What is Vitiligo?
Vitiligo is a long-term condition that makes the skin lose its color (x). About 0.2 to 1 percent of the world’s population suffers from this condition (x). In vitiligo, white skin patches appear on different areas of the body due to a lack of melanin. It is considered an autoimmune condition.
Vitiligo may develop in people of all races. However, it is most noticeable in dark-skinned people as the difference between the white patches caused by vitiligo and the normal skin is more pronounced (x).
There are two major kinds of vitiligo — nonsegmental and segmental. The more common kind is nonsegmental vitiligo. Patients with this type have white patches of skin on both sides of their bodies. On the other hand, segmental vitiligo mainly occurs in one segment of the body. Segmental vitiligo comprises 10 percent of all vitiligo cases (x).
Vitiligo Symptoms
The most obvious sign of vitiligo in an individual is depigmented or light spots occurring on the skin. The spots can appear on any part of the body, but they typically first appear in parts that receive plenty of sunshine, like on the face, hands and arms (x).
It is also quite common for the patches to develop in the armpits, in the groin region and near the belly button.
Other signs and symptoms of vitiligo include:
- Loss of color in the mouth and nose
- Hair turning white or gray prematurely
- Eyebrows or eyelashes losing color and going white
- Changed color of the eye’s retina
Where the patches appear, how vitiligo progresses, and how widespread it is varies from one individual to the next. Most individuals with vitiligo have it in various body parts. This type, known as nonsegmental vitiligo, tends to occur on both sides symmetrically. Others have vitiligo in only a few areas or one side.
Apart from noticeable white skin patches, other physical symptoms have been associated with vitiligo. Since the patches are skin areas without melanin, which may block out some harmful UV rays, they could be extra sensitive to sunshine (x). Plus, vitiligo can also lead to hearing loss or inflammation of the iris (x).
More importantly, vitiligo can cause serious psychological distress. Many people with vitiligo often have low self-esteem and confidence, particularly if the condition affects skin areas that are difficult to cover up under clothes (x).
Vitiligo may have a significant impact on patients. One can be extremely self-conscious and even suffer from depression.
Vitiligo Causes
Autoimmune conditions, such as diabetes, pernicious anemia, thyroid disease and Addison’s disease are thought to be the root causes of vitiligo (x). But some studies show that people with vitiligo are sometimes deficient in some vitamins and minerals, including vitamin B12, folic acid, zinc and copper (x).
In addition, genetics and heredity may also have a role to play in vitiligo, as do severe sunburns, exposure to certain chemicals and stress. In some cases, immunotherapy for some skin cancers, including melanoma, can cause vitiligo. Conversely, researchers maintain that this is an incredible sign that immunotherapy is working (x).
Vitiligo is often known as “white leprosy” in Ayurveda practice, where it has been identified for more than 2,000 years. Its causes include eating too much fish, curd, grain or sour substances and eating contradictory foods, as well as a range of other emotional and physical traits (x).
Vitiligo Treatment
Vitiligo treatments aim to restore the balance of color to the skin. Some treatments seek to remove pigment while others add it. Your treatment options will vary based on:
- The size and location of your patches
- The seriousness of your vitiligo
- How many spots you possess
- How widespread the spots are
- Your response to treatment
Types of vitiligo treatment include medical, surgery or a mix of both. However, not all treatments are right for everybody and some can even cause undesirable side effects (x).
Always consult your physician if you begin to experience side effects during treatment. He or she can provide alternatives or readjust your dose.
Prescription Ointments and Creams
Ointments and creams for vitiligo are only available by prescription. They are available as powerful anti-inflammatories, like calcineurin inhibitors and corticosteroids. Lowering inflammation may decrease loss of pigmentation. In some cases, the skin may restore its natural color as well.
It may take months for topical vitiligo treatments to work (x). They may also be unsuitable for kids and seniors due to their more sensitive, thin skin.
Corticosteroids are ideal for widespread vitiligo areas. On the other hand, calcineurin inhibitors work best for smaller parts of pigmentation loss.
Corticosteroid creams have some potential side effects, including:
- Thinning skin
- Lines of discoloration
- Increased risk of cancer (lymphoma, skin cancer)
Photochemotherapy
Photochemotherapy (light therapy) involves limited exposure to UV rays to treat discoloration. Often, UVA photochemotherapy is combined with psoralen (a plant-based medication), which is applied to smaller regions of affected skin or taken orally. This treatment is referred to as PUVA (x).
PUVA combination treatments are as much as 85 percent effective (x) and are particularly useful in treating spots on the head, neck, trunk, arms and legs.
Patients may need additional PUVA sessions up to three times a week for six months at least (x).
Laser Treatment
This involves high-powered beams being used to remove the skin’s outer layers. Laser treatment may be useful for vitiligo as it evens out spots of lighter-than-usual skin.
