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Vitiligo is a disorder that causes regions of skin color loss. The discolored spots typically become larger over time. The illness can affect any portion of the body's skin. It can also harm your hair and the inside of your lips.
Melanin is normally responsible for the color of one's hair and skin. Vitiligo develops when melanin-producing cells die or cease to function. Vitiligo affects people of all skin colors, however it is more visible in people with brown or black skin. The illness is neither dangerous nor communicable. It can be stressful or make you feel self-conscious.
Treatment for vitiligo may result in the restoration of color to the damaged skin. However, it does not prevent further skin color loss or recurrence.
WHAT ARE THE SYMPTOMS OF VITILIGO?
Vitiligo symptoms include:
- Skin color loss that develops in patches, commonly on the hands, face, and areas surrounding body openings and the genitals.
- Premature whitening or graying of your scalp hair, eyelashes, brows, or beard
- Color loss in the tissues lining the inside of the mouth and nose (mucous membranes)
Vitiligo can arise at any age, however it is more common before the age of 30.
Depending on the type of vitiligo you have, it may have an impact on:
- Almost all skin surfaces: The darkening affects practically all skin areas in this kind, known as universal vitiligo.
- Several bodily parts: The discolored patches on adjacent body areas frequently proceed identically in this most common kind, known as generalized vitiligo (symmetrically).
- One side or part of the body only: This form, known as segmental vitiligo, appears at a younger age, progresses for a year or two, and then stops.
- One or a few parts of the body: This is known as localized (focal) vitiligo.
- The hands and face: Acrofacial vitiligo affects the skin of the face and hands, as well as around body openings such as the eyes, nose, and ears.
It is difficult to forecast how this condition may develop. Without therapy, the patches may stop developing. In most cases, pigment loss extends to cover the majority of the skin. Occasionally, the skin regains its color.
WHAT ARE THE CAUSES OF VITILIGO?
Vitiligo develops when pigment-producing cells (melanocytes) die or cease producing melanin, the pigment responsible for the color of your skin, hair, and eyes. The affected skin patches lighten or turn white. It is unknown what causes these pigment cells to fail or perish. It could be connected to:
- Immune system disorder (autoimmune condition)
- Family history (heredity)
- A precipitating event, such as stress, intense sunburn, or skin trauma, such as chemical contact
WHAT ARE THE COMPLICATIONS OF VITILIGO?
Vitiligo patients may be more susceptible to:
- Distress, either social or psychological
- Sunburn
- Issues with the eyes
- Hearing impairment
HOW IS VITILIGO DIAGNOSED?
Your doctor will ask you about your medical history and inspect your skin, potentially using a special lamp. A skin biopsy and blood tests may also be included in the examination.
WHAT ARE THE TREATMENTS FOR VITILIGO?
The treatment you receive is determined by your age, the amount and location of skin implicated, the rate at which the disease progresses, and how it affects your life.
There are medications and light-based therapies available to help restore or level out skin tone, but results vary and are unpredictable. Furthermore, some medications have substantial negative effects. So your doctor may advise you to start by modifying the appearance of your skin by using a self-tanning product or makeup.
If you and your doctor decide to treat your disease with a medicine, surgery, or treatment, determining its success may take months. And you may need to try more than one strategy or a combination of approaches before you find the optimal treatment for you.
Even if treatment is effective for a period of time, the benefits may not last or new patches may form. To assist avoid recurrence, your doctor may recommend a medicine that is applied to the skin as maintenance therapy.
Medications
There is no medicine that can stop the vitiligo process – the loss of pigment cells (melanocytes). However, several medications, when used alone, in combination, or in conjunction with light therapy, can help restore some color.
Drugs that control inflammation: A corticosteroid cream applied to afflicted skin may restore color. This works best when the vitiligo is still in its early stages. This type of lotion is effective and simple to apply, although you may not notice any changes in the color of your skin for several months. Skin thinning or the formation of streaks or lines on your skin are possible side effects.
Children and people with extensive regions of discolored skin may be administered milder formulations of the medicine.
Corticosteroid tablets or injections may be an option for those whose condition is rapidly worsening.
