What is vitiligo?
A skin condition known as vitiligo causes white spots to develop on various body areas. The pigment is present everywhere and can cause these white areas to appear. It can make hair white, cause some people to lose color in their mouths, or even have an impact on their eyes. White spots appear on the skin when the pigment-producing cells are damaged.
Life-altering but not life-threatening or contagious is vitiligo. It can lead to social isolation in some cases, low self-esteem in others, or even depression in some cases. It's crucial to educate yourself about vitiligo and come up with coping mechanisms because some people may live with it forever.
Although vitiligo is more common in persons under the age of forty, half of those who have the condition start to exhibit symptoms before the age of twenty. All ethnicities and genders are equally susceptible, however those with darker skin tend to notice it more. Vitiligo affects up to 65 million people worldwide, or 0.5 to 1 percent of the total population.
Epidemiology
Vitiligo is present in 0.4 to 2.0% of the world's population, with some regions having a higher or lower prevalence. The majority of research show a somewhat higher frequency in females and a 50% childhood onset, however there are exceptions to both of these generalizations. Atopic dermatitis, halo nevi, and vitiligo and autoimmune disease in the family have all been linked to childhood vitiligo.
Types of Vitiligo
Segmental vitiligo (SV) most often begins at an early age and affects only one area, on one side of the body, such as one side of the mouth, or neck. It generally spreads fairly quickly at the onset, then slows and remains stable after a year or so, with more than half also developing patches of white hair. SV is rarely associated with autoimmune disease.
Non-segmental vitiligo (NSV) is an autoimmune disease and typically begins on areas such as the hands, wrists, around the eyes or mouth, or on the feet, then spreads to areas such as the neck, chest, knees, and legs. NSV is considered to be progressive but has cycles of spreading and cycles of stability. NSV includes all types of vitiligo except segmental vitiligo.
Generalized: widespread and largely symmetrical distribution
Acrofacial or Acral: depigmented areas away from the center of the body such as the face, head, hands and feet
Focal: one or more areas of pigment loss in a confined area
Mucosal: mucous membranes are affected
Universalis: complete or nearly complete depigmentation
Mixed vitiligo (MV) begins as segmental vitiligo, and then later progresses into non-segmental vitiligo, becoming “mixed vitiligo.”
Risk factors of Vitiligo
Age below 30 years
FHx of vitiligo
Autoimmune disease
Chemical contact
Causes
The exact causes of vitiligo are unclear. A number of factors may contribute.
These include:
An autoimmune disorder, in which the immune system becomes overactive and destroys the melanocytes
A genetic oxidative stress imbalance
A stressful event
Harm to the skin due to a critical sunburn or cut
Exposure to some chemicals
A neural cause
Heredity, as it may run in families
A virus
Vitiligo is not contagious. One person cannot catch it from another.
It can appear at any age, but studies suggest that it is more likely to start around the age of 20 years.
Symptoms and Signs
White patches on the skin are the main sign of vitiligo. These patches are more common in areas where the skin is exposed to the sun. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:
The armpits and groin (where the leg meets the body)
Around the mouth
Eyes
Nostrils
Navel
Genitals
Rectal areas.
People with vitiligo often have hair that turns gray early. Those with dark skin may notice a loss of color inside their mouths.
Complications of Vitiligo
Potential complications include an increased risk of:
Psychological or social issues
Sunburn
Skin cancer
Iritis and other problems related to the eyes
Hearing loss
Treatment side effects such as itching
Diagnosis and test
The doctor will use a family and medical history, physical exam, and tests to diagnose vitiligo. The doctor may ask questions such as:
Do you have family members with vitiligo?
Do you or family members have any autoimmune diseases?
Did you have rash, sunburn, or other skin problem before the white patches appeared?
Did you have some type of stress or physical illness?
Did your hair turn gray before age 35?
Are you sensitive to the sun?
The doctor will do a physical exam to rule out other medical problems.
Tests might include:
Taking a small sample (biopsy) of the affected skin to be examined
Blood tests
An eye exam.
Treatment and medications
Since no cure is available for vitiligo, the main goal of treatment is to improve the appearance of discolored skin. The safest treatment option is cosmetics. Medication, light therapy, and surgery can cause dryness, itching, and burning of the skin or more serious side effects.
Cosmetics: Applying makeup or skin tanners to the affected areas can mask minor cases of vitiligo. Although cosmetics require a frequent application, they are generally safe and free of side effects.
Medication: Topical creams that affect the immune system or control inflammation (corticosteroid) may help re-pigment the skin. These creams may be used in combination with ultraviolet light to improve results. Due to adverse reactions, these treatments are generally used for small areas on the face and neck. Those with widespread vitiligo may wish to remove pigment from the remaining unaffected areas by applying topical creams that gradually lighten the skin.
Light therapy: Regular sessions of light therapy can assist affected skin on the face, trunk, and limbs in regaining some of its color by triggering the skin's natural healing process. The use of ultraviolet A (UVA) or ultraviolet B (UVB) light and a drug that makes the skin more sensitive to UV light are both used in photochemotherapy. Only the use of narrow band UVB radiation is an alternative.
Surgery is an option if other treatments, such as cosmetic operations, medicines, or light therapy, are ineffective. Skin and blister grafting procedures can be utilized to attach pigmented skin from unaffected areas to small sections of discolored skin. These operations could have unintended consequences include scarring and textural alterations to the treated areas. In addition, the colour surgical options pose the risk of triggering pigment loss in neighboring skin.
Protection against vitiligo
Vitiligo cannot typically be prevented. Reduced exposure to established triggers, such as stress, chemicals, and sunlight, can help stop pigment loss in newly exposed body parts.