World Vitiligo Day

Vitiligo is a skin pigmentation condition that results in the loss of the brown skin pigment melanin. Pigments are typically […]

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Vitiligo is a skin pigmentation condition that results in the loss of the brown skin pigment melanin. Pigments are typically produced by particular skin cells known as melanocytes. 

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Spotlight on Vitiligo: Understanding, Coping, and Treating White Patches

June 25th is World Vitiligo Day! The campaign was initiated in 2011 by the non-profit organizations VR Foundation (USA) and VITSAF (Nigeria) and their supporters across the world. #WorldVitiligoDay aims to bring this “forgotten” disease into the public eye and shine a light on the challenges faced by those suffering from vitiligo.

Its mission has evolved over time, from spreading awareness of vitiligo to recognizing the bullying, social neglect, psychological distress, and impairments that millions of people with vitiligo experience.

Vitiligo: At a glance Vitiligo is a skin pigmentation disorder. It stops the production of pigments in certain areas of the body, causing white patches to appear on the skin.

Vitiligo does not cause pain, is not life-threatening, and is not contagious.

Many people find the changes in their skin distressing, in many cases because they feel stigmatized by others.

Treatment with medication and light can bring about a partial improvement in skin pigmentation.

What is Vitiligo?

Vitiligo is a skin pigmentation condition that results in the loss of the brown skin pigment melanin. Pigments are typically produced by particular skin cells known as melanocytes. Vitiligo occurs when the immune system, by error, attacks and destroys melanocytes, causing pigment production to cease. This results in the formation of white patches on the skin.

It affects around one to two person in every hundred to some extent. Vitiligo typically begins between the ages of 10 and 30, but it can occur to anybody at any age and in any social group. When vitiligo develops at a young age, the illness typically proceeds more quickly, and the region affected by depigmentation expands.

Most of the white patches initially appear on the face, hands, and feet. When they form in isolated sections of the body, this is referred to as “localized” or “segmental” vitiligo. Typically, such depigmentation ends after about a year and does not extend further. “Generalized vitiligo” occurs when vitiligo arises on several sections of the body, typically in big patches. This kind of vitiligo relates to an increased risk of developing autoimmune diseases, the most prevalent of which is thyroid disease. To a lesser extent, type 1 diabetes, rheumatoid arthritis, and alopecia areata hair loss have been observed.

It is crucial to note that vitiligo does not reduce life expectancy, is not communicable, and the patches are not painful. However, it may have dramatic negative impact on people’s psychological well-being, particularly when vitiligo develops in visible parts of the body. It can cause challenges with self-esteem, triggering feelings of anxiety and depression. In addition, people with vitiligo sometimes isolate themselves out of fear of not being accepted.

What May Cause Vitiligo?

Researchers assume that the reason for vitiligo is in your genes, waiting for a bad luck moment. If a family member has vitiligo, it is more likely that you will also develop it. Emotional stress is the most frequently reported trigger for vitiligo. Severe sunburn, skin injury, and chronic exposure to certain chemicals may induce or aggravate vitiligo. Chemical triggers may be present in many products, such as hair colors, perfume, cosmetics, and detergents. Hormonal changes during pregnancy, childbirth, and menopause are also observed in correlation with the start of vitiligo.

What Are Vitiligo Symptoms?

People with vitiligo are usually healthy. Vitiligo isn’t painful or irritating. The typical depigmentation signs differ greatly from person to person. It is particularly noticeable in those with dark or tanned skin. Some people may have a few white patches that may not spread. Others develop bigger lesions that overlap and cover considerable portions of the skin.

Vitiligo commonly affects sun-exposed skin, prior locations of skin damage, body folds, and areas around body openings. Vitiligo may begin as a pale area on your skin that eventually fades to white. Hairs above vitiligo patches may also lose pigmentation and turn white.

However, not all white lesions are indicative of vitiligo. A well-trained dermatologist can distinguish vitiligo from other skin disorders that have similar features.

How is vitiligo treated?

After giving you the diagnosis, your dermatologist will ask if you wish to treat the vitiligo. Some people may be unconcerned by white patches of skin if they are not apparent to others. Some may wish to hide the white areas with special cosmetics. Skin camouflage uses special colored cover creams or self-tanning lotions. Others just accept their skin as it is and take pride in their individuality.

