What is Vitiligo?

Human beings get their skin color from a pigment called melanin. The cells that produce melanin are called melanocytes. If these pigment-producing cells are destroyed, the skin will lose melanin and, thus, its natural color. The result of numerous cells dying is patches of lighter blotches of skin. This patchy loss of pigment is vitiligo.

The pigmentation loss condition destroys the melanocytes in anyone of any race, age, or gender. Changes to the skin can be minor or extensive. In lighter-skinned people, it can barely be noticeable, while in dark-skinned people, it’s more obvious with the starker contrast.

About two percent of Americans are afflicted with pigmentation loss, and roughly a third of those affected have a genetic history of loss of pigment. It’s as likely to manifest in people younger than 20 as it is in people over 20.

Symptoms of Pigmentation Loss Disorder

Symptoms of vitiligo include often-symmetrical patches of white skin bordered by red or dark boundaries, and they can occur anywhere on the body. Common areas to be affected include areas that have been sunburnt or that have skin folds, such as under the arm, as well as the face and the back of the hand. Body orifices are susceptible, as well, including eyes, lips, and nipples.

Vitiligo can be unpredictable. It can occur suddenly and aggressively – large areas of the body can quickly be drained of their skin pigmentation at the onset of the condition – and it can stop without warning and not worsen for months or even years.

Causes of this Skin Discoloring Condition

To be succinct, the exact cause of vitiligo is unknown. Of course, there are various hypotheses. Some medical experts believe vitiligo to be an autoimmune disorder, a condition where the body’s immune system is overactive, leading it to accidentally destroy the body’s melanocytes, resulting in pigmentation loss.

Other ideas about vitiligo causes include viruses, stress, sunburns, cuts or wounds from injury, exposure to certain chemicals, and heredity. Learn more about potential causes of pigmentation loss at webmd.com.

Types of Pigmentation Loss

It is separated into two types: non-segmental and segmental.

Non-Segmental Vitiligo

This type is the most common, occurring in roughly nine out of every 10 people afflicted with the condition. Given the unpredictability of vitiligo, it’s somewhat surprising that the patches in the non-segmental condition often appear symmetrically on the body – they often affect each side of the body equally. Vitiligo can appear anywhere on areas of the body exposed to daily sun, such as the face, arms, neck, hands, and feet.

Non-segmental vitiligo itself can be divided into sub-categories:

Generalized: This is the most common type and can appear anywhere and be of any size.
Acrofacial: This usually appears on fingers or toes.
Mucosal: Typically appears around lips and areas with mucous membranes.
Universal: This covers nearly the whole body, but it is rare.
Focal: Characterized by a few scattered patches in discrete areas.

Segmental Vitiligo

Affecting only about 10% of Americans, the segmental version of vitiligo spreads more aggressively. However, it is usually more stable and non-symmetrical. Furthermore, it appears to be more noticeable in younger people, as it is responsible for nearly a third of children’s cases.

Pigmentation Loss Treatment

Patient responses to vitiligo treatment vary, but there are options known to be effective. The goal should be twofold: a) reduce the skin color contrast between the normal areas and the patches, and b) decrease the adverse emotional or social impact vitiligo can foster.

Sun Protection

Protect the white patches from the sun because they’re vulnerable to sunburn, which increases the risk of skin cancer. Sun-protective apparel and/or sunscreen of at least 30 SPF are recommended regardless of other treatments.

Topical Treatments

Directly applied to the skin, topical treatments such as steroid creams or ointments are massaged into the vitiligo areas daily for several months.

Ultraviolet B Light Treatment

UVB light targets the affected areas for a short period of time, often three times a week for no fewer than six months.

Psoralen Plus Ultraviolet A Light Treatment (commonly called PUVA)

A combination of UVA light and the drug Psoralens causes the skin to darken. The drug can be ingested in pills or applied as a cream.

For severe cases, depigmentation can be used to completely remove color from the normal skin, rendering the skin all the same color white. This treatment is rarely employed because the non-pigmented skin is extremely susceptible to sun damage.

Skin grafting is another option for severe vitiligo, as it entails replacing patches with normal skin removed from more concealed areas of the body.