by Kimberly Allen, RN
Vitiligo is a disorder in which you develop white patches on your skin. It affects as many as 5 million Americans and 65 million people worldwide. Vitiligo affects all races, however, it tends to be more noticeable in people with darker skin. It usually begins between 10 to 30 years of age and 95% of the time will have started by the age of 40. Vitiligo affects both males and females equally and it also has a tendency to run in families. Vitiligo has also been associated with other autoimmune diseases like thyroid disease and pernicious anemia.
Vitiligo develops when the melanocytes, which are the cells that produce melanin, malfunction and do not produce melanin. Melanin is the pigment in your skin that gives it it’s color. When the cells, the melanocytes, that produce that pigment are destroyed there is a loss of pigment in the skin causing vitiligo. The exact cause of the destruction of the melanocytes is not known, however, many researchers believe they are destroyed by your immune system. There is also significant evidence indicating a group of 3 genes that people with vitiligo inherit making them more susceptible to the condition. Some doctor’s feel that the cytokines, which are proteins produced by our bodies, alter the melanocytes, the cells that produce melanin, causing them to die.
Although vitiligo can affect any part of your body most people with vitiligo first notice patches of white skin on areas that are exposed to the sun like your hands and feet as well as your face and lips. It can also affect you genital area. Some people also experience premature graying or whitening of the hair on their scalp as well as their eyebrows and eye lashes. Men tend to have premature gray beards. Some also experience a loss of pigment in the mucous membranes that line your mouth and some experience either a loss of or change in the color in the inner layer of their eye.
Vitiligo usually develops in one of three patterns. The most common pattern is generalized. In this pattern the loss of pigment is wide spread over many parts of your body and frequently is symmetrical. In people with a segmental pattern the loss of pigment occurs only on one side of their body. this type also tends to develop at an earlier age and usually progresses for 1 to2 years before stopping. In the third patten known as focal the loss of pigment is limited to either one or a few areas on your body. Both focal and segmental vitiligo are localized and remain in one area of your body without spreading. However, in generalized vitiligo while there is no way to predict how it will progress it is a progressive disorder and over time the loss of pigment will spread to other areas of your body. Vitiligo spreads at a different pace for each person. In some people it progresses slowly over several years while in others it spreads rapidly. There have also been people that have reported an increase in the loss of pigment after episodes of emotional or psychological stress.
To date there is no known cure or way to prevent vitiligo. Treatment if needed is aimed at improving the appearance of your skin. Some people don’t need treatment while for others the use of cosmetic creams that camouflages the white patches is sufficient. However, if you have a large number of patches and/or larger patches, especially in conspicuous areas you may choose to seek treatment. treatment for this condition can take up to 18 months, and you may need to try more than one treatment to get the desired effect. There are a variety of medical therapies available including a variety of topical creams like corticosteroid creams and topical psoralen plus ultra violet A or PUVA cream, which is also known as photochemotherapy and must be applied in the doctor’s office. There is also an oral form of PUVA that your doctor may recommend if your white patches cover over 20% of your body. Another type of therapy your doctor may recommend is a special form of UVB light called narrowband ultraviolet B therapy as an alternative to PUVA. If your vitiligo covers more than half of your body you may choose depigmentation. In this therapy the unaffected areas of your skin are lightened to match the affected areas.
Though vitiligo is not life threatening it can be devastating, especially for young people that are very conscious of their appearance anyway. Because of this it can affect your emotional and psychological well being. finding a dermatologist that is knowledgeable in the treatment of vitiligo and learning about the condition can help you to cope with this very visible condition.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.