Although there is no cure for vitiligo, there are certain treatments that can assist. Some therapies have been demonstrated to slow down the progression of vitiligo, while others cause the afflicted skin to revert to normal in some cases. However, you should be aware that no one therapy for vitiligo is effective in every instance. The reaction to various therapies differs and may depend on the kind of vitiligo.

Specialist advice may be required to choose the most appropriate treatment. Before developing a treatment plan, a dermatologist considers your age, overall health, and the impact of the condition on your life. The type of vitiligo, its location on the body, and its progression are all critical factors. Treatments that may be considered by a skin specialist are:

Steroid cream

A steroid cream may prevent a smaller patch from becoming bigger, and occasionally, skin color may return in a treated area. As longer use of steroid creams results in thinning of the skin, it is not the best option for the face or for children.

Tacrolimus or pimecrolimus cream

Tacrolimus or pimecrolimus creams can be used as an alternative to steroid creams. They have been shown to restore skin color to some people with vitiligo. It seems to be most effective for vitiligo on the face and can also be used on the skin of children.

PUVA treatment

PUVA stands for Psoralen and Ultraviolet A (UVA) light. It involves taking a special medicine (psoralen) which makes the skin very sensitive to light. The skin is then treated with UVA light from a special machine in the hospital. This treatment is very time-consuming, as treatment is needed twice a week for up to two years. PUVA may cause side effects such as sunburn-type reactions or skin freckling. Even if the therapy works and the skin color returns, there is still a chance that it may go white again at a later stage.

Narrowband UVB phototherapy

Another light treatment more commonly used than PUVA is based on ultraviolet B (UVB) light. As with PUVA, treatment is twice a week, but it is not necessary to take a medicine to sensitize the skin, and the treatment sessions are much shorter. It is less damaging to the skin than PUVA and is particularly useful when large areas are affected. Sometimes it is used in combination with tacrolimus or pimecrolimus cream.

Laser treatments

Excimer lasers are a popular choice of laser treatment, using a high-energy beam of ultraviolet (UV) light called UVB to treat vitiligo. Laser treatments are relatively expensive and suited for limited body surface areas. They may be an option for people who have not responded well to other treatments, such as topical creams or lotions. The treatment sessions take around half an hour and should be attended twice weekly for 4-6 months, but this can vary between people. About 70% of people who opt for excimer laser treatment are reported to see results. However, the skin color may disappear again for those who stop treatment within one year.

Complete De-Pigmentation

In some people with extensive vitiligo, a treatment may be considered to make the remaining normal areas of skin go white. This is done only after a full discussion with a specialist. The removal of all the skin pigment is permanent, and it takes up to a year to complete.

General advice for people with vitiligo

When exposed to the sun, white vitiligo patches cannot tan, they can only burn. Therefore, sun protection is very important, and full sun should be avoided in the hottest times of the day. White patches should be covered with clothes or a hat, where possible, or with high-factor sunblock.

Skin disorders that alter appearance generally have the potential to affect an individual’s well-being, personal and social interactions, and even career. Multiple studies have documented the psychological devastation that is inflicted by vitiligo. Children are sometimes teased or even bullied in school. People with vitiligo often feel stigmatized. These experiences may damage self-esteem, affect quality of life, and, in some cases, lead to psychological problems. Psychological counseling and support can be beneficial in such cases.

Beauty lies within

There has been a positive wave in recent years about self-acceptance in general. People are starting to accept beauty in all its forms. Self-acceptance of your vitiligo doesn’t take away the need to have treatment options for those who want them. But everyone should know that they are beautiful and have self-worth. We found Vitiligo_Dubai’s page for you, an Instagram collection of examples, that vitiligo fits with natural beauty #dubai #vitiligoworld #vitiligo. And we found a Vitiligo Video Link from the Vitiligo Aarus Foundation for you.
It’s important to educate our society about vitiligo. It is not contagious, it is not painful, and it is not dangerous! Your individual beauty matters!

TheKnowHow Independent Second Opinion Service

Are you or a loved one suffering from vitiligo and are unsure about the exact diagnosis or are concerned about your current treatment choices?

TheKnowHow Independent Second Opinion Service provides an extra level of competence. Get an unbiased assessment from an international expert in dermatology without having to travel or schedule appointments. Our impartial specialists conduct a record-based assessment of your current health state and all available treatment options, including their advantages and potential hazards. Read more on PATIENS and SECOND OPINION REQUEST

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