Vitiligo: Types, Symptoms, Causes, Treatment

Is an autoimmune disorder that affects people’s skin color, life and their self-perception. 1% of the world population suffer from this disorder regardless of their origin, age or gender. Moreover, in more than 50% of cases, it develops before the age of 20. Whether it is a small white spot, or large and homogenous or scattered, it can still affect the person’s life and health. Contrary to the popular belief, it is not contagious and does not infect anyone who touched or came in contact with the affected skin.

What is Vitiligo?

Vitiligo is an autoimmune disorder that leads to the appearance of spots that differ in pigment from the main melanin pigment in the skin. This occurs as a result of the immune system attacking and eliminating the melanocytes responsible for producing melanin on the skin, creating spots through which the skin loses its color, which usually increase in time.

In addition, vitiligo may affect any body part, with the possibility of also affecting the hair and inside the mouth. The spots could also be more noticeable in individuals with brown or dark skin.

Is Vitligo hereditary?

Studies show that approximately 30% of people with vitiligo have a genetic predisposition. This means that it is possible to inherit vitiligo from your biological family. Many potential gene mutations affect how pigment-producing cells function. If the genetic mutation targets the pigment-producing cells then you might develop vitiligo.

How can I know if the spots are Vitiligo?

Vitiligo might appear similar to some fungal infections making it difficult to distinguish. It is essential to get a consultation from a specialised healthcare provider for an accurate diagnosis.

Here are some of the characteristics that can help differentiate vitiligo from other disorders:

1. It appears suddenly, pale sports that gradually turn white.
2. Vitiligo patches lose their pigment completely.
3. The spots are characterised by their milky white color.
4. There is typically no itching.
5. The spots are usually formed within sharp clear borders which may look like the skin’s natural color or might lose their pigment like the spots or appear red and inflamed.
6. The patches form in different parts of the body, but might frequently appear on the eyelids, nose, lips, fingertips and toes, navel and around the nipples.
7. The tissues lining the inside of the mouth and nose may also lose their color.

How do Vitiligo patches start and how do they progress?

The vitiligo spots start as small patches, and might either remain the same size for years or grow and become larger. New patches may also appear in the same area or on different parts of the body. Additionally, the patches can take weeks, months, or even years to spread and progress. Patches may spread on specific body parts in a connected pattern or may be scattered. It is also possible that even when vitiligo is treated, the spots may reappear in other locations.

What are the areas mostly affected by Vitligo?

Vitiligo spots may appear anywhere on the body, specially the areas exposed to sunlight, bruises and repetitive movement. Additionally, the areas with skin folds such as the hands, hair, eyes, face, neck, lips and the areas inside the mouth.

Who is at higher risk of developing vitiligo?

Vitiligo can affect anyone, regardless of age, race, or ethnicity. However, certain risk factors may increase a person’s chances of developing the condition, such as:

1. Genetic Factors.
2. A family history of other autoimmune diseases such as a parent having Malignant Anemia.
3. Skin cancer such as melanoma or lymphoma.
4. The presence of genetic changes or mutations related to vitiligo.
5. Moles on the skin.
6. Having a personal history of an autoimmune disease such as Addison’s disease, rheumatoid arthritis and type 1 diabetes.

6 causes of Vitligo

The exact known cause of Vitligo is unknown currently, and opinions differ on what might cause it to appear. In addition to the risk factors that might increase the incidence of it occurring, there are other potential causes:

1. Environmental factors and stress.
2. Severe sunburns and injuries.
3. Hormonal changes such as puberty.
4. Liver or Kidney disease.
5. Exposure to chemical agents such as Phenol.
6. Severe Skin strain or injuries such as scratching or cutting.

Major Vitiligo complications

Vitiligo patients may suffer from a variety of complications, including:

1. Painful sunburn due to loss of melanin pigment.
2. Low self-esteem, and social anxiety because of the visible appearance of vitiligo on their skin.
3. Eye diseases and conditions, such as inflammation of the middle layer of the eye (uveitis).
4. Ear problems, such as inflammation of the ear and loss of hearing.

