Vitiligo

Vitiligo is a medical condition in which patches of skin lose color. Over time, the discolored areas normally grow larger. This disorder can affect any part of a person’s skin. Hair, as well as the inner part of the mouth, may also be affected. 

Melanin is usually responsible for the color of the skin and hair. If the cells that make melanin die or suddenly stop working, vitiligo develops. Vitiligo can affect all people regardless of skin color and type. However, it is more visible in those who have darker skin. Generally, it’s not a fatal or infectious disease, but it can be overwhelming and make you self-conscious. 

Types of Vitiligo

Vitiligo can be categorized into the following; 

Generalized vitiligo (nonsegmental vitiligo): This is the most common form of vitiligo characterized by the appearance of white patches on either side of your body. It usually begins around the hands, near the mouth or eyes, on your feet, or in a region of the body in which the skin rubs against itself frequently. Color loss in nonsegmental vitiligo occurs in spurts during a person’s life, spreading and getting more apparent as time passes.

Segmental vitiligo (unilateral vitiligo): This form of vitiligo normally begins when an individual is still young. It usually advances for about a year before coming to a halt. Segmental vitiligo is a type that affects only one part of the body, like one leg or arm. It's mostly followed by color modification in the hair, brows, or eyelashes in about half of the cases. However, segmental vitiligo is not as common as nonsegmental vitiligo, affecting around one out of every ten vitiligo patients. 

Medical providers can use these subtypes to illustrate the amount of pigment loss appearing on a person’s body; 

Localized: Vitiligo that occurs in either one or a few spots within the body.

Generalized: Color loss patches can be found all over the body.

Universal: The majority of the original skin color vanishes. This is, however, a very unusual occurrence.

Signs and Symptoms of Vitiligo 

Vitiligo can occur at any age, although it mostly develops before the age of 30. The associated vitiligo symptoms and signs can include; 

• Skin color loss that occurs in patches on the face, hands, and around the body openings, including the genitals.
• Premature graying or whitening of the hair on the scalp, eyebrows, eyelashes, or mustache
• Loss of the color of the tissue in the lining of the inside part of the nose (mucous membranes) and mouth. 

In most cases, vitiligo causes no pain, soreness, irritation, or skin dryness. It also has varying effects on different individuals. Other people will only have a few white spots that don't spread, while others may develop large white patches that connect and affect the significant areas of skin. 

Causes of Vitiligo 

When melanocytes, pigment-producing cells die or no longer produce melanin, the pigment giving your skin, eyes, and hair its color, vitiligo develops. The affected skin patches lighten or turn white. What triggers these pigment cells to die or fail is unknown. However, it might be linked to the following; 

Autoimmune issue: The immune system of the affected person can produce antibodies that kill melanocytes, hence causing vitiligo. 

Genetic factors: Some factors that may raise the risk of developing vitiligo may be passed down across generations. Vitiligo runs in families in approximately 30% of the cases.

Neurogenic factors: Nerve endings in your skin can release a harmful or toxic substance to the melanocytes. 

Self-destruction: Melanocyte defects can cause self-destruction.

Some events, including emotional or physical stress, may also trigger vitiligo. Since neither of the reasons appears to account for the disorder fully, it's likely that a combination of these factors causes vitiligo. 

Vitiligo Diagnosis 

The physician will conduct a physical examination, inquire about your medical background, and order lab tests during your appointment. Report to your doctor any incidents that may be contributing aspects. This includes premature graying of the hair, recent sunburns, or autoimmune disorders you could be having. Also, if your notice any vitiligo early signs seek medical attention right away. If any member of your family has vitiligo or any other skin disorders, tell your doctor. 

The doctor can sometimes use an ultraviolet (UV) lamp to scan for vitiligo patches. The lamp, which is also referred to as Wood's lamp, enables the doctor in distinguishing vitiligo from other skin disorders. 

The doctor might sometimes need to remove a small skin sample; a procedure called a biopsy. These samples will be examined in the lab. Skin biopsies usually reveal whether pigment-producing cells are still present in that region of the body. They can also recommend blood tests can check for other issues that can accompany vitiligo. Examples of such problems are thyroid issues, anemia, and diabetes. 

