Vitiligo

Vitiligo

Vitiligo is a skin condition that causes white patches on the skin due to a lack of pigmentation. Vitiligo is an auto-immune disease where the production of melanin, responsible for the pigmentation of the skin, is impaired.

What causes vitiligo? 

The exact cause of vitiligo is unclear. The color of skin is determined by the pigmentation produced by the chemical melanin. When the body produces a limited amount, or does not produce melanin at all, de-pigmentation appears.

The cells producing melanin, melanocytes, fail to function properly in patients with vitiligo. This can be caused by damage to the nerve cells, an autoimmune reaction causing the body to attack and destroy the melanin producing cells or the cells themselves can be self-destructive.

De-pigmentation can affect the eyes and the hair however the most obvious sign of de-pigmentation is on the skin.  

Vitiligo symptoms

Vitiligo is symptomatic with white patches on the skin. The white patches are caused by de-pigmentation of the area of skin. The most commonly affected areas are the hands, feet, face and genitalia.

Vitiligo can also affect the hair. Patients suffering from vitiligo often develop grey hair at a young age. 

The retina of the eyes can also be affected by vitiligo. The color of eyes may change slightly if vitiligo develops. 

Treatment for vitiligo

There is no cure for de-pigmentation of the skin. Vitiligo treatment involves controlling any inflammation or painful irritation of the skin and camouflaging the white patches for cosmetic purposes. Treatment my be able to restore lost pigmentation to some areas of affected skin following prolonged treatment. 

Topical steroid creams  - Applying steroid creams during the initial stage of the condition may prevent the loss of pigmentation developing further and in children may even restore some colour to the affected patches. Steroid creams can cause the skin to shrink so must be applied under doctors guidance and the patient will be monitored for adverse skin changes as a side effect of treatment.

PUVA therapy -This treatment is two-fold. The patient must first take a drug called psoralen which reacts with UV light. The drug may be taken orally or applied to the skin. The patient is then placed under UV (ultra-violet) light for a controlled period. 

PUVA is the most common treatment for vertiligo however there are potential side effects. Too much exposure to UV light or sunlight can cause sunburn on the affected non-pigmented areas of skin. PUVA can also cause the skin to darken more than desired, leading to hyper-pigmentation or dee colouring of the skin.

If taken orally, psoralen can increase the risk of cataract development. 

Depigmentation of the surrounding skin - It is possible for dermatologists to de-pigment the surrounding skin - fading the color of skin to blend with the vertiligo affected areas.

Skin grafts - It is possible for healthy, normally pigmented skin to be transfered from another area of the body as a skin graft. 

Micro-pigmentation/permanent tattooing - If the area of affected skin is small, the area can be filled with a tattoo to color the area. This is especially effective in the lip and nose area.

For more information on vertiligo and the treatments available, contact a dermatologist.