your vitiligo is widespread and other treatments haven't worked. A depigmenting agent is applied to unaffected areas of skin. This gradually lightens the skin so that it blends with the discolored areas. The therapy is done once or twice a day for nine months or longer.
Side effects can include redness, swelling, itching and very dry skin. Depigmentation is permanent.
If light therapy and medications haven't worked, some people with stable disease may be candidates for surgery. The following techniques are intended to even out skin tone by restoring color:
Skin grafting. In this procedure, your doctor transfers very small sections of your healthy, pigmented skin to areas that have lost pigment. This procedure is sometimes used if you have small patches of vitiligo.
Possible risks include infection, scarring, a cobblestone appearance, spotty color and failure of the area to recolor.
Blister grafting. In this procedure, your doctor creates blisters on your pigmented skin, usually with suction, and then transplants the tops of the blisters to discolored skin.
Possible risks include scarring, a cobblestone appearance and failure of the area to recolor. And the skin damage caused by suctioning may trigger another patch of vitiligo.
Cellular suspension transplant. In this procedure, your doctor takes some tissue on your pigmented skin, puts the cells into a solution and then transplants them onto the prepared affected area. The results of this repigmentation procedure start showing up within four weeks.
Possible risks include scarring, infection and uneven skin tone.
Treatments being studied include:
If you have vitiligo, the following self-care tactics may help you care for your skin and improve its appearance:
Protect your skin from the sun and artificial sources of UV light. 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 of the discolored skin. Sunscreen also minimizes tanning, which accentuates the vitiligo patches.
Limited studies show that the herb Ginkgo biloba may return skin color in people with vitiligo. Other small studies show that alpha-lipoic acid, folic acid, vitamin C and vitamin B-12 plus phototherapy may restore skin color for some people.
As with any over-the-counter (nonprescription) treatment, check with your doctor before trying alternative medicine therapies to be sure they won't interfere with other treatments you're using.
The change in your appearance caused by vitiligo might make you feel stressed, self-conscious or sad. These self-care approaches can help you cope with vitiligo:
You're likely to start by seeing your primary care doctor. You may then be referred to a specialist in skin disorders (dermatologist).
Here's some information to help you prepare for your appointment.
Some basic questions to consider include:
Your doctor is likely to ask you a few questions, such as:
While you're waiting to see the doctor, limit your sun exposure and use a broad-spectrum sunscreen with an SPF of at least 30. If you're feeling self-conscious about the changes in your skin, use makeup or a self-tanning product to cover the affected areas.
December 24th, 2020