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Vitiligo (vit-ih-LIE-go) is a disease that produces the loss of skin color in blotches. The extent and rate of color loss from vitiligo is random, so it is difficult to know where it will strike on the body. It can affect the skin in any area of your body. It may also impact hair and the skin inside of the mouth.
Normally, the color of hair and skin is defined by melanin. Vitiligo happens when the cells that handle the production of melanin die or stop working. Vitiligo affects people of all skin types, but it may be more recognizable in people who have darker skin tones. The condition is not fatal or contagious. However, it can affect the quality of life and create anxiousness or self-esteem issues.
There are treatment options for vitiligo may reinstate color to the impacted skin areas. But it does not preclude continued loss of skin color or a reappearance.
Vitiligo signs include:
Sporadic and irregular loss of skin color
Untimely whitening or graying of the hair on your eyelashes, scalp, eyebrows or beard
Loss of color in the wall tissue that lines the inside of your nose (mucous membranes) and mouth
Loss of or alteration in color of the inner layer of the eyeball (retina)
Vitiligo can begin at any age but frequently appears before age 20.
Contingent on the type of vitiligo you have, the discolored spots may cover:
Many areas of your body. With this most prevalent type, referred to as generalized vitiligo, the discolored patches often advance to different stages similarly on parallel body parts (symmetrically).
Vitiligo only one side or part of your body. This type, referred to as segmental vitiligo, generally to arise at a younger age, continues progression for a year or two, then stop.
Vitiligo that happens in one or only a few areas of your body. This type is called localized (focal) vitiligo.
It’s tough to foresee how your disease will progress. Occasionally the blotches stop forming without treatment management. In most cases, pigment loss spreads and eventually involves most of your skin. Seldom, the skin gets its color back.
When Should I See a Physician?
See your physician if areas of your skin, eyes or hair lose coloring. Vitiligo has no cure. However, treatment may aid to stop or slow the discoloring course and return some level of color to your skin.
Vitiligo ensues when pigment-generating cells (melanocytes) deteriorate or stop creating melanin — the pigment that gives your skin, hair and eyes hue and tone. The affected patches of skin become brighter or white. Experts don’t know why the cells deteriorate or stop creating. It may be related to:
An ailment in which your immune system attacks and destroys the melanocytes in the skin
Family history (genetics)
A trigger event, such as sunburn, or exposure to industrial chemicals or heightened stress
People with vitiligo may be at elevated risk of:
Social, emotional or psychological distress
Sunburn and skin cancer
Eye problems, such as inflammation of the iris (iritis)
Medical history and exam
If your physician assumes you have vitiligo, he or she will inquire about your medical history, evaluate you and try to exclude other medical problems, such as psoriasis and dermatitis. He or she will utilize a special lamp to shine ultraviolet light onto the skin to aid in determining if you have vitiligo.
Skin biopsy and blood samples
In addition to gathering your family and personal medical history and checking your skin, your physician may:
Take a small sample (biopsy) of the skin affected by vitiligo.
Take a blood sample for lab tests to look for underlying autoimmune conditions, such as diabetes or anemia.
Many treatments are possible to help restore skin color or balance out skin tone. Results of the treatment options may vary and are not consistent with everyone and their unique. Some treatments have severe side effects. So your physician may recommend that you initially try adjusting the appearance of your skin by employing makeup or self-tanning products.
If you and your physician choose to treat your condition with medication, therapy or surgery, the process can take many months to evaluate its effectiveness. And you may need to try more than one approach or a combination of methods before you determine the treatment plan that works best for you.
Even if treatment is effective for a while, the outcomes may not last, or new spots may appear.
No medication can prevent the advancement of vitiligo — the destruction of pigment cells (melanocytes). However, some drugs used alone or with light therapy can help restore some skin tone.
Creams that control swelling and inflammation – Applying a corticosteroid cream to the impacted skin may assist in returning color, especially if you begin using it early in the stages condition. You may not see a difference in your skin’s color for several months.
