Vitiligo or White Patch on Skin: Causes and Treatment

What is vitiligo?

Vitiligo also know as Safed daag (In India), is a type of skin disorder in which white patches called macules develops on skin. It generally starts on the hands, forearms, feet and face. Vitiligo causes the skin to lose its color or pigmentation over the period of time. In this blog we will be knowing about Vitiligo or white patches causes and treatment.

The white areas of skin are know as macules if they are less than 5mm in diameter and patches if they are more than 5mm. Vitiligo can also cause hairs to turn white in the affected areas.

Primarily this skin disorder develops when the number of melanocytes (cells that are responsible for maintaining skin pigmentation) declines in your body.

Is vitiligo a common skin disorder?

Globally, Vitiligo has a prevelance rate of about 1% or slightly more. Although vitiligo can affect all races and genders, it is more prominent in dark skin people. Although vitiligo can develop at any point of time, but commonly affected age group is between 10 to 30 years of age. Fresh development of vitiligo is rare in very young or very old age group.

Course of vitiligo

Vitiligo skin disorder begins with small areas of white discoloration. Slowly these discoloration spots increases in size and spread over different parts the body. Typically starts from the hands, forearms, feet, and face but can develop on any part of the body, including the inner lining of the mouth, genital, and even anal region.

The rate of progression of this skin disorder varies from person to person

Types of vitiligo

• Generalized Vitiligo: This is the most common type in which when macules appear in various places on the body.
• Mucosal Vitiligo: In this varient the mucous membranes of the mouth and/or the genitals are mainly affected.
• Focal Vitiligo:  Focal type is a rare type. In this the macules develops in a small area and do not spread.
• Segmental Vitiligo: This type limited to one side of the body or one area, such as the hands or face.
• Universal Type: This is also a rare type , and one in which more than 80% of the skin of the body lacks pigment. Also know as vitiligo totalis.

Read about: Top 10 Daily Habits for Healthy & Radiant Skin

What causes vitiligo?

The exact cause of vitiligo is still not understood. However, there are different possible hypothesis:

• Genetic factors: Studies have shown that about 30% of vitiligo cases run in families.
• Autoimmune disorder: In this, the patient’s own immune system develops antibodies that destroy the melanocytes causing loss of pigmentation.
• Neurogenic factors: A substance that is toxic to melanocytes may be released at nerve endings in the skin.

Is vitiligo painful?

No, Vitiligo is not painful. But some patients do develop sunburns, which can cause discomfort. So, if you have vitiligo it is important for you to protect yourself against the harmful UV rays coming from the sun. Protective measures includes good quality sunscreen lotions, avoiding peak sun time.

Is vitiligo familial?

Scientific data shows that about 30% of people who have vitiligo do have at least one close relative in their family who also has vitiligo. So, it’s not generally inherited.

Signs and symptoms of vitiligo

Signs and symptoms of vitiligo include the following:

• Small spots of hypo-pigmentation develop on the skin. This can include the eyes and/or the mucous membranes in your mouth or nose.
• If the affected area of skin has hairs then they will turn grey or white prematurely.

What problems are associated with vitiligo?

Although vitiligo is mainly a cosmetic condition, people with vitiligo may experience a variety of problems:

• Because they lack melanocytes, macules are more sensitive to sunlight than the rest of the skin, so they will burn rather than tan.
• People with vitiligo may have some abnormalities in their eyes mainly retinas and some variation of color in their iris. In some cases, there is some inflammation of the retina or iris, but vision is usually not affected.
• People with vitiligo may feel embarrassed or anxious about their skin. Sometimes people are rude – they may stare or say unkind things. This could cause a person with vitiligo to develop low self-esteem. This in turn could create anxiety or depression issues and make someone want to isolate. If this happens, you should talk to your healthcare provider or your family and friends to help you find a solution.

How is vitiligo diagnosed?

Usually the white patches are easily visible on the skin, but healthcare providers can use a Wood’s lamp, which shines ultraviolet (UV) light onto the skin to help differentiate from other skin conditions.

How can I prevent vitiligo?

As the basic underlying cause of vitiligo is still not clear, so accurate preventive measures are difficult to outline. So, In general, it is advisable to everyone to follow safe sun exposure habits and follow healthy skincare routine in correct order.

Click to know what is correct skincare order routine

Vitiligo Treatment

How is vitiligo treated?

Unfortunately vitiligo cannot be cured as of now. The main aim of the treatment is to restore uniformity of skin tone. Common treatments include camouflage therapy, repigmentation therapy, light therapy and surgery. Counseling is also an integral part of entire treatment plan..

Camouflage therapy:

• Good quality sunscreen is an important component. Sunscreen capable of filtering UV-A and UV-B with an SPF of 30 or more is recommended. Also, the sunscreen should shield ultraviolet B light and ultraviolet A light (UVB and UVA). They also help in reducing tanning thereby giving a more even tone to your skin.
• Artificial coloring of hairs if hairs are depigmented.
• Local application of monobenzone is sometimes advised in case of extensive disease. This will help depigmentation of the pigmented patches to match the tone of rest of the skin.

Repigmentation therapy:

• Corticosteroids use is an important part of repigmentation therapy. It may take upto 3 months for any visible appreciable results. Patients on this therapy should be monitored for any side effects.
• Local application of vitamin D analogs.
• Local application of immunomodulators such as calcineurin inhibitors.

Light therapy for vitiligo treatment:

• Narrow band ultraviolet B requires two to three treatment sessions per week for several months.
• Excimer lasers emits a wavelength of ultraviolet light close to that of narrow band UVB. This is better for patients who do not have widespread or large lesions.
• Combination therapy using oral psoralen and UV-A is commonly practiced to treat large areas of skin with vitiligo. This therapy option is very effective in patients who have vitiligo in the areas of the head, neck, trunk and extremities.

Surgery in treatment of vitiligo:

• Autologous skin grafts: Healthy pigmented skin grafts are taken from one part of the patients body and is used to cover another affected part. Possible complications include scarring, infection or a failure to repigment.
• Tattooing is also sometimes done. It is usually applied to the lips of people affected by vitiligo.

Counseling:

• Vitiligo can cause psychological distress and has the ability to affect a person’s outlook and social interactions. If this happens, your caregiver may suggest that you find a counselor or attend a support group.

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