Vitiligo Treatment Options 

The treatment options and cure of vitiligo usually depend on the various factors, including; 

• Patient’s age
• The extent of the affected skin
• Location of the disease 
• How fast the condition is advancing
• Its effects on day to day living 

Your doctor can thus recommend one or a combination of the following treatment choices to address vitiligo in babies and adults:

Medications:

There is no cure for vitiligo progression, which is characterized by the loss of skin pigment cells (melanocytes). However, certain medications, whether used alone, in combination or conjunction with light therapy, can aid in the restoration of skin tone. These drugs include; 

A corticosteroid cream: Doctors recommend applying this medication to the affected skin to help to restore color. During vitiligo early stages, this is the most helpful treatment. Although this form of cream is safe and simple to use, you will not notice any changes in the color of your skin for some months.

Calcineurin inhibitor ointments:  Examples are pimecrolimus (Elidel) or tacrolimus (Protopic). They can be helpful for individuals with smaller parts of depigmentation, particularly on the neck and face.

Therapies:

• Light therapy 

Active vitiligo can be treated with narrowband ultraviolet B (UVB) phototherapy, which has been proven to stop or delay the progression of the disease. When combined with corticosteroids or calcineurin inhibitors, it may be more effective. You will require the treatment at least two or three days a week. It may take one to three months to see a difference, and it may take up to six months or more to see the full impact. 

• Depigmentation (removal of the remaining color)

If vitiligo is severe and other forms of treatment have failed, this therapy could be an alternative. Unaffected parts of the skin are treated with a depigmenting agent. This lightens your skin over time, blending it in with the discolored regions. For nine months or more, the treatment is performed at least once or twice per day. 

• Light therapy and psoralen combination

This procedure combines a plant-derived material, psoralen, and light therapy (photochemotherapy). You will undergo exposure to ultraviolet A (UVA) light after taking psoralen orally or applying it to the infected skin. Though successful, this method is harder to implement. Also, narrowband UVB treatment has widely replaced it in most practices.

Surgical procedure:

Sometimes, individuals with stable condition could be candidates for surgical operation if light therapy and drugs are not effective. These strategies are designed to restore color and even out your skin tone; 

Skin grafting: Your doctor will perform this procedure by transferring the small parts of healthy, pigmented skin to sections that have lost their pigment. If you have small vitiligo patches, this treatment can be helpful.

Cellular suspension transplantation: This procedure involves the removal of some pigmented skin tissue, dissolving the cells in a solution, and then transplanting the cells to the affected area. After four weeks, the effects of this repigmentation approach will be noticeable. 

Blistering grafting: During this process, the doctor uses suction to make blisters on the pigmented skin. After that, he or she transplants the blisters' tops into the discolored area of the skin.

Other Additional Management and Therapeutic Options 

Even though you might be undergoing vitiligo treatment, the results may sometimes be slower than expected. In such cases, you might want to include the following options; 

Sunscreen: Keeping the skin even requires limiting your exposure to the sun. Your skin can become more contrasted as a result of tanning, causing the damaged areas to be more noticeable. The higher the sun protection factor (SPF), the better the defense. Since areas with no pigmentation are more vulnerable to sun damage and sunburns, it’s essential to apply sunscreen. 

Cosmetics: Self-tanning lotions, as well as makeup, could help you achieve a more even skin tone. Self-tanning lotions can be preferred because the result lasts for an extended period, even after washing. 

Mental health management: According to one report, medicine and psychotherapy could help you live a better life. If you're having problems with your mental health, consult your medical provider.

Conclusion 

Vitiligo is a skin condition characterized by loss of the skin's original color. Luckily, it is not a contagious disease and doesn’t result in any negative physical impacts. As such, the affected people can continue living an active and healthy life. However, individuals with vitiligo can sometimes experience problems of self-esteem and emotional stress. 

Finding a therapist with significant knowledge in skin disorders and the effects on mental health could be helpful. Also, joining vitiligo support could be beneficial to you, your family, and even friends.