Medications that affect the immune system: Calcineurin inhibitor ointments, such as tacrolimus (Protopic) or pimecrolimus (Elidel), may be useful for those who have minor areas of depigmentation, particularly on the face and neck. The Food and Drug Administration (FDA) in the United States has issued a warning concerning a possible link between these medications and lymphoma and skin cancer.
Therapies
- Light therapy: Narrow band ultraviolet B (UVB) phototherapy has been demonstrated to stop or delay the growth of active vitiligo. When combined with corticosteroids or calcineurin inhibitors, it may be more effective. You will require therapy two to three times per week. It may take 1 to 3 months to detect any difference, and it may take 6 months or longer to see the entire benefit.
Given the FDA's warning about the potential risk of skin cancer with the use of calcineurin inhibitors, consult with your doctor about the risks and advantages of combining these medications with phototherapy.
Smaller portable or handheld devices for narrow band ultraviolet B therapy are available for home use for those who cannot travel to a clinic for treatment. If necessary, discuss this option with your health care practitioner.
Redness, itching, and burning are all possible side effects of narrow band ultraviolet B therapy. These adverse effects normally go away after a few hours of treatment.
- Using psoralen in conjunction with light therapy: To restore color to the light patches, this treatment combines a plant-derived chemical called psoralen with light therapy (photochemotherapy). You are exposed to ultraviolet A (UVA) light after taking psoralen or applying it to the affected skin. While effective, this method is more difficult to implement and has been mostly superseded in many practices by narrow band UVB therapy.
- Getting rid of the remaining color (depigmentation): If your vitiligo is severe and other treatments have failed, this therapy may be an alternative. Unaffected portions of skin are treated with a depigmenting chemical. This gradually lightens the skin, blending it with the discolored parts. For nine months or longer, the therapy is administered once or twice daily.
Redness, swelling, itching, and extremely dry skin are all possible side effects. Depigmentation is irreversible.
Surgery
Some persons with stable illness may be candidates for surgery if light therapy and drugs have not succeeded. The procedures listed below are meant to balance out skin tone by restoring color:
- Skin grafting: In this surgery, your doctor transfers extremely small portions of healthy, pigmented skin to regions where pigment has been lost. If you have minor areas of vitiligo, this technique may be performed.
Infection, scarring, a cobblestone look, uneven color, and failure to recolor the area are all possible dangers.
- Blister grafting: In this operation, your doctor uses suction to produce blisters on your pigmented skin, then transplants the blister tops to discolored skin.
Scarring, a cobblestone appearance, and failure to recolor the region are all potential concerns. Furthermore, the skin damage induced by suctioning may result in another patch of vitiligo.
- Cellular suspension transplant: In this operation, your doctor removes some pigmented skin tissue, places the cells in a solution, and then transplants them onto the prepared damaged area. Within four weeks, the results of this repigmentation technique are visible.
Scarring, infection, and uneven skin tone are among potential dangers.
Potential future treatments
Among the treatments being researched are:
- A medication that stimulates the production of color-producing cells (melanocytes): This prospective medication, known as afamelanotide, is implanted beneath the skin to stimulate the formation of melanocytes.
- A medication that aids in the control of melanoctyes: Prostaglandin E2 is being studied as a treatment for persons with vitiligo that is neither extensive or spreading. It is applied to the skin in the form of a gel.
HOME REMEDIES FOR VITILIGO
If you have vitiligo, the following self-care techniques may help you care for and improve the appearance of your skin:
- Protect your skin from UV rays from the sun and artificial sources: Use a broad-spectrum, water-resistant sunscreen with a minimum SPF of 30. Apply sunscreen liberally and reapply every two hours, or more frequently if swimming or sweating.
You can also seek shade and wear clothing that provides sun protection. Avoid using tanning beds and sunlamps.
Sun protection for discolored skin aids in the prevention of sunburn. Sunscreen also reduces tanning, which highlights the vitiligo spots.
- Hide the affected skin: Makeup and self-tanning creams can help to conceal skin color discrepancies. To choose a cosmetics or self-tanner that blends nicely with your natural skin tone, you may need to try several products. The colour of self-tanning products does not wash off, although it fades with time. If you use a self-tanner, choose one that contains dihydroxyacetone, which has been approved by the US Food and Drug Administration.
- Avoid getting a tattoo: A fresh patch of vitiligo may form within two weeks if your skin is damaged, such as by a tattoo.