How to live with Vitligo?

It might feel embarrassing and shameful for vitiligo patients to go out or show their spots, and some may resort to hiding them, and avoid the outside world. But let’s look at it from a health and psychological point of view… From a physical health perspective, you should protect your skin from sunlight by using a sunblock, as well as covering the patches before going out. It is also essential to choose a dermatologist who specialises in vitiligo cases. As for the psychological aspect, you can cover vitiligo spots using cosmetic products or skin pigment dye. You can benefit from participating in vitiligo support groups as you can learn from other patients’ experiences and know their treatment journey.

I would like to remind you that there is no flaw in having these spots on your skin, in fact it might be what makes you unique. Finally if you find yourself in need of moral support, don’t hesitate to ask for it from your friends, family members or a specialist.

Types of Vitiligo

Vitiligo is divided into several types according to the body area affected by the white spots, including:

1. Generalised Vitiligo: the most common type of vitiligo, where white patches spread symmetrically on both sides of the body, and can affect its pigment cells.
2. Segmental Vitiligo: is associated with one area of the body being affected, such as one arm or one leg and also including the face and hands. In addition, it develops at a young age and progresses over a year or more then stops.
3. Non-segmental Vitiligo: this type of vitiligo, is closely associated with autoimmunity, as the immune system attacks the body cells which leads to the formation of white spots all over the body. It usually starts appearing in the area of the hands, eyes, mouth or feet.
4. Focal Vitiligo: is the mildest type of vitiligo, during which white patches appear in a few areas of the body.
5. Universal Vitiligo: this type is considered rare,but when it does happen, it appears on most parts of the body and white patches can cover nearly 80% of it.
6. Trichrome Vitiligo: is characterised by the appearance of more than one color together. In one area, it appears dark then is followed by a lighter color, then by a natural color.

Vitiligo Treatment

There are many circulating beliefs on how to treat vitiligo, but many agreed on and reached the conclusion that there is no definitive cure to help you completely eliminate vitiligo. However, there are many treatments targeted towards restoring the lost skin pigment.

Topical skin creams

These creams help in restoring the lost skin color, when applied directly on the spots such as Corticosteroids, Calcineurin inhibitor and Calcipotriene. These medications might help in evening the skin tone out when used alone or in conjunction with other treatments such as phototherapy.

Pharmacological treatments

Oral medications are used to reduce white spots and restore the color of the skin. And the most known drug is Prednisone.
Phototherapy
It works by exposing the affected skin to ultraviolet rays. It might be the most suitable treatment if the vitligo spots have spread widely across the skin. It has been proven that this treatment stops or slows down the progression of vitiligo and it might be more effective when used with corticosteroids or Calcineurin Inhibitors.

Depigmentation Therapy

Doctors resort to this treatment for severe cases of vitiligo, where the disease has spread to more than 50% of the body. This involves removing pigment from the skin completely, gradually unifying the skin tone.

Surgery

Doctors might resort to performing surgery on chronic segmental vitiligo, or vitiligo that is unresponsive to other treatments and that is to restore the skin’s natural color, examples of these surgical procedures are:

Skin grafting

in this procedure, a piece of healthy skin is removed and transplanted in one or more areas affected by vitiligo so eventually it blends in and creates a more even uniform skin appearance.

Melanocyte Transplantation

this procedure involves harvesting melanocytes from a healthy area of skin and implanting them into the affected areas so they can grow and multiply. Results of this procedure are often visible within 6-12 months.

Ultimately, developing vitiligo might be a nuisance, but dealing with it the right way and learning to live with the disorder and starting a treatment journey is the approach instead of withdrawing and isolating yourself, avoid going out with your family and friends, and rushing to hide the spots as soon as they appear.

To schedule a consultation and find the best therapy plan, book an appointment with Dr Muhannad Adas, an excellent dermatologist and venereologist by contacting this number (+962) 799377600.
For other informative articles on the skincare field, we advise you to visit Dr Adas’s website: dradas.com