Almost 1 percent of the world’s population has vitiligo. When you have vitiligo, the cells that are responsible for your skin color are destroyed. These cells, called melanocytes, no longer produce skin pigment, called melanin. Once the cells no longer produce melanin, areas of your skin will lose color or turn white.
Areas of lost pigment can develop anywhere on your body, including:
- sun-exposed areas like the hands, feet, arms, and face
- inside the mouth or other mucus membranes
- nostrils
- genitals
- back of the eye
- within the hearing system of the ear
Your hair may also turn grey or white if the areas involved have hair.
Even though vitiligo can affect many different parts of the body, it’s not contagious. A person with vitiligo can’t transmit it to someone else.
The primary symptom of vitiligo is white patches on the skin. And it can affect any area of the body, even the areas around your eyes. The patches can be large or small and appear as one of the following patterns:
Segmental or focal: White patches tend to be smaller and appear in one or a few areas. When vitiligo appears in a focal or segmental pattern, it tends to stay in one area one side of the body. Many times it continues for a year or so, then stops. It also progresses slower than generalized vitiligo.
Non-segmental or generalized: Widespread white patches appear symmetrically on both sides of the body. This is the most common pattern and can affect pigment cells anywhere on the body. If often starts and stops many times over the course of a person’s lifetime. There’s no way to determine when, if, or how fast patches will develop.
One study showed that 75 percent of people with vitiligo have loss of pigment on the hands and face. Other common areas are in body folds, like the skin under your arms and around your groin.
It’s unknown exactly what causes vitiligo. The condition doesn’t appear to be inherited. Most people with vitiligo don’t have a family history of the disorder. But family history of vitiligo or other autoimmune conditions may increase your risk even though it doesn’t cause vitiligo.
Another risk factor may be having genes associated with vitiligo, including NLRP1 and PTPN22
Most researchers believe that vitiligo is an autoimmune disorder because your body is attacking your own cells. But it’s also unclear how your body attacks your pigment cells. What is known is that about 20 percent of people with vitiligo also have one other autoimmune disorder. Depending on the population, these disorders can include the following, from most common to least common:
- scleroderma, a disorder of the connective tissue of the body
- lupus
- thyroiditis, caused by an improperly functioning thyroid
- psoriasis
- alopecia areata, or baldness
- type 1 diabetes
- pernicious anemia, an inability to absorb vitamin B-12
- Addison’s disease
- rheumatoid arthritis
Some experts also report vitiligo appearing after incidents of:
- severe sunburns or cuts
- exposure to toxins and chemicals
- high levels of stress
The good news is that many times vitiligo has few physical side effects on the body. The most serious complications may affect the ears and eyes, but these aren’t common. The primary physical effect is that the loss of pigment that increases your risk for sunburn. You can protect your skin by applying sunscreen with a SPF of 30 and wearing sun protective clothing.
Psychological effects
Research shows that vitiligo can cause significant psychological effects. Scientific reviews show that over 50 percent of people with vitiligo reported negative effects on their relationships. Some people reported thinking about their condition all day, especially due to the unpredictability of it.
They also reported:
- avoiding physical activities
- withdrawing from events
- feeling like their condition is a disfigurement
- depression
- anxiety
- emotional burden
If you have vitiligo and are feeling any of these negative effects, talk to your doctor or someone who cares about you. It’s also important to learn as much as you can about the disorder. This can help alleviate stress you may have about your condition or treatment options.
Treatments for vitiligo aim to restore color balance to your skin. Some treatments aim to add pigment while others remove it. Your options will vary according to:
- the severity of your condition
- the location and size of your patches
- how many patches you have
- how widespread the patches are
- how you respond to treatment
The types of treatments include medical, surgical, or a combination of both. But not all treatments work for everyone and some may cause unwanted side effects.
Always contact your doctor if you start experiencing side effects due to a treatment. They may readjust your dosage or provide alternatives.
Medical
You’ll usually need at least three months of treatment before you can see its effects. Medical treatments include:
Topical creams: Some creams, including corticosteroids, can help return color to white patches in the initial stages. Others help slow the growth. You’ll need a prescription for creams that are strong enough, but they can also cause side effects when used for a long time. Side effects can include:
- skin shrinkage
- thinning
- excess hair growth
- skin irritation
Oral medications: Some medications like steroids and certain antibiotics may be effective in treating vitiligo. These are only available by prescription.
Psoralen and ultraviolet A (PUVA) therapy: This treatment combination requires you to take psoralen as a pill or apply it to your skin as a cream. Then your doctor exposes you to UVA light to activate the drugs which help restore color to your skin. Afterwards, you’ll need to minimize sun exposure and wear protective sunglasses. PUVA does have side effects that can include:
- sunburn
- nausea
- itching
- hyperpigmentation
Narrow band UVB light: This is an alternative to traditional PUVA therapy. This treatment provides a more focused type of light therapy often leading to fewer side effects. It can also be used as part of a home treatment program under a doctor’s supervision.
Excimer laser treatment: This treatment helps with small areas of patches and takes less than four months, two to three times per week.
Depigmentation: Your doctor may recommend depigmentation if more than 50 percent of your body is affected and you want to balance your skin. This often is a solution when treatments to return pigment to your skin have failed. Depigmentation focuses on fading the rest of the skin to match the areas that have lost color. It can take up to two years for treatment to be effective. You’ll apply a medication like monobenzone as directed by your doctor. The biggest side effect of depigmentation is inflammation. This treatment tends to be permanent and you’ll be extra sensitive to sunlight.
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