Vitiligo (vit-uh-lie-go) causes the skin to lose color. Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.
Vitiligo usually affects the skin, but it can develop anywhere we have pigment. Patches of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color.
People of all races and ethnicities get vitiligo.
Vitiligo is not contagious. It is not life-threatening. But, vitiligo can be life-altering. Some people develop low self-esteem, no longer want to hang out with friends or develop serious depression. Most people have vitiligo for life, so it’s important to develop coping strategies.
A coping strategy that helps many people is to learn about vitiligo. Another helpful strategy is to connect with others who have vitiligo.
Vitiligo causes loss of color. Your dermatologist may call this “loss of pigment” or “depigmentation.” We can lose pigment anywhere on our bodies, including our:
Most people who get vitiligo lose color on their skin. The affected skin can lighten or turn completely white. Many people do not have any other signs or symptoms; they feel healthy.
A few people say that the skin affected by vitiligo itches or feels painful.
Vitiligo has types and subtypes
If you are diagnosed with vitiligo, your dermatologist may tell you what type and subtype you have.
Subtypes: The subtype tells you how much vitiligo appears on the body. The vitiligo subtypes are:
Localized: One or a few spots or patches appear, but these are limited to one or a few areas of the body.
Generalized: Most people develop this subtype, which causes scattered patches on the body.
Universal: Most pigment is gone. This is rare.
There is no way to predict how much color a person will lose. Color loss can remain unchanged for years. Some people see patches enlarge and new patches appear. On a rare occasion, the skin regains its lost color.
Who gets vitiligo?
Millions of people worldwide have vitiligo. Nearly half get it before they reach 21 years of age. Most will have vitiligo for the rest of their lives. It is very rare for vitiligo to disappear.
Vitiligo occurs about equally in people of all skin colors and races. About half the people who get vitiligo are male and half are female.
The risk of getting vitiligo increases if a person has:
What causes vitiligo?
Vitiligo develops when cells called melanocytes (meh-lan-o-sites) die. These cells give our skin and hair color.
Scientists do not completely understand why these cells die. One type of vitiligo, non-segmental vitiligo, may be an autoimmune disease. An autoimmune disease develops when the body mistakes a part of itself as foreign. If the body mistakes these cells as foreigners, it will attack and kill these cells.
Studies suggest that the other type of vitiligo, segmental vitiligo, has a different cause. This type seems to develop when something in the body’s nervous system goes awry.
How do dermatologists diagnose vitiligo?
If your dermatologist suspects that you have vitiligo, your dermatologist will:
You also may need a blood test to check the health of your thyroid gland. People who have vitiligo often have an autoimmune thyroid disease. A blood test will tell whether your thyroid is healthy. If you have thyroid disease, treatment can successfully control it.
How do dermatologists treat vitiligo?
If you have vitiligo, you should discuss treatment options with your dermatologist. There are many treatment options. The goal of most treatments is to restore lost skin color.
Vitiligo cannot be cured, but many treatments help to restore lost skin color.
Here are some key facts about treatment options to help you start a conversation with your dermatologist. The type of treatment that is best for you will depend on your preference, overall health, age and where the vitiligo appears on your body. Some people choose not to treat vitiligo.
1. No medical treatment (use cosmetics to add lost color):
Cosmetic options include makeup, a self-tanner and skin dye.
2. Medicine applied to the skin:
Several different topical (applied to the skin) medicines can repigment the skin.
3. Light treatment:
Uses light to repigment the skin.
4. PUVA light therapy:
6. Unconventional treatment:
If you have treatment to restore lost skin color, it’s possible that the color will return slowly or incompletely. Sometimes, a treatment does not work.
It is not possible to predict how a patient will respond to treatment. It is important to keep in mind that no one treatment works for everyone. Results can vary from one part of the body to another. Combining two or more treatments often gives the best results.
Q: Can a child with vitiligo be treated?
A: Yes, but some treatments are not appropriate for children. The following may be an option for a child:
Medicine applied to the skin.
PUVA that uses psoralen applied to the skin. PUVA therapy that uses the psoralen pill is usually not recommended until after 12 years of age. Even then, the risk and benefits of this treatment must be carefully weighed.
For children with extensive vitiligo, a dermatologist may recommend narrowband UVB light treatments.
Q: Are researchers looking for more effective treatment?
Yes. They are studying the genes involved in vitiligo. Researchers believe that by identifying all of the genes involved in vitiligo, they will learn what destroys the cells that give skin its color. With this knowledge, it should be possible to develop better treatments. One of the key goals of this research is to develop a treatment that will permanently stop the skin
Dermatologists share the following tips with their patients who have vitiligo.
Protect your skin from the sun
To protect your skin from the sun, dermatologists recommend:
1. Use sunscreen.
Generously apply sunscreen every day to skin that will not be covered by clothing. Use a sunscreen that offers:
2. Apply sunscreen every day.
Be sure to apply it at least 15 minutes before going outdoors.
3. Reapply sunscreen when outdoors.
If you will be outdoors, be sure to reapply the sunscreen:
4. Wear clothing that protects your skin from the sun.
Skin covered by clothing that has a high SPF does not need sunscreen. Not all clothing offers high SPF. A long-sleeve denim shirt has an SPF of about 1,700. A white t-shirt only has an SPF 7, and a green t-shirt has about an SPF 10.
You can boost the SPF of clothing, by adding a product that increases the SPF of clothing during the wash cycle. You add this product to the wash machine. The increase in SPF is usually good for about 20 washings.
5. Seek shade.
This is especially important when your shadow is shorter than you are. That’s when the sun’s damaging rays are at their strongest and you are likely to sunburn.
Do not use tanning beds and sun lamps.
These are not safe alternatives to the sun. These, too, can burn skin that has lost pigment.
If you want to add color to your skin, consider using a cosmetic.
Cosmetics can safely add color to your skin if you want to add color without undergoing treatment. Cosmetics that can add color are self-tanners, dyes, and makeup. Here are some tips that dermatologists offer their patients:
Do not get a tattoo.
Getting a tattoo can cause something called Keobnerization or the Koebner phenomenon. What this means is when you wound your skin, which getting a tattoo does, a new patch of vitiligo can appear about 10 to 14 days later.
Learn about vitiligo.
Knowledge often improves a person’s quality of life. It helps to know about treatment options so that you know what is possible. Learning more about vitiligo can help you decide what feels right for you. You may want to treat it, camouflage with cosmetics, or just let it be. Only you can decide what’s right for you.
If you decide not to treat vitiligo, it’s still important to see a dermatologist for an accurate diagnosis and physical. Vitiligo is a medical condition, not just a cosmetic concern.
Connect with others who have vitiligo.
The emotional aspects of having vitiligo are often overlooked, but they are real. If a child has vitiligo, other children may tease and bully. People can stare. Studies conclude that many people who have vitiligo have a decreased quality of life.