The skin disorder vitiligo causes your skin to lose its color or pigment. Your skin either becomes white or seems lighter than it is naturally. If the area of your skin that is losing pigment is less than 1 centimeter broad, it is referred to as a macule, and if it is more than that, it is referred to as a patch. Your hair may become white or silver if you have vitiligo on a portion of your body where you have hair.

When melanocytes in your body are destroyed by the immune system, the condition results. Skin cells called melanocytes are responsible for producing melanin, the substance that imparts pigmentation or color to skin.

Who is affected by vitiligo?

Both sexes and races are equally affected by vitiligo. People with darker complexion tones are more likely to notice it. Even though vitiligo may appear at any age, macules or patches often show up before the age of 30.

If you have specific autoimmune diseases, such as:

• Addison’s condition
• Anemia
• Type 1 diabetes
• Lupus
• Psoriasis
• Arthritis rheumatica
• Thyroid condition

How widespread is vitiligo?

A little more than 1% of people worldwide have vitiligo.

How does vitiligo begin and develop?

The first signs of vitiligo are often a few little white macules or patches, which may later spread over your body. Every region of your body, including your mucous membranes (the moist lining of your mouth, nose, vaginal, and rectal areas), your eyes, and your inner ears, may develop vitiligo. However, it usually starts on your hands, forearms, feet, and face.

Larger patches may continue to grow and expand, although they often remain in one spot for years. As specific parts of skin lose and develop color over time, the position of smaller macules varies throughout time.

Each individual with vitiligo has a different amount of skin that is affected. While some individuals just have a few depigmented spots, others lose their skin color all over.

What variations of vitiligo are there?

Various forms of vitiligo include:

• Generalized: This is the most prevalent kind of vitiligo, which results in macules showing up all over your body.
• Segmental: Only one side of your body or one particular part of your body, such as your hands or face, is affected by this kind.
• Mucosal: Mouth and/or vaginal mucous membranes may be affected by mucosal vitiligo.
• Focal vitiligo is a rare kind in which the macules only appear in a limited region and do not expand outward over the course of one to two years.
• Trichome: This kind creates a bullseye with a white or colorless center, then a lighter-pigmented region, and finally a toned portion of your skin.
• Across the board: This uncommon form of vitiligo results in more than 80% of your skin being pigment-free.

What are the vitiligo symptoms?

Vitiligo symptoms and signs include:

• Skin or mucous membrane patches that have lost their color. These might have a whiter or paler appearance than your actual skin tone.
• Your body begins to develop silver, gray, or white patches of hair.
• A tiny section of your body may only have minor symptoms, or your skin may experience severe symptoms across a big area. Before depigmentation begins, the skin of some vitiligo patients itches.

Where will my vitiligo symptoms appear?

Vitiligo symptoms may show up anywhere on your body’s skin. The most typical sites for vitiligo symptoms to appear are:

• Hands
• Feet
• Arms
• Face
• Mucous membranes, including those on your lips, nose, and mouth
• Penis, or genitalia

Why does vitiligo occur?

Vitiligo is brought on by a shortage of melanin, the skin’s pigment. This does not make sense, for some reason. According to research, vitiligo may originate from:

• An autoimmune disorder occurs when your immune system misidentifies healthy cells (melanocytes) as harmful germs or other external invaders that might damage your body. Your immune system overreacts to this, producing antibodies that attack your melanocytes.
• Genetic modifications: A genetic mutation or alteration to your body’s DNA may have an impact on how well your melanocytes work. There are more than 30 genes that might make you more likely to have vitiligo.
• Stress: If you often suffer physical stress on your body or mental stress on your body, particularly after an accident, the quantity of pigment your melanocyte cells produce may alter.
• Environmental triggers: Your melanocyte cells’ ability to operate may be impacted by conditions including exposure to harmful chemicals and UV light.

Is vitiligo inherited?

While investigations on the origins of vitiligo are still being conducted, it has been shown that roughly 30% of cases are inherited. This indicates that the disease is inherited, and you may get vitiligo from your biological relatives. Melanocyte cell function may be impacted by a variety of genetic alterations. You will exhibit vitiligo symptoms if a genetic mutation affects the cells that supply your skin color.

