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Vitiligo: What It Is And How To Treat It?

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Vitiligo is a skin condition that can affect any person, irrespective of their ethnicity. It is estimated that 70 million people all over the world are affected by this condition. Studies have shown that in Asia, vitiligo has a pooled population prevalence rate of 0.1% and is most commonly found among South Asians.

What is vitiligo? 

Vitiligo is a skin condition in which white patches appear on the body. These white patches can be on the face, hands, legs or any part of the body. It is a long-term condition that can affect both men and women of any age group. 

In most cases, vitiligo develops during the early stages of life, between 10 and 30 years. You are more likely to get this condition if:

  • You suffer from autoimmune thyroid disease or type 1 diabetes
  • Anyone in your family suffers from it
  • You have a family history of other autoimmune conditions
  • You have a type of skin cancer called melanoma

Sometimes, vitiligo can be triggered by stressful events like childbirth or damage caused to the skin through sun exposure or chemical exposure. 

What is the main cause of vitiligo?

Vitiligo is caused by the lack of a pigment called melanin that provides colour to the skin. In the normal human body, skin cells called melanocytes are responsible for producing melanin. In people with vitiligo, melanocytes do not work properly or produce less melanin. However, it is not clear why melanocytes do not work properly in certain parts of the body. 

What are the symptoms of vitiligo?

Loss of melanin results in white-coloured patches all over the body. 

Initially, a small patch will appear with white in the centre and pale colour surrounding it. If vitiligo has affected an area with an underlying blood vessel, it will appear slightly pink in colour. This white patch stays like that for a while and slowly spreads to the surrounding area and become bigger. 

Vitiligo mostly affects your:

  • Face, especially inside and outside the mouth and eyes, including the eyelid
  • Hands including the wrist, fingers and armpit
  • Groin and genital areas

In some people, vitiligo can affect areas with hair roots, like the scalp. This results in greying of hair in that region. 

The intensity varies from person to person, and there is no way to predict how much it affects a person. It does not cause any dryness or other discomfort, except for occasional itchiness. 

What are the different types of vitiligo?

Vitiligo can broadly be classified into two categories – non-segmental and segmental. 

Non-segmental vitiligo

Non-segmental vitiligo is the most commonly found type. In this condition, the white patches appear to be symmetrical and on both sides of the body. The development will be slower. 

This form is mostly found in the arms, back of the hands, feet, elbows and knees. This condition can further be sub-divided into different categories:

  • Generalised: the white patches appear in different parts of the body. 
  • Focal: the white patches are concentrated in a certain area. This category is mostly found in children. 
  • Mucosal: this category affects the membrane of the mouth or the genitals. 
  • Universal: the discolouration covers 80% of your body. However, universal non-segmental vitiligo is very rare. 

Segmental vitiligo

Segmental vitiligo is not very common and only affects 10% of patients. It is most commonly found in children. In this condition, the white patches spread very rapidly. It is not symmetrical and affects only a certain part of the body.

What are the problems faced by a person suffering from vitiligo?

The most common problem faced by people with vitiligo is mental trauma. They feel embarrassed and anxious about their skin condition, which can eventually lead to low self-esteem. In some cases, it can even lead to depression. 

Besides, the person will also suffer from the following issues:

  • Sensitivity to sunlight: Because of the lack of melanocyte, the area affected by vitiligo will be highly sensitive to sunlight. Sun exposure can cause burns rather than simply tanning. 
  • Eye problems: Patients suffering from this condition will have abnormalities in their retina and experience variation of colour in their iris. Some may even experience inflammation in the iris or retina. Thankfully, vision is generally not affected. 
  • Co-morbidities: Those with vitiligo are at a higher risk of developing other conditions like anaemia, hypothyroidism and diabetes. 

How to treat vitiligo?

There is no cure for this condition. All treatments are aimed at creating a uniform skin tone. The treatments available are:

Camouflage therapy

This includes using makeup to conceal the white patches. If the condition has turned the normal hair grey, hair colour can be used to cover up the affected area. 

Using sunscreen with SPF 30 or higher helps reduce tanning and minimises the contrast between normal skin and the affected area. 

Re-pigmented therapy

This involves taking corticosteroids orally or topically. You can also use topical vitamin D and immuno-modulators to treat the condition. 

Surgery

  • Skin graft: In this type of surgery, skin is taken from the patient’s other body parts and used to cover the white patch. 
  • Micro-pigmentation: This is a type of tattoo done to cover up the white patch. 

Bottom Line

Though vitiligo is not a serious ailment that can affect your health, it could create a significant amount of mental trauma and embarrassment. Through proper counselling and various forms of therapy, this condition is manageable. Good support from friends and family also plays a key role in managing it. 

Article is written in conjunction with World Vitiligo Day 2021.

(Do visit our skin category page on Medical Channel Asia to read on other skin conditions such as rosacea, and acne!)

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