Vitiligo – Overview
Vitiligo, also called ‘leucoderma’ is a type of skin condition in which the affected skin area loses its color. The skin area affected by vitiligo varies from person to person. It can even affect areas like eyes, hair, and even the interior of the mouth. The affected skin area will look white or pink in appearance.
This skin condition is completely unpredictable and in some patients, it could spread rapidly while in some it could be stable. The patch created by Vitiligo is photosensitive which means it is very sensitive to sunlight. Although vitiligo can start at any age, 95% of people who have vitiligo develop the condition before their 40th birthday.
Types of Vitiligo
There are different types of Vitiligo that vary in the way it affects the skin. Usually vitiligo manifests as multiple spots on the skin that are found on both sides of the body, most commonly in a symmetric pattern. So, if there is a spot on one side of the face, there is often a matching spot on the other side.
Vitiligo is generally categorized as below:
Generalized (aka non-segmental vitiligo) is a type of Vitiligo in which the skin patch can appear anywhere on the body and there is no specific size or shape. This is the most common type of vitiligo and is also known as ‘universal’ or ‘complete’ vitiligo.
Segmental type of vitiligo happens to as few as 10% of the affected population. This type spreads rapidly but is much more stable and predictable compared to non-segmental type. Segmental vitiligo is mostly found in young children (30% of children with vitiligo skin disease have a segmental type). The discoloration of the skin happens to the nerves arising in the dorsal roots of the spine.
As the name suggests, in this type of vitiligo, the skin of mucous membranes such as the lips, inner nose, or genital areas are affected with discoloration. If it involves the lips or other parts of the face plus the hands and/or feet, it’s called acrofacial vitiligo (“acral” means hands and feet). This is really common, since vitiligo most frequently affects the face and/or hands .
In this type, the skin patches either one or a few occur in a discrete area. This type of vitiligo often occurs in young children. These are the types in which the macules are in a small area and do not spread in a certain pattern within one to two years.
In this type of vitiligo, the skin patch discolors at different intensity. Hence you get to see three distinct types of discolored patches in the patient. The color depends on the natural skin color of the patient.
This type of vitiligo is a very rare occurrence and happens to very few individuals. In this type, the entire skin of the patient depigments or discolors. Thus, if the vitiligo spreads almost every part of the body then it is Universal.
Being a skin disease, there are some symptoms that give you a clear indication that it is a Vitiligo. Understanding the symptom is very important as this would help the patient to take the early measures and medication in order to minimize the spread.
The main sign of vitiligo is pigment loss that produces milky-white patches (depigmentation) on your skin. Other common signs may include:
- The skin area around hands, face, and other generally exposed body parts start having patchy loss of skin color.
- The hair on the scalp, beard, eyebrows, and eyelashes start turning prematurely white or gray in color
- The mucous membranes areas or interior part of nose and mouth particularly the tissue start losing color
Vitiligo is primarily caused when cells that produce pigmentation die or they stop producing melanin. Melanin is responsible for the natural color that our eyes, hair, and skin have. Because of this, certain discolored patches start appearing on the skin.
The exact reason for the cells to stop producing melanin or why do the cells die is not clear. It could be because of the following reasons:
- Immune System Disorder
Many times the person immune system goes into autoimmune condition due to which the cells stop producing melanin thereby causing Vitiligo
It has been found that Vitiligo could be passed on to the next generation through genetics. Hence if your family member has Vitiligo, there is a chance that you might develop it as well. However the probability is just 5%, so 1 in every 20 first degree relatives of vitiligo patients can get the same skin disease.
- Event Triggering Reaction
There are also chances of Vitiligo due to some triggering events. This could be skin exposure to extreme sunlight, Skin trauma and even due to contact with some chemicals
Who Gets Vitiligo?
The thing about Vitiligo is that it can happen to anyone and at any age. Even after extensive research, it is not clear who exactly get this skin disease.
But it has been observed that people with a family history of Vitiligo have a substantial chance of getting it. It can also happen to a person who has a certain autoimmune disease such as rheumatoid arthritis and type 1 diabetes.
Who Treats Vitiligo?
A dermatologist can usually diagnose Vitiligo after examining the skin and will look out for signs and symptoms related to other skin conditions like psoriasis, to rule them out. The doctor will look at every area of the skin to understand which type of vitiligo you have depending upon the location of the patch.
A dermatologist will also look for symptoms associated with other skin conditions, such as psoriasis, in order to rule them out.
Vitiligo Diagnosis & Treatment
The patient is first thoroughly diagnosed by the doctor before going forward with any treatment. The common diagnosis used for Vitiligo is first understanding the person’s medical history followed by an examination of the skin with the help of specialized light. A doctor can also opt for blood tests and skin biopsy if required. The treatment for vitiligo is entirely subject to the patient’s age, the area of skin that needs treatment. The growth and speed at which vitiligo is growing is also a factor that needs to be considered.
Now through medication and light-based surgeries, you can restore the skin color but that does not guarantee that it would stay like that forever. The patches could start appearing again, hence the doctors also recommend the application of medication in order to stabilize the treatment and avoid a relapse. A patient might have to try multiple treatments to get the desired result. The procedure could take months before understanding its effect. Below mentioned are some of the treatments available for vitiligo.
