Vitiligo is a condition in which white or depigmented patches develop on the skin. Patients often lose pigment quickly on several areas of their skin. After the white patches appear, the patches may remain stable for a period or they may progress rapidly. Any location on the body can be affected, however some locations are more commonly affected. A person may have only a single patch but most people with vitiligo have white patches on many areas. Patients may have cycles of pigment loss and stability.
Vitiligo commonly affects:
- Body folds (like armpits)
- Places that have been injured in the past
- The “tips” fingertips, elbow and knees
- Around body openings like the mouth and eyes
It can also affect the hair. It’s rare for pigment to return to areas once the white patches of hair have developed.
Vitiligo Causes and Risk Factors
Vitiligo results when the pigment-forming cells in the skin, known as melanocytes, have been destroyed.
We know that the destruction of these cells, the melanocytes, is a result of an autoimmune condition where your body’s defenses turn on your own cells instead of attacking invading bacteria and viruses.
Although vitiligo affects all races equally, it may seem as if it is more common in people of color as it is more noticeable.
An estimated 2 to 5 million Americans have the condition or an estimated 2% of the population. Men and women are equally affected.
It generally develops early in life, between ages 10 and 30, almost always before age 40.
We know vitiligo can run in families. You’re more likely to get vitiligo when someone else in your family has it or if people in your family get gray hair prematurely.
Other autoimmune diseases, such as autoimmune thyroid disease (Hashimoto’s thyroiditis) or type 1 diabetes, are associated with vitiligo.
What triggers vitiligo? Vitiligo triggers include neurogenic factors, genetics, sunburn, stress and chemical exposure. Although it’s often viewed as a cosmetic problem since it affects your appearance, vitiligo is a medical condition.
How fast can Vitiligo spread? This is highly variable it depends on the type of vitiligo you have and the treatment received.
There are five types of vitiligo.
Generalized: The most common type. This is when discolored patches show up all over your body.
Segmental: When vitiligo is confined to one area of the body, like your face or your hands.
Focal: Occurs when the vitiligo stays in one spot and doesn’t spread.
Trichrome: Can be present with any of the other types. This is where there are areas that are white, pale brown, dark brown and normal skin color.
Universal: This is rare and where at least 80% of your skin is affected by vitiligo.
A Board-Certified Dermatologist can usually make a diagnosis of vitiligo simply by looking at your skin during a physical exam. Two other exams may be helpful:
- Skin biopsy, where a sample of your skin is sent to a laboratory for further examination
- A Wood’s lamp test, where a doctor looks at your skin under UV light
Can vitiligo go away on its own? There is no cure for vitiligo, but there are several treatments that will improve vitiligo.
Can vitiligo be stopped from spreading? Treatment is more effective at stopping the spread of vitiligo then treating it once it is present.
Medications for vitiligo
Corticosteroid creams are usually the first treatment for vitiligo. These creams are usually combined with UVB light either natural or artificial. Calcineurin inhibitors are also used to treat vitiligo. If the vitiligo is progressing rapidly corticosteroid pills or injections can be used.
Phototherapy for vitiligo
Phototherapy, or light therapy, using UV light can slow or stop the progression of vitiligo. In most cases, this is used in combination with topical and/or oral medications.
Procedures for vitiligo
Skin grafting is sometimes used to improve the appearance of vitiligo. In blister grafting, blisters are created on healthy skin with suction. The roof of the blisters are then grafted to areas of skin affected by vitiligo.
This is a treatment of last resort for some patients. It is used if other treatments haven’t worked and your vitiligo covers a large percentage of the body. Cream is used to gradually permanently lighten the normal skin so that it matches the skin affected by vitiligo. This is irreversible so must be considered carefully.
For the first time in many years there are new treatments on the horizon for vitiligo both topical and oral. At Sullivan Dermatology we are currently conducting a clinical trial of one of these new treatments. For more information click here: Vitiligo Clinical Trial.
To learn more or if you suspect you have vitiligo, please call our office today or book online to schedule a comprehensive consultation.