Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin, the mucous membranes (tissues that line the inside of the mouth and nose, as well as genital and rectal areas), and the retina (inner layer of the eyeball) are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo usually turns white as well.
Who Is Affected By Vitiligo?
About 1 to 2 percent of the world's population, or 40 to 50 million people, have vitiligo. In the United States, 2 to 5 million people have the disorder. Ninety-five percent of people who have it develop it before their 40th birthday. The disorder affects all races and both sexes equally.
The cause or
causes of vitiligo are unknown, but doctors and researchers have several different theories.
Risk Factors for Vitiligo
While not a cause of vitiligo, certain factors seem to increase a person's risk of developing it. Issues known to be risk factors for the condition include certain
autoimmune diseases and a family history of the disease.
However, just because someone has risk factors, it does not mean he or she will develop the condition. Most people who develop vitiligo have no risk factors.
Autoimmune Diseases
Vitiligo seems to be more common in people with certain
autoimmune diseases (diseases in which a person's immune system reacts against the body's own organs or tissues). These autoimmune diseases include:
- Hyperthyroidism (an overactive thyroid gland)
- Alopecia areata (patches of baldness)
- Adrenocortical insufficiency (Addison's disease)
- Pernicious anemia (a low level of red blood cells caused by a failure of the body to absorb vitamin B12).
Family History
Vitiligo may also be hereditary, meaning it can run in families. Children whose parents have the disorder are more likely to develop vitiligo.
White patches on the skin are the primary
vitiligo symptom. 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
- Lips.
Other common areas for white patches are:
- The armpits and groin
- Nostrils
- Around the mouth
- Eyes
- Navel
- Genitals.
In addition to having white patches on the skin, people may have premature graying of the scalp hair, eyelashes, eyebrows, and beard. People with dark skin may notice a loss of color inside their mouths.
How Is Vitiligo Diagnosed?
In order to make a diagnosis of vitiligo, the doctor will ask a number of questions about a person's medical history, perform a physical exam to look for any signs of vitiligo or other conditions, and order certain tests.
The goal of treatment is to restore the function of the skin and to restore color to the white patches. Treatment for vitiligo can take a long time -- it usually must be continued for 6 to 18 months.
The choice of treatment depends on:
- The number of white patches
- How widespread the patches are
- The treatment the patient prefers to use.
Current vitiligo remedies include medical, surgical, and adjunctive therapies (therapies that can be used along with surgical or medical treatments).
Medical Vitiligo Treatment
Medical treatments include:
- Medicines (such as steroid creams) that you put on the skin
- Medicines that you take by mouth
- Combining a medicine plus ultraviolet A (UVA) light (PUVA)
- Removing the color from other areas so that they match the white patches.
Surgical Vitiligo Treatment
Surgical treatments include:
- Skin grafts from a person's own tissues. The doctor takes skin from one area of a patient's body and attaches it to another area; this is sometimes used for people with small patches of vitiligo.
- Tattooing small areas of skin.
Other Treatments for Vitiligo
Other treatments include:
- Sunscreens
- Cosmetics, such as makeup or dye, to cover the white patches
- Counseling and support.
Some treatments for vitiligo are not right for everyone. Many treatments can have unwanted side effects. Each patient responds differently to therapy, and a particular treatment may not work for everyone. Your doctor can describe your treatment options and the expected results of each. Together, you and your doctor can develop a treatment plan that meets your medical needs and personal values. Choosing the most appropriate treatment for vitiligo is a decision that ideally involves the patient and healthcare team.
Several strategies can help a person cope with vitiligo, including:
- Finding the right doctor
- Learning about vitiligo
- Obtaining support
- Counseling
- Using sosmetics.
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