There are three types of therapies that a patient can undergo
- Light Therapy
In this therapy, narrowband ultraviolet rays are used to stop or slow the progression of active vitiligo. This procedure can prove effective when combined with corticosteroids. A patient needs to undergo this procedure two to three times a week. The result will be visible only after a month or in some cases three months while 100% result will be visible after six months.
Patients undergoing light therapy have a risk of developing skin cancer, hence it is important to consult doctors before finalizing the procedure. There are also some side effects of redness, itching, and burning on the skin.
- Depigmentation Therapy
This treatment is the reverse of all other therapies. Here instead of restoring the color of the affected skin, the patches that are still having natural color are depigmented to match the color of the remaining skin. This procedure is useful for someone with widespread vitiligo and a very little area remaining unaffected.
The depigmentation is permanent and the side effects of this procedure include swelling, itching, dryness, and redness in the skin.
- Combination Of Light And Psoralen Therapy
In this treatment, the light UV ray therapy is combined with a plant-derived substance called psoralen to achieve a natural color. The substance is either taken by mouth or applied on the affected skin and later exposed to UV light rays. This treatment is quite effective but Is tedious to administer.
Only medication cannot stop the spread of vitiligo, but the combination of light therapy along with medication can help. The application of corticosteroids can help in restoring the original color of the skin. There are also calcineurin inhibitor ointments like tacrolimus or pimecrolimus that reduces the effect of the immune system and slow the growth of Vitiligo. Corticosteroid can cause skin thinning or appearance of streak while ointments could cause skin cancer.
If medication and therapy are not working then the patient is advised to undergo surgery. There are three types of surgery offered for vitiligo patients
- Blister Grafting
In this procedure, a blister is created on the healthy skin area with the use of suction. Later the blistered area is transferred to the discolored area. This procedure has a risk of scars on the skin or a cobblestone look.
- Cellular suspension transplant
In this procedure, the doctor acquires tissue from the healthy skin and puts it in a solution and later transplants it on the discolored area. You can see the result of the surgery in four weeks.
- Skin grafting
This procedure is used for patients with small vitiligo surface. The doctor takes small sections of healthy pigmented skin and transfers it to the affected area. The side effects include cobblestone look, spotty color, etc.
Vitiligo Treatment Risk & Complications
Just like any medical surgery or treatment, there are some risks and complications involved in vitiligo treatment. Below mentioned are some of the risks you need to be aware of.
- The treatment could cause skin cancer in the future
- The recovered skin area could go back to its previous form in some time
- The skin color could look patchy and unnatural post the treatment
- Redness, swelling, and permanent scars would appear of skin post-procedure
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Vitiligo Treatment Cost
The cost of vitiligo treatment varies from patient to patient. The primary factor that drives the cost is the amount of skin area that needs to be treated, greater the area, higher would be the cost of treatment. A consultation with the doctor would give a clear idea about the cost and time required for the treatment.
- If required consult with the doc and understand this element how they charge, and if possible we can let users know the average cost directly from the expert.
- Also, mention a subheading related to parameters based on cost may change
If you take necessary precautions, the probability of vitiligo disease affecting your skin can be reduced to a large extent. However, doctors cannot predict whether a person will develop the condition based on their genetic makeup.
Below mentioned are some of the preventive measures that you can take
- Consume green leafy vegetables, fruits like apple, banana can prevent vitiligo
- Reducing the consumption of alcohol, red meat, fish and coffee can prevent the formation of white patches
- Drinking a lot of water can keep the skin healthy and prevent any skin disease
- Consumption of minerals like zinc, copper, iron in your food also helps
- Consumption of food containing vitamin B, C, amino acids and folic acids can help in the prevention of white patches
- Skin pigmentation can also trigger due to deep wounds on the skin which loses some color. So avoiding such injuries and making sure to take immediate medical assistance is important to prevent such triggers.
Diet could play an important role in building your body so strong that it would resist disease like vitiligo. Because one of the reasons a person can get vitiligo due to autoimmune disease hence a strong immune system can prevent depigmentation of any kind.
Below mentioned are foods and ingredients that need to be a part of your diet
- You should consume fruits like fig, apricot, and ripe mango
- When it comes to vegetables, you should include green leafy vegetables like spinach. Also, beetroot, cabbage, potato, red chili are a great addition of vegetables.
- Dairy product can be consumed for some patients while for some it may not be advisable
Vitiligo Diet Restrictions
There are also some foods and beverages that are counterproductive and could in fact reduce the immune system making it susceptible to skin diseases like Vitiligo. Below mentioned is the list of food and beverages that should be avoided:
- Carbonated sweet drinks, packaged fruit juices, coffee and alcohol
- Vegetables like eggplant, tomato, green chili, onion and garlic
- Animal meat like beef, pork, and fish
- Spices like turmeric
Below mentioned are some frequently asked questions that we have tried to answer in a simple and understandable way.
Is Vitiligo a contagious disease?
No. vitiligo is not contagious. It is a genetic disease that runs in a family and keeps passing on to future generations
What is an autoimmune disorder?
When your own immune system starts attacking your organs due to multiple conditions. In the case of vitiligo, the antibodies develop and start attacking melanin-producing cells thereby creating a white patch
What does Vitiligo look like?
It looks like white patches that appear on the skin. The whiteness could vary from person to person. Vitiligo often appears bilaterally I.e if one elbow has it then the other too would soon get it.
Do you have any other questions? Do you have a patch on your skin that needs medical assistance?
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