Vitiligo (patient information)
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Vitiligo |
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Vitiligo On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Vitiligo is a skin condition in which there is a loss of brown color (pigment) from areas of skin, resulting in irregular white patches that feel like normal skin.
What are the symptoms of Vitiligo?
- Flat areas of normal-feeling skin without any pigment appear suddenly or gradually. These areas have a darker border. The edges are well defined but irregular.
- Vitiligo most often affects the face, elbows and knees, hands and feet, and genitalia.
- Vitiligo affects both sides of the body equally.
- Vitiligo is more noticeable in darker-skinned people because of the contrast of white patches against dark skin.
- No other skin changes occur.
What causes Vitiligo?
Vitiligo appears to occur when immune cells destroy the cells that produce brown pigment (melanocytes). This destruction is thought to be due to an autoimmune problem, but the cause is unknown.
Vitiligo is associated with three other autoimmune diseases:
Who is at highest risk?
Vitiligo may appear at any age. There is an increased rate of the condition in some families. The condition affects about 1 out of every 100 people in the United States.
Diagnosis
Your health care provider can usually examine your skin to confirm the diagnosis.
Sometimes, a health care provider may use a Wood's light. This is a handheld ultraviolet light that causes the areas of skin with less pigment to glow bright white.
In some cases, a skin biopsy may be needed to rule out other causes of pigment loss. Your doctor may also perform blood tests to check the levels of thyroid hormone or other hormones, and vitamin B12.
When to seek urgent medical care?
Call for an appointment with your health care provider if areas of your skin lose their coloring for no reason (for example, there was no injury to the skin).
Treatment options
Vitiligo is difficult to treat. Early treatment options include the following:
- Phototherapy, a medical procedure in which your skin is carefully exposed to ultraviolet light. Phototherapy may be given alone, or after you take a drug that makes your skin sensitive to light. A dermatologist performs this treatment.
- Medicines applied to the skin, such as:
- Corticosteroid creams or ointments
- Immunosuppressant creams or ointments, such as pimecrolimus (Elidel) and tacrolimus (Protopic)
- Topical drugs such as methoxsalen (Oxsoralen)
- Skin may be moved (grafted) from normally pigmented areas and placed onto areas where there is pigment loss.
- Several cover-up makeups or skin dyes can mask vitiligo. Ask your health care provider for the names of these products.
- In extreme cases when most of the body is affected, the remaining skin that still has pigment may be depigmented. This is a permanent change that is used as a last resort.
- It is important to remember that skin without pigment is at greater risk for sun damage. Be sure to apply a broad-spectrum (UVA and UVB), high-SPF sunscreen or sunblock and use appropriate safeguards against sun exposure.
Where to find medical care for Vitiligo?
Directions to Hospitals Treating Vitiligo
What to expect (Outlook/Prognosis)?
The course of vitiligo varies and is unpredictable. Some areas may regain normal pigment (coloring), but other new areas of pigment loss may appear. Skin that is repigmented may be slightly lighter or darker than the surrounding skin. Pigment loss may get worse over time.
Possible complications
Depigmented areas are more likely to sunburn and develop certain skin cancers.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000831.htm
Support Groups
Support groups and organizations are available to help individuals learn more about vitiligo, understand treatment options, and find support from other individuals with vitiligo.
- Vitiligo Support International is the largest vitiligo organization in the world. The nonprofit organization provides free access to online message boards, chat rooms, frequently asked questions, information and articles, as well as a patient-referred doctor search. The group advocates on behalf of patients, conducts patient conferences and has local support groups.
- The National Vitiligo Foundation (NVF) is a 501(c)(3) nonprofit organization that provides access to online resources, physician listings, frequently asked questions (etc); funds research through grants and sponsors local support groups and workshop style conferences.
- The American Vitiligo Research Foundation Inc. (AVRF) is a non-profit, tax-exempt charity that aims to increase public awareness about vitiligo and to help those affected by vitiligo, focusing specifically on children and their families. It supports finding a cure through alternatives to animal testing.
- VITFriends, LLC is a support group in the North East USA. Formed in 2004, VITFriends is still growing and touching the world. They are a web-community offering words of encouragement and sharing hope to individuals dealing with Vitiligo. The goal is to raise public awareness about vitiligo.[2]