The negative is that the treatment may be painful and need a long period of recovery (usually several weeks). You will also require multiple treatments to get results.
Sunscreen
Limiting your exposure to the sun can help maintain the even color of your skin. Tanning will bring contrast to the skin, making affected parts even more noticeable. Always go for higher SPF for added protection. It is vital to use sunscreen because areas without melanin are particularly susceptible to sun damage and sunburns.
Cosmetics
Cosmetics play a significant role in helping cover up depigmentation, hyperpigmentation and redness. Self-tanners are one way to hide vitiligo spots. You also can try powders, foundations and tinted primers. Make sure to pick a color that matches your original skin tone most closely. Darker colors can make you appear fake.
The benefits of covering up with cosmetics can be great when it comes to your self-esteem. You can quickly apply cosmetics before going out. The bad news is that cosmetics are not long-lasting and can be deterred by rain, sweat and humidity.
Mental Health Management
One study shows that psychotherapy and medication may improve the quality of your life (x). Let your doctor know if you are experiencing adverse mental health effects.
Depigmenting Agents
If there are widespread white patches, and other treatments have not worked, a dermatologist can recommend depigmenting areas not affected, by lightening them to blend with or match the discolored area.
Depigmenting is often done one or two times daily for at least nine months, and the final result will be irreversible. When considering this conventional treatment, it is imperative to note that permanent depigmentation can cause severe sensitivity to light.
Living with Vitiligo
You might feel self-conscious, sad, stressed, embarrassed or even overwhelmed by your changed appearance due to vitiligo. You might even feel that vitiligo stops you from going about your day-to-day activities, particularly if it affects noticeable parts of your body (like the face, arms, hands and feet) or it is widespread.
The following tips can help you manage vitiligo better:
Communicate your feelings: If you are feeling depressed, please inform your doctor. He or she can recommend a mental health specialist in assisting people with depression.
Learn all about vitiligo: Learn as much as possible about vitiligo and your treatment choices so you can decide what you need to do.
Talk with others: Determine from your doctor what type of support or psychotherapy groups for individuals with vitiligo exist in your area.
Confide in those closest to you: Seek support and understanding from your loved ones.
Establish a good connection: Look for a doctor who is experienced with the disorder. A dermatologist is paramount.
Supplements for Vitiligo
Some doctors prescribe supplements to help strengthen the immune system of people suffering from vitiligo. The supplements are usually used alongside other treatments. Be sure to consult your physician for the right dosages.
Para-Aminobenzoic Acid
This amino acid protects your skin from damaging UV rays, so it is a popular sunscreen ingredient. It also promotes healthy connective tissue. Take PABA in servings of 100-500 milligrams daily.
L-Phenylalanine Powder
This essential amino acid is believed to keep the nervous system healthy. Take 500 milligrams of L-phenylalanine powder 1-3 times a day, based on the effect you want to achieve. It may take up to a month for its effects to be noticed fully.
Pure DL-Phenylalanine Powder
This amino acid may promote pain management and elevate mood. Take 375 milligrams of this supplement three or four times daily. Sometimes it may take up to four weeks for DLPA effects to be noticeable.
Green Tea Extract
Green tea extract contains antioxidants that are believed to promote overall health and wellness. Take 500 milligrams of green tea extract one or two times daily. Don’t take more than 1,000 milligrams a day, and never use this supplement for more than 90 days at a time.
Turmeric Curcumin Extract Powder
The anti-inflammatory effects of turmeric can benefit overall health. Take a single dose of 1,000 milligrams daily, depending on your intended effect. You should take it with a meal or water.
Pure Quercetin Dihydrate Powder
This flavonoid antioxidant may increase levels of vitamin C and support immune function. Take between 250 and 500 milligrams of quercetin thrice daily, depending on your desired effect.
The Bottom Line
Vitiligo is a long-term medical condition that causes loss of skin pigmentation. It occurs when the cells that make skin pigment (melanocytes) are damaged. It can manifest as white skin patches on the body.
The white spots more commonly appear where the skin comes into contact with the sun. Often, the patches spread. If you have dark skin, vitiligo can make you lose color in your mouth. It may make your hair grey prematurely.
While researchers have not yet pinpointed the exact cause of vitiligo, autoimmune conditions appear to be the most obvious culprit. However, a lack of certain minerals and vitamins, as well as genetics and heredity can also play a role in this disorder, as can exposure to certain chemicals, severe sunburns and stress.
Using sunscreen will protect your skin from the sun, and cosmetics can conceal the patches. Vitiligo treatments include medicine, light therapy (phototherapy) and surgery. Not all treatments work for everyone. Many cause side effects.
Treatment for vitiligo can restore color to the area affected, but it will not prevent a recurrence or continual loss of color of skin.