LIVING WITH VITILIGO

We can safely say that vitiligo is not a skin condition that most people would recognize based on its name. Most of us have not heard the term before unless we are living with the disorder or know someone who is. June 25^th is World Vitiligo Day, and at Vitalogy Skincare, we would like to help spread the word by providing you with some basic information about this disorder. Let’s join the over 100 million people living with vitiligo in the world, and perhaps we can all learn something new.

Vitiligo Basics

Vitiligo, also called leucoderma, is a chronic depigmenting disorder of the skin. Skin cells that produce pigment (called melanocytes) are lost when the body’s immune system attacks them, resulting in well-defined white patches of skin. This disorder can vary widely from person to person. For some, it can be just a few patches of depigmented skin, while on others, the patches start to merge and cover significant areas of the body.

Vitiligo can appear anywhere on the body, but common sites affected are the exposed areas such as the face, neck, hands, or feet. It can also appear in places where trauma to the skin has occurred, like when you cut yourself. Vitiligo can affect people of all ages, skin colors, and races, but it is more pronounced in people with dark or tanned skin. Of note, though this is a life-long condition, it is not contagious or life-threatening.

What causes vitiligo is still unknown, though it is thought to be an autoimmune disorder in which the body’s immune system attacks its own cells. A percentage of people affected by vitiligo will also be affected by one other autoimmune disease such as rheumatoid arthritis, hyperthyroidism, type 1 diabetes, or Addison disease.

There seems to be a hereditary factor that is still being researched, as it sometimes runs in families. Certain events may also trigger vitiligo or make it worse. Psychological stress seems to be the most common trigger event, followed by damage to the skin from things like sunburns, chemical burns, and cuts. Lastly, hormonal changes during adolescence, pregnancy, and menopause can contribute to its onset.

Types of Vitiligo

There is no specific test for diagnosing vitiligo. It requires a physical examination, with your Provider looking closely at your skin and getting a medical history. A Wood lamp (blacklight) is sometimes used, allowing the white patches to be more easily seen. 

Once you are diagnosed with vitiligo, ascertaining the type of vitiligo is essential in predicting disease activity. The two basic types are Generalized Vitiligo (also known as Non-Segmental) and Segmental Vitiligo. This information will allow your Provider to individualize your treatment for better results. 

Generalized Vitiligo is the most common type. White patches appear symmetrically on the body (equally affecting both the right and left sides of the body), almost like mirror images. It often begins with a rapid loss of color, then stops for a while. This stop and grow cycle can go on for the person’s lifetime. The color loss also tends to expand and cover large body areas.

Segmented Vitiligo appears on one body segment, such as the face, leg, or arm. About half of patients will also lose hair color on the head, eyelashes, or eyebrows. This type seems to begin at an earlier age and often progresses for a time and then stops. 

Treatments Available

There are a variety of treatments for Vitiligo. Most treatments aim to restore skin color, although it is challenging to achieve re-pigmentation in many cases. There are also depigmentation treatments that try to remove skin color to match the patches you already have. There is no “cure” for Vitiligo, and the disorder tends to be chronic once it appears.

Try to keep in mind that treatments take time, and not everyone responds to them equally. Your Provider may have you try more than one approach or a combination of approaches to see what works best for you.

Topical Medications – Several topical medications, such as corticosteroids or calcineurin inhibitors, can be used. These treatments are best for smaller areas and aim to return skin color to these areas.

Phototherapy – This therapy uses ultraviolet (UV) light to stimulate melanocytes to re-pigment the skin. This can be particularly useful in larger areas of the body. Treatments typically must be done several times a week for several months. Another form of phototherapy is the use of a specialty laser. These can be directed more effectively to a specific smaller area. They are not usually used on the hands or feet, as it is not very effective there.

Systemic Medications – these are medications that work throughout the body. Your Provider may want to use these in conjunction with other treatments.

A specialist, such as a Board-Certified Dermatologist, will consider different factors to put together a treatment plan specific to your situation. They will also let you know what type of risks are involved with each treatment.

Vitiligo Self-Care

Living with a skin condition that is visible for all to see can be difficult. Those living with vitiligo sometimes suffer low self-esteem, depression, and anxiety. You can do some things to help manage your condition and take back some control.

• Avoid injury to the skin: these can develop patches of white skin where you injured yourself. Injury includes any prolonged contact with certain chemicals and sunburns. Chemicals you might want to avoid include insecticides, latex gloves, paints, printing inks, synthetic oils, and disinfectants. You also want to avoid tattoos since these, by nature, cause damage to your skin. You will usually see a new patch develop within two weeks of getting a tattoo.  

• Protect your skin from the sun: Patches of depigmented skin become more susceptible to the sun’s UV radiation and will burn easily. Always be mindful of sun protection by using sunscreen daily. Use sunscreen with an SPF of 50+ and seek shade whenever possible. Stay away from artificial UV light sources such as tanning beds and sun lamps which will also damage your skin.

• Always wear protective clothing such as long-sleeve shirts, broad-brimmed hats, and long pants or skirts. 

• Try using self-tanning products and cover-ups:  you can safely add color to your skin by using products you can find over the counter. There are some great self-tanning products, plus there are also concealers, dyes, and make-up that can help even out your skin tone.

• Reach out to a vitiligo support group in your area or online. Talking to someone who is experiencing the same diagnosis can be beneficial.

At Vitalogy Skincare, we can help you with any questions about vitiligo or if you need a consultation for any of your dermatology needs. Please reach out to one of our highly experienced and qualified Board-Certified Dermatologists and Certified Physician Assistants. You can book an appointment online for any of our eight convenient locations