This kind of cream is sufficient and easy to use. But it can produce side effects, such as skin thinning or the occurrence of lines or streaks on your skin.
Milder forms of the medications can be prescribed for children and for people who have blotches that cover significant regions of their skin.
Drugs that impact the immune system. Ointments comprising chemicals such as pimecrolimus (calcineurin inhibitors) or tacrolimus may be helpful for people with minuscule and small areas of depigmentation, specifically on the face and neck.
This treatment may have fewer side effects than corticosteroids and can be utilized with ultraviolet B (UVB) light. Nevertheless, the Food and Drug Administration has cautioned about a potential link between these drugs and skin cancer and lymphoma.
Joining and light therapy and. This treatment combines light therapy (photochemotherapy) with a plant-derived material called psoralen to regain color in areas where there are light patches. After you orally take the psoralen by or apply it to the affected skin, the patch of skin that is affected is exposed to ultraviolet A excimer light, (UVA) or UVB light. These tactics tend to show improved results over just treating with medication or just light. You may require repeat treatments for up to three times a week for six to 12 months. So this treatment plan makes take a lot of time and commitment to go to your doctor’s office to receive this treatment over time.
Removing the residual color (depigmentation). Rather than return pigmentation to your skin, this would remove pigment from the remaining colored skin. This therapy may be an alternative if your vitiligo is extensive and other treatments have not worked. A depigmenting agent is applied to the colored /unaffected areas of skin. This progressively lightens it so that it balances with the discolored areas. The treatment is done once or twice a day over the course of nine months or longer.
Side effects can comprise inflammation, dry skin, redness, and itching. Depigmentation is permanent, and you’ll always be very sensitive to sunlight.
Surgery may be an alternative for you if light therapy doesn’t work. Surgery can also be leveraged with those therapies. The objective of the following methods is to even out your skin tone by reestablishing color.
Skin grafting. In this is a medical procedure, your surgeon removes very small sections of your normal, pigmented skin and connects them to areas that have lost it pigment. Skin Grafting is sometimes utilized if you have small blotches of vitiligo.
Potential risks include, spotty color, scarring, infection, a cobblestone appearance, and failure to re-color the area of focus.
Blister grafting. In this operation, your physician creates blisters on your pigmented skin, normally with sucking. He or she then removes the tops of the blisters and grafts them to an area of discolored skin.
Again, much of the risk is similar to standard skin grafting. There are possible risks include blemishing, a bumpy cobblestone appearance and failure to re-establish color in the non-pigmented area. There is also possible harm it can cause the skin by suctioning – triggering another patch of vitiligo.
Tattooing (micropigmentation). In this procedure, your physician uses a special surgical apparatus to implant pigment into your skin. It’s most effective in and encompassing the lips in people with darker complexions.
Drawbacks include difficulty matching the skin color and potential for the tattooing to trigger another patch of vitiligo.
Potential future treatments
Treatments being examined include:
A drug to stimulate color-producing cells (melanocytes). Called afamelanotide, this potential treatment is implanted under the skin to promote the growth of melanocytes.
A drug that helps control melanocytes. Prostaglandin E2 is being tested as a way to rebuild skin color in people with localized vitiligo that isn’t expanding. It’s administered to the skin as a gel.
A drug that stops and reverses the loss of color. Tofacitinib, an oral drug typically employed to treat rheumatoid arthritis, has conferred some potential as a treatment for vitiligo.
Lifestyle and home remedies
The following self-care tactics may help you care for your skin and improve its appearance:
Gaurd your skin from the sun and artificial sources of UV light. If you have vitiligo, especially if you have light skin, apply a broad-spectrum, water-resistant sunscreen with an SPF of at least 30. Apply sunscreen liberally and reapply every two hours — or more often if you’re sweating or swimming.