Does vitiligo hurt?

Vitiligo is not painful, no. However, vitiligo may cause severe sunburns on lighter spots of skin. It’s crucial to safeguard oneself from the sun by taking precautions like using sunscreen, avoiding the sun during its peak hours, and donning protective clothes.

Does vitiligo have side effects?

Despite being mostly a cosmetic disorder, vitiligo may result in:

• Skin sensitivity: Because macules and patches lack melanocytes, they may be more susceptible to sunburn than other parts of your skin. Instead of tanning, this might soon burn your skin.
• Eye abnormalities include color variations in the irises, the colorful portion of the eye, as well as various abnormalities in the retina, the inner layer of the eye that includes light-sensitive cells. Though eyesight is often unaffected, the retina or iris may sometimes become inflamed.
• Autoimmune disorder predisposition: People with vitiligo may be more susceptible to developing other autoimmune diseases that alter the way their immune systems respond. Anemia, diabetes, and hypothyroidism are typical autoimmune diseases.
• Emotional difficulties: Victims with vitiligo may feel ashamed of the appearance of their skin. Some vitiligo patients have poor self-esteem. Anxiety or sadness may result from this, making the person desire to withdraw or avoid social settings. You should speak with your healthcare practitioner, a mental health professional, your family, or friends if this occurs.

Tests and Diagnosis

Exactly how is vitiligo identified?

Vitiligo is often diagnosed correctly by a visual examination conducted by a medical professional. A Wood’s lamp could be used by your doctor to examine your skin. Using an ultraviolet (UV) light that shines on your skin, this lamp may help your doctor distinguish between vitiligo and other skin diseases. Your healthcare professional could also inquire about your personal and family medical histories.

What other diseases can mimic vitiligo?

Other disorders that alter or lighten your skin’s pigmentation include:

• Chemical leukoderma: Skin cells are harmed by exposure to certain industrial chemicals, resulting in linear or splotchy white patches on the skin.
• Tinea versicolor: This yeast infection may produce light or dark patches that are visible on different skin tones.
• Low amounts of melanin in your skin, hair, or eyes are a sign of albinism, a hereditary disorder.
• Pityriasis alba: This ailment causes red, scaly patches of skin that eventually turn into lighter, scaly patches of skin.

Administration and Therapy

Exactly how is vitiligo handled?

Vitiligo doesn’t need treatment since it just affects your appearance and has no health risks. Your healthcare practitioner may assist you in finding a treatment option to achieve a uniform skin tone by either restoring color to your skin (repigmentation) or eradicating the residual color (depigmentation) if you have extensive vitiligo if your physical symptoms influence your mental well-being. The following are typical vitiligo treatments:

• Medications
• Luminous treatment
• treatment for skin lightening
• Surgery
• Counseling

Medications

There isn’t a particular treatment that will stop vitiligo from damaging your skin, but there are several medications that can decrease the rate at which pigmentation is lost, aid in the growth of new melanocytes, or restore color to your skin. Drugs that might be used to treat vitiligo include:

• Corticosteroids
• Ruxolitinib, a topical Janus kinase inhibitor
• Calcineurin inhibitors

Luminous therapy

To help your skin regain color, try light therapy or phototherapy. Your skin will be exposed to light boxes, ultraviolet B (UVB) lamps, or medical-grade lasers for a brief period of time. For your skin to start changing after light treatment, it may take numerous sessions.

Vitiligo in broad portions of the skin may be treated with PUVA, which combines oral psoralen medicine with ultraviolet A radiation. For those who have vitiligo on their head, neck, torso, upper arms, and legs, this therapy is beneficial.

Dermabrasion treatment

In order to match the vitiligo-affected portions of your skin, depigmentation treatment lightens your normal skin tone. Monobenzone is a medication used in depigmentation treatment. This medicine may be used to treat pigmented skin lesions. Your skin will become white as a result, matching the vitiligo-affected portions of your body.

