What is vitiligo?

Millions of people around the world have vitiligo. Almost all of them will have the condition for the rest of their lives.

Vitiligo develops when skin cells called melanocytes die. These cells give your skin and hair their natural color, called pigmentation.

Doctors do not know what causes this loss of color. The good news, however, is that vitiligo is not contagious. It cannot be spread from one person to another. The condition is not deadly, but it does cause low self-esteem in some people.

Vitiligo is a skin condition that causes your skin to lose its natural color. People who have this condition will notice patches of their skin becoming lighter than the rest.

While some people develop a few patches, others may lose much more skin color. In other cases, vitiligo will affect different parts of your body. It can cause your hair to turn white, or discolor parts of the mouth or eyes. The texture of the affected skin remains the same as the surrounding skin.

Sometimes people may confuse vitiligo with other conditions like tinea versicolor, nevus depigmentosus, and others. Unlike these diseases, with vitiligo, you don’t feel anything when you start seeing a change of color on your skin.

Symptoms of vitiligo

Vitiligo causes your skin to lose its natural skin color. This process is called depigmentation. Your dermatologist or may simply refer to it as a loss of pigment. This depigmentation may occur anywhere including your:

  • Skin
  • Hair (scalp, eyebrow, eyelash, beard)
  • Eyes
  • Mouth (inside)
  • Genitals

When most people get vitiligo, they notice the affected area lightening or turning completely white. The majority of people with vitiligo do not have any other signs or symptoms. You will probably feel completely healthy. In rare cases, people report a minor itch or pain on the affected skin.

Causes of vitiligo

Doctors suspect that one type of vitiligo, called non-segmental or generalized vitiligo, may be an autoimmune disease. This type of disease develops when the body mistakes a part of itself as foreign. If your body mistakes your melanocytes for invaders, it will attack and kill these cells.

With generalized vitiligo, depigmented patches appear almost equally on both sides of your body. They may spread to other areas over time.

The other type of vitiligo, segmental vitiligo, originates from something else. Scientists have not yet identified the root cause of this type. They suspect that segmental vitiligo occurs due to a complication in your body’s nervous system.

If you have segmental vitiligo, depigmented patches appear in one area at a time on the left or right side of your body.

Occupational vitiligo is very rare, and it is caused by exposure to certain industrial chemicals, such as those used to make rubber.

Who gets vitiligo?

Anybody can get vitiligo, no matter their skin color. Nearly half of the people living with vitiligo began to show symptoms of it before they reached the age of 21.

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Diagnosis for vitiligo

Only a licensed healthcare professional can diagnose vitiligo. Your doctor will examine your skin to determine whether your loss of pigmentation is a symptom of vitiligo.

If there is a need for more tests, your doctor may perform a skin biopsy. This is a procedure in which a doctor cuts and removes a small sample of skin to have it tested. This test will help you and your doctor identify whether your missing melanocytes are the result of vitiligo.

Your doctor may also be interested in knowing whether you have been diagnosed with autoimmune diseases, including type 1 diabetes or hypothyroidism. Your medical history is also very important, particularly if any of your family members have had similar symptoms.

Treatments for vitiligo

Medications

Some of the medications used to treat vitiligo include topical steroids that come as a cream or ointment which you apply to your skin. These may restore some of your original skin color and stop the spread of the white patches.

Your doctor may prescribe a topical steroid if:

  • You have non-segmental vitiligo on less than 10% of your body
  • You want further treatment like sun protection and camouflage creams
  • You are not pregnant
  • You understand and accept the risk of side effects

Before you consider using a topical steroid on your face, consult a dermatologist. Some of the steroids that your doctor may prescribe include:

  • Fluticasone propionate
  • Betamethasone valerate
  • Hydrocortisone butyrate

Home care

When your skin is exposed to sunlight, it produces a pigment called melanin to help protect it from ultraviolet (UV) light. However, if you have vitiligo there may not be enough melanin in your skin to be protected.

If you have vitiligo, you should apply sunscreen with a sun protection factor (SPF) of 30 or higher. This will protect your skin from sunburn and long-term damage, especially if you have fair skin.

Complications and side effects of vitiligo

Every medicine that treats vitiligo may have different side effects. Consult your healthcare provider about possible complications of any medications you might take for your condition.

Some people may experience side effects of topical steroids. These include:

  • Streaks or lines in your skin
  • Thinning of your skin (atrophy)
  • Visible blood vessels appearing (telangiectasia)
  • Excess hair growth (hypertrichosis)
  • Inflammation of your skin (contact dermatitis)
  • Acne

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Medically Reviewed on 3/26/2021
References
American Academy of Dermatology Association: "VITILIGO."

American Academy of Family Physicians: "Choosing Topical Corticosteroids."

Dermatology Research and Practice: "Nonsegmental Vitiligo and Autoimmune Mechanism."

Indian Dermatology Online Journal: "Side-effects of topical steroids: A long overdue revisit."

Indian Journal of Dermatology: "VITILIGO: A REVIEW OF SOME FACTS LESSER KNOWN ABOUT DEPIGMENTATION."

Medical Journal of the Islamic Republic of Iran: "Treatment of segmental vitiligo with normal-hair follicle autograft."

National Health Service: "Treatment-Vitiligo."

Indian Journal of Dermatology: "Chemical vitiligo: A subset of vitiligo."

NYU Langone Health: "Diagnosing Vitiligo."

International Journal of Women's Dermatology: "Vitiligo: Patient stories, self-esteem, and the psychological burden of disease."