Vitiligo: a Skin Disorder with Milky-white Patches

Vitiligo is a chronic skin disorder that causes patchy loss of skin pigmentation.

Vitiligo may start at any age but often appears before the age of 20 years. This condition can affect any part of your body, commonly involving the hands and feet. In addition to that, it may also make your hair turn grey or white (called leucotrichia).  It tends to progress with time and, as a result, gradually involves larger areas of skin. However, this condition is neither life-threatening nor contagious.

Why does VITILIGO occur? 

• It basically occurs when the cells (melanocytes) that produce melanin, the pigment responsible for skin color, cannot do so. This, in turn, leads to blotches of milky-white patches on various body parts.
• Though this phenomenon’s main cause is unknown, it has been widely linked with autoimmune etiology. With autoimmune etiology, it basically means that it is a disorder in which your own immune system attacks your body and destroys the melanocytes in the skin.
• Though not directly responsible for causing vitiligo, a positive family history may act as a risk factor.
• Genes associated with vitiligo, including NLRP1 and PTPN22 may also increase the risk.
• Triggering events such as sunburn, stress, or exposure to industrial chemicals, are also associated with the risk of vitiligo.

Symptoms- What changes does vitiligo cause?

• The most important manifestation involves patchy loss of skin color, which is usually bilateral and symmetrical.
• Depigmentation initially affects the sun-exposed areas, such as the hands, feet, arms, face, and lips.
• The white patches may, at times, have a hyperpigmented border and scalloped margins.
• Depigmentation of hair (on your scalp, eyelashes, eyebrows, or beard) is called leucotrichia and is a poor prognostic factor.
• Discoloration may involve the inside of your mouth and nose (mucous membranes) and even the eyeball’s inner layer (retina).

Hoe does vitiligo get diagnosed?

• It usually involves a proper physical examination and medical history.
• Any contributory factors such as recent sunburns, premature graying of your hair, or any autoimmune diseases, are paid attention to.
• Tracing family history is also important.
• The ultraviolet lamp (known as wood’s lamp) helps differentiate between vitiligo and other skin conditions.

What are the Possible Complications?

• More than the physical complications, it is the psychological stress that is quite commonly observed. Patients affected with vitiligo usually develop a tendency to social withdrawal and depression.
• In addition to that, these patients are at an increased risk of sunburn, skin carcinoma, iritis (inflammation of the iris), hearing loss, etc.
• Therefore, it becomes all the more important to apply a good amount of sunscreen (at least SPF 30) and wearing proper clothes for adequate protection.

Know more about Albinism

Is there any Treatment for Vitiligo? 

Treatments for vitiligo mainly focus on the restoration of normal pigmentation of the skin. The treatment options usually vary according to the severity of the condition, number of patches present, locations of the depigmentation, size of these blotches, and the patient’s response to treatment. It involves both medical as well as surgical intervention. At times, it may involve a combination of both.

Medical treatments include the following:

• Topical creams– There are quite a few creams available, including corticosteroids, that can help treat cases that are still in the initial stages.
• Psoralen and ultraviolet A (PUVA) therapy: This method involves administering psoralen as a pill or its application as a cream onto the skin directly. This is followed by the exposure of skin to UVA light to activate the drugs that help restore color to your skin.
• Narrowband UVB light: This is another option or alternative to traditional PUVA therapy. It involves the exposure of skin to a more focused type of light therapy. It basically has comparatively fewer side effects.
• Depigmentation – This often is a solution when most treatments have failed in returning the normal skin pigmentation.

Surgical intervention is required when any of the above-mentioned solutions fail to yield results. It involves the following:

• Skin grafting– Transfer of pigmented skin to the affected areas. Risks of skin grafting involve infection and scarring.
• Melanocyte transplants– In this type, the melanocytes are removed and allowed to grow in a laboratory setting. These are then transplanted to the areas affected.
• Micro-pigmentation