Vitiligo is a persistent or chronic condition in which areas of skin lose their normal pigment and become very pale or pink. It is common, affecting about1% of the world’s population. It can start at any age after birth, but in more than half of people affected it does so before 20 years of age.
What is Vitiligo?
The extent of the condition is unpredictable, varying from single small patches to total loss of skin color. In most people, it tends to change slowly, with periods of stability often lasting several years. The pigment may return in some patients, but is not guaranteed, and seldom returns completely.
What You should know / Frequently Ask Questions
The pigment that gives your skin its normal color is called melanin and is made by cells known as melanocytes. In patches of vitiligo the melanocytes inactive but still present. The reason for this is not fully understood. However, vitiligo is considered to be an ‘autoimmune’ condition in which the body’s own immune system rejects some of its own cells (melanocytes in the case of vitiligo). As a result, thyroid disease and other autoimmune conditions are more common in individuals with vitiligo. Repeated trauma such as rubbing or scratching the skin may trigger vitiligo. Vitiligo affects men and women of all races equally, but is more noticeable in people with skin of colour. It is not infectious. There is no medical evidence of any link between diet or smoking and vitiligo.
Yes, vitiligo has a genetic basis, although less than half of those with vitiligo know of someone in their family who also has it. If you have vitiligo, it does not necessarily follow that your children will develop it.
Vitiligo is not usually itchy or sore, but some people experience some irritation of the skin before a new vitiligo patch appears. Sunlight may cause sunburn to exposed areas. Some people may feel embarrassed by this as it will stand out more obviously when the surrounding skin is tanned or in naturally dark-skinned individuals.
Vitiligo consists of irregularly shaped patches of skin that lack the normal melanin pigmentation, and are thus completely very pale, pink or almost white. It is often symmetrical, affecting both sides of the body, although less commonly, it can be localized to one part of the body. The skin otherwise feels entirely normal. The most common sites for vitiligo are the hands and face, around body openings (the eyes, nostrils, mouth, umbilicus and genital regions), and within body folds such as the underarms and groin. When hair-bearing skin is involved, the hair may lose its pigment and appear white. Re-pigmentation (recovery) often commences around hair follicles, initially giving the skin a speckled appearance.
Examination under an ultraviolet lamp is helpful to confirm affected areas, especially in light-skinned people. Once the diagnosis of vitiligo has been made, your doctor may take a blood sample to check for thyroid disease and for other autoimmune conditions. Clinical photographs may sometimes be taken by your doctor to monitor vitiligo and the effect of any treatment you receive.
There is no cure for vitiligo. Although treatment may be helpful in restoring the colour, it cannot prevent its spread or recurrence and re-pigmentation (recovery) may not be permanent.
Often no treatment may be required other than good sun protection, especially in pale-skinned individuals, and skin camouflage creams and powder.
- Sunscreen cream
- Topical corticosteroids, calcineurin inhibitors and vitamin D analogues
- Removing the remaining pigment
- Skin camouflage