Surgery

Vitiligo patients may choose surgery as a kind of therapy. A surgical procedure could involve:

• Skin grafts: This procedure involves taking skin from one area of your body and applying it to another. Scarring, infection, or a failure to repigment are examples of potential side effects. Another name for this is mini-grafting.
• Blister grafting: In blister grafting, a blister is formed on your skin using suction, and the top of the blister is then cut off and attached to the vitiligo-affected part of your skin.

In the following circumstances, your doctor could advise against surgery:

• Possess vitiligo that spreads fast
• Easily scarred
• Develop keloids, which are elevated scars that enlarge to the size of a wound

Counseling

Some vitiligo patients find that seeking therapy or seeing a mental health expert helps them to better manage their worry, despair, or low self-esteem, which may be related to the changes in their skin. Psychological anguish brought on by vitiligo might influence a person’s worldview and social relationships. If this occurs, your caregiver could advise that you see a therapist or go to a support group.

Prevention

How can vitiligo be avoided?

There is no known technique to stop vitiligo since it may have a number of causes. You can lower your chance of getting vitiligo by:

• Adopting sensible sun exposure practices
• Employing a moisturizer on a regular basis to take care of your skin.
• Preventing physical stress or harm to your body
• Managing any autoimmune disorders that may be present

Prospects / Prognosis

If I have vitiligo, what can I anticipate?

Your look and how you feel about your skin in public are both impacted by vitiligo. Speaking with a mental health expert may often make individuals feel more at ease, which can boost their confidence and self-esteem.

Although there is no known therapy for vitiligo, your healthcare professional can assist you in selecting the course of action that is best for you and your skin.

Will vitiligo cause my original skin color to return?

10% to 20% of vitiligo patients completely recover their skin color. This is more prevalent among those who:

• Before the age of 20, get an early diagnosis
• Within six months or less, the illness will reach its height in spreading
• have symptoms that are mostly facial in nature

You have a lower chance of getting your pigment back if you:

• Manifest signs of vitiligo beyond the age of 20
• experience symptoms in your hands, limbs, or lips

How can I cover up vitiligo?

If the appearance of your vitiligo on your skin bothers you, you may conceal macules or patches at home by:

• Using sunscreen that has an SPF of at least 30. Sunscreen application reduces tanning and lessens the difference between skin that has been damaged and skin that is healthy
• Using cosmetics to cover up regions of skin that lack colour
• Using hair dye to color your hair will help it blend in with the rest of your head’s healthy hair.
• Getting a tattoo called micropigmentation, which covers your vitiligo lesions. In order to mask the condition’s symptoms, it functions like permanent makeup

Vitiligo: Is it spreadable?

No. It’s impossible to spread vitiligo. Physical contact is not a way for it to transfer from one person to another.

Living with Vitiligo

When should I schedule a visit with my doctor?

Get in touch with your doctor if:

• Rapid color or pigment loss occurs in your skin.
• The depigmentation covers a substantial portion of your body.
• Your mental health and general well-being are impacted by the changes to your skin. 

What inquiries ought I to make of my physician?

• IWhat kind of vitiligo do I have?
• Will the color in my skin return?
• How can I defend myself against the sun?
• Which medical procedures are ideal for my skin?
• Will this condition pass to my offspring in the future?

Questions and Answers

What distinguishes vitiligo from tinea versicolor?

The pigment in your skin is affected by a variety of disorders, including tinea versicolor and vitiligo. White, yellow, red, pink, or brown patches may appear on your skin as a result of the fungus illness tinea versicolor. Losing pigment is a symptom of the autoimmune disease vitiligo. It makes your skin become whiter or paler than it is naturally.

Is vitiligo the same as piebaldism?

No. White or pale spots of skin or hair are a symptom of both illnesses. Piebaldism develops when melanocytes, which are cells that create the pigment (melanin), are absent from a section of your skin. You have piebaldism by birth. When melanocytes in your body are damaged, vitiligo develops. Throughout your lifespan, you may acquire vitiligo.

Overview

Your skin will alter cosmetically if you have vitiligo. Because it is not harmful, therapy is not necessary. However, it’s typical for vitiligo skin changes to have an impact on self-esteem and cause individuals to feel uneasy or anxious. To talk about how your physical appearance impacts your mental health, contact your healthcare professional. Vitiligo cannot be cured, however there are treatments that may make you more comfortable.