You can also seek shade and wear clothing that shields your skin from the sun. Don’t use sunlamps and tanning beds.
Shielding your skin from the sun assists stop sunburn and long-term damage. A bad sunburn can cause your condition to worsen. Sunscreen also decreases tanning, which executes the contrast between natural and discolored skin less pronounced.
Conceal impacted skin. Concealing products may enhance the appearance of the skin and assist you in feeling better about yourself, particularly if your vitiligo patches are on the exposed skin. You may need to try many brands of makeup or self-tanners to find one that mixes well with your natural skin tone. The coloring of self-tanning products do not wash off, but it slowly fades over several days. If you apply a self-tanner, choose one that contains dihydroxyacetone, as it is allowed by the Food and Drug Administration.
Don’t get a tattoo. Avoid tattooing that’s not associated with treating your vitiligo. Damage to your skin, such as that produced by a tattoo, may generate a new patch of vitiligo to develop within two weeks.
Small studies show that the herb Ginkgo biloba may restore skin color in individuals with vitiligo. Other limited studies exhibit that folic acid, alpha-lipoic acid, vitamin C and vitamin B-12 plus phototherapy may rebuild skin color for some people.
As with any over-the-counter (nonprescription) therapy, check with your physician before trying alternative medicine therapies to be sure they won’t cooperate poorly with other treatments you may be using.
Coping and support
You may feel anxious, self-conscious, ashamed, sad, or even overwhelmed by the change in your appearance produced by vitiligo. You may feel that the condition restricts your capacity to go about your daily activities, particularly if it’s widespread or affects visible areas of your body, such as the face, arms, hands, and feet.
These tips may help you cope with vitiligo:
Make a good connection with your physician. Find a physician who is knowledgeable about the condition. A dermatologist is a physician who specializes in the care of skin.
Learn all about it. Find out as much as you can about the condition and your therapy options so that you can help determine what steps to take.
Communicate your feelings. Let your physician know if you think you are depressed. He or she can refer you to a mental health provider such as psychiatrist or psychologist specialized in helping people with mental diseases.
Talk with others. Ask your physician about psychotherapy or support groups in your area for people with vitiligo.
Confide in loved ones. Seek understanding and support from your family and friends.
Preparing for your appointment
You may to start by seeing your primary care physician. You may then be referred to a expert in skin disorders (dermatologist).
What can you do?
Examine your family medical history. Find out if someone in your family suffers from vitiligo, a thyroid condition or a disorder in which the immune system invades healthy tissues in the body (autoimmune disease).
List relevant personal information, such as recent significant stressful events, sunburns, life changes, and rashes.
List any medications, vitamins, and supplements you’re taking, including doses.
Make a note of questions you’d like to ask your doctor, which will help you make the most of your limited time together.
Some basic questions to consider include:
What websites would you recommend for information on this condition?
What’s the most likely cause of my symptoms?
What are other possible causes of this condition?
Do I need any tests?
Is this condition temporary or long lasting?
What treatments are accessible, and which do you advise?
Can I do something to help, such as bypass the sun at certain times or wear a specific sunscreen?
What side effects can I expect from treatment?
Can you suggest a product to conceal the discolored patches?
What to expect from your doctor
Your physician is likely to ask you a few questions, such as:
Did you have a sunburn or skin rash before you noticed the patches?
When did you begin noticing light patches on your skin?
Are you sensitive to the sun?
Have you ever had this kind of change before?
Do the discolored patches itch or cause any other symptoms?
What is your profession, and what are your hobbies? Are you exposed to any harsh chemicals in either?
Does anyone in your household have vitiligo, a thyroid ailment or an autoimmune disease?
Does this condition affect your quality of life?
What you can do in the meantime
While you’re waiting to see the doctor, restrict your sun exposure and use a broad-spectrum sunscreen with an SPF of at least 30. If you’re sensing self-conscious about the changes in your skin, use makeup or a self-tanning product to cover the affected area.