Vitiligo is a skin condition in which the pigment producing cells of the skin called as melanocytes are destroyed. Melanocytes produce melanin which impacts brown colour to skin so the loss of these cells causes the loss of colour causing white patches.
The exact cause of Vitiligo is not known. Vitiligo is an auto immune disease with underlying genetic disposition. There are three theories on the causation:
Malfunction of the nerves may cause deranged nerve supply and subsequent damage to the melanocyte.
Sometimes the body destroys its own tissue, perceiving it as being foreign. This is known as auto immune reaction, which may also be the cause of melanocyte damage.
Some researchers believe that the melanocytes can self-destruct and certain triggers like trauma, trigger this self-destruction.
Vitiligo affects approximately 1% of the population. The inheritance pattern is complex since Vitiligo is caused by multiple factors. On an average it has been found 20 to 30% of all Vitiligo patients have at least one close relative afflicted by the disease.
No. Vitiligo is not transmissible to family members or contacts.
There are reports of pigment loss shortly after an emotional stress, psychological crisis or some major illness.
Sometimes a physical trauma to an area may lead to the development of the disease in that area.
Diet does not appear to play any role in the appearance or continuation of the disease.
Vitiligo is not contagious, which means it does not spread by touch.
Vitiligo presents as an asymptomatic white or off-white patch on the skin. The hair overly the area may also lose colour and become white other than loss of colour. Skin affected by Vitiligo is completely normal.
Vitiligo can affect the skin at different areas of the body. Depending on the area of involvement, different types of Vitiligo are seen.
Lip-tip vitiligo- involvement of the lips and the tips of the fingers and toes
Segmental Vitiligo-involvement of an area or a body in a linear fashion
Focal Vitiligo- involvement of small localised area of skin
Generalised Vitiligo- involvement of a large area of the body
All white patches on the skin are not Vitiligo. A Dermatologist can help differentiating between the different types of white patches. A dermatologist will also suggest the optimal mode of therapy and counsel the patient and his/her family about the disease.
Vitiligo can be usually diagnosed based on clinical appearance and bedside test such as woods lamp examination.
Rarely a small piece of skin (skin biopsy) may be examined to differentiate with go from other white spots on skin.
Among patients having 15% may also have other auto immune diseases such as thyroid disease, rheumatoid disease, diabetes, perishes, anaemia, blood test may be needed to confirm the absence of these diseases
The goals of treatment are to control the spread of disease and to regenerate pigmentation in the areas that have lost the same. Treatment choice is based on number, site, extent of involvement and patient convenience. Also, supportive camouflage treatment helps to reduce social problems while patient is on corrective therapy.
Various treatment options include
Medical treatment : medical treatment includes oral medication and topical cream, which may achieve the objective of stopping the spread of disease and regaining pigmentation in most areas
UV therapy : Ultraviolet therapy includes exposing the affected areas to ultraviolet A or ultraviolet B therapy. Ultraviolet A is usually given with a drug called as psoralen that can be used orally or applied topically to the affected area and then exposed to UV A. Narrow band UVB light is usually given by making the patient stand in a light box or by exposing a localised area to focus beam of NB UVB light. Multiple sessions of UV light therapy are required at a frequency of 2 to 3 sessions per week.
Surgical therapy: surgical treatment, such as taking skin gras from a person’s own body and transplanting the entire skin or the melanocytes in an affected area. This is usually done when the disease is stable, not increasing in size or number. Various surgical grafting modalities like Punch grafting, blister grafting , grafting, and melonocyte transfers are described.
Tattooing: Tattooing the vitiligenous skin and cosmetic camouflage can help cover the white patches
Skin protection: Protecting the skin against exposure is very important and can be achieved by wearing full sleeve clothes and sunscreen.
Counselling: Understanding the innocuous and cosmetic nature of the disease can help prevent psychological distress. It is important to also understand the limitation of therapy and providing a complete pigmentation working with and supporting the doctor through therapeutic course, gives better results
Vitiligo can occur in young children. There are fewer options in children as compared to the adult. NB UVB can be used in children, but psoralen and UVA light is recommeded only after the age of 12 years. Topical cream and lotion can be used under the supervision of a Dermatologist.
Vitiligo is an auto immune disease and therefore, as with any other auto immune disease, it cannot be fully cured. Treatment can slow its progress and in many cases prevent further spread of the disease. However, the disease may after stopping the treatment which can be treated effectively. A person consult a dermatologist at a very early stage, proper treatments with regular follow-up, increase the chances of pigmentation.
Yes, a person with can marry. Vitiligo is not contagious and therefore any individual afflicted with this conditiona does not need to abstain from any activity, including physical contact.
In case of a school going child, the teachers, the support staff of school and parents of other teachers need to be sensitised about the innocuous nature of the disease and special care to be taken by the school to prevent psychosocial harassment of the child by his or her peers.
Disclaimer: This article is only for general patient information and is not intended for self medication. There is no legal liability of IADVL arising out of any adverse consequence to the patient. Subsequent to its use for self treatment of the disease images adjust for the depiction of the condition and is not to be used for any other purpose.
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