Vitiligo: When Your Skin Pigment Decides to Go Incognito

Vitiligo is a skin disorder that impacts millions of individuals worldwide, and it can sometimes cause confusion and concern. If you’ve noticed white patches on your skin or are curious about vitiligo, you’re in the right place. This article will clearly explain vitiligo, including its causes, symptoms, and available treatment options. Approximately 0.5%-2% of the global population is affected by vitiligo.

Vitiligo is a long-lasting skin condition that causes some areas of your skin to lose colour, resulting in lighter patches.  It occurs as a result of increased autoimmunity in which the body mistakenly attacks its own cells that produce skin colour, called melanocytes. The lighter patches can appear on any part of the body, often on the face, neck, and hands, and they usually show up on both sides symmetrically.

In some cases, vitiligo can affect only one side of the body. While anyone can develop vitiligo, it may run in families, and people with this condition might also be more likely to get other autoimmune diseases.

Several skin conditions can resemble vitiligo, leading to confusion. Here are some common ones:

• Albinism: A lifelong condition in which very pale skin and hair result due to a deficiency of melanin. It is present at birth and affects the entire skin surface, unlike vitiligo, which develops over time.
• Hansen’s Disease (Leprosy): This bacterial infection can cause flat, faded patches similar to vitiligo but may also lead to numbness in those areas.
• Idiopathic Guttate Hypomelanosis (IGH): This condition produces lighter spots, usually on sun-exposed areas like the arms and chest. Unlike vitiligo, IGH spots are hypopigmented rather than completely devoid of pigment.
• Pityriasis Alba: Similar to vitiligo, this condition causes lighter patches but starts as red, scaly spots, primarily on the face and upper body.
• Scleroderma: This autoimmune disorder causes the skin to become hard and can lead to lighter or shiny patches. It is generally more severe than vitiligo and may also affect internal organs.
• Tinea Versicolor: A fungal infection that causes discoloured patches with sharp borders. Unlike vitiligo, it is treatable with antifungal medications.

If you're unsure whether you have vitiligo or another skin condition, it's best to consult a dermatologist for a proper diagnosis and subsequent treatment options.

Vitiligo is a skin condition that comes in two main types:

• Non-segmental vitiligo: This is the most common type. It causes white patches of skin on both sides of the body, like on the hands, arms, around the eyes, knees, elbows, and feet.
• Segmental vitiligo: This type affects only one body part, such as the face, arm, or leg. It usually starts in childhood and lasts for about one to two years. Some people might also notice that their hair colour in the affected areas lightens.

There are also a few subtypes of vitiligo:

• Focal vitiligo: Small patches of skin lose colour, and this stays the same for one to two years.
• Universal vitiligo: This serious type affects a large portion of the skin, losing colour in at least 80% of the body.
• Mucosal vitiligo: This type affects the moist areas inside the body, like the mouth or genitals.

In rare cases, vitiligo can spread to cover the entire body, known as universal vitiligo.

• The skin develops white patches, often on the hands, feet, arms, face, and other areas of the body.
• The patches can also appear inside the mouth, nose, and genitals.

• Vitiligo can cause the inside of your mouth, nose, and other moist areas to lose colour.

• Vitiligo can cause the inside of your mouth, nose, and other moist areas to lose colour.

• Itchiness: Sometimes, the white patches can feel itchy, especially when they are spreading.
• Sun Sensitivity: The white patches burn easily in the sun, so they need extra protection.
• Emotional Impact: Changes in appearance can affect a person’s confidence and self-esteem.

• Hearing Loss: Vitiligo can sometimes affect hearing if the cells that produce colour in the inner ear are damaged.
• Eye colour changes: It can cause a change in eye colour, though this is rare.
• Associated health issues: Some people with vitiligo may also develop other autoimmune conditions, such as thyroid problems.

Everyone experiences vitiligo differently. Some may only get a few white spots, while others may have large patches that spread over time.

If you notice a rapid increase in the number or size of vitiligo lesions, it indicates that the disease is unstable. It becomes important to stop the disease’s progression by addressing the heightened autoimmune response. This may require oral medications. In such a scenario, it is essential to consult a dermatologist promptly for proper treatment.

The risk of developing vitiligo is heightened by the following factors:

• Genetics: Family history increases the risk. Individuals with a genetic predisposition have a higher likelihood of developing vitiligo.
• Autoimmune conditions: Vitiligo is linked with thyroid issues, diabetes, and lupus.
• Age: Vitiligo often starts before age 30.
• Environmental triggers: Sunburn, skin injuries, and chemical exposure may trigger it.
• Immune dysfunction: The immune system attacks pigment-producing cells.
• Stress: Emotional or physical stress can worsen or trigger the condition.
• Chemical exposure: Contact with chemicals like phenols in detergents and adhesives may increase the risk.

People with vitiligo may face several complications, including emotional distress from social stigma and mental stress. The depigmented skin is more susceptible to sunburn and, in rare cases, skin cancer. Eye problems, such as iritis (inflammation), can also occur. Additionally, there may be hearing loss due to the loss of pigment cells in the ear. Prolonged use of topical steroids for treatment can lead to skin thinning as a side effect. Dr Dilip Kumar, Dermatologist, Bangalore Medical College, adds, “Complications are primarily psychological, such as depression, and there is also an association with other autoimmune disorders.”

Vitiligo is chronic in nature, indicating that while treatment can help manage symptoms, it cannot ensure a complete and lasting cure. Dr Dilip Kumar, Dermatologist, Bangalore Medical College says, “The progression of the condition can be slowed by avoiding known triggers. Vitiligo is an autoimmune disease, and unfortunately, a permanent cure is not possible as recurrence can occur.”

In conclusion, vitiligo impacts the skin by causing patches of skin to lose their colour, affecting many people around the world. While it’s not dangerous, it can make some individuals feel self-conscious and impact their mental well-being. Although there isn’t a permanent cure, knowing what triggers the condition can help manage it better. With the right support and care, people with vitiligo can lead happy lives and feel confident in their skin.

Vitiligo can affect anyone, regardless of age, gender, or ethnicity. It typically starts before age 30, but it can develop at any age. People with a family history of vitiligo or other autoimmune conditions may be at a higher risk.

Vitiligo impacts approximately 0.5% to 2% of the global population, making it a relatively common skin condition.

Vitiligo typically begins with small white patches on the skin, which occur when the immune system mistakenly attacks and destroys melanocytes, the cells that produce skin color. These patches can gradually spread over time, affecting larger areas of the skin. The progression varies for each person; some may experience rapid changes, while others may see little change for years.

The main difference between tinea versicolor and vitiligo lies in their causes and appearance. Tinea versicolor is caused by a fungus and results in discoloured patches on the skin, often with sharp borders, and can be treated with antifungal medications. In contrast, vitiligo is an autoimmune condition that leads to the loss of skin colour due to the destruction of melanocytes, resulting in lighter patches that usually appear symmetrically on both sides of the body. Tinea versicolor patches are usually covered with fine powdery scales, unlike vitiligo patches. If you're unsure whether you have tinea versicolor or vitiligo, it's best to visit a dermatologist. They can accurately differentiate between the two through a clinical examination and a Wood's lamp test, ensuring the correct diagnosis and treatment plan.

When discussing vitiligo with your doctor, consider asking these questions:

• What are the different options for treating my condition?
• How can I manage or slow the progression of vitiligo?
• Are there any side effects from treatments?
• What are the ways to prevent sun damage to my skin?
• Is my vitiligo linked to other health conditions or risks?