Vitiligo: This skin disease often forms on both sides of the body as shown here on the knees.
Vitiligo (vit-uh-lie-go) causes the skin to lose color. Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.
Vitiligo usually affects the skin, but it can develop anywhere we have pigment. Patches of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color.Vitiligo: This skin disease often forms on both sides of the body as shown here on the knees.
Vitiligo is not contagious. It is not life-threatening. But, vitiligo can be life-altering. Some people develop low self-esteem. They may no longer want to hang out with friends or develop serious depression. Most people have vitiligo for life, so it’s important to develop coping strategies.
A coping strategy that helps many people is to learn about vitiligo. Another helpful strategy is to connect with others who have vitiligo.
Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
References:Gawkrodger DJ, Ormerod AD, Shaw L et al. Guideline for the diagnosis and management of vitiligo. Br J Dermatol 2008; 159: 1051-76.Nicolaidou E, Antoniou C, Stratigos A et al. Narrowband ultraviolet B phototherapy and 308-nm excimer laser in the treatment of vitiligo: a review. J Am Acad Dermatol 2009; 60: 470-7.Whitton ME, Ashcroft DM, Gonzalez U. Therapeutic interventions for vitiligo. J Am Acad Dermatol2008; 59: 713-7.
Vitiligo causes loss of color. Your dermatologist may call this “loss of pigment” or “depigmentation.” We can lose pigment anywhere on our bodies, including our:
Most people who get vitiligo lose color on their skin. The affected skin can lighten or turn completely white. Many people do not have any other signs or symptoms; they feel healthy.Vitiligo can progress: With time, some people see their vitiligo cover a large area.
A few people say that the skin affected by vitiligo itches or feels painful.
Living with vitiligo can cause other symptoms such as low self-esteem and depression that is hard to beat. This can happen regardless of the amount of color loss or type of vitiligo.
If you are diagnosed with vitiligo, your dermatologist may tell you what type and subtype you have.
Types: Today, most doctors recognize two types:
|Type||Traits||Segmental vitiligoAlso called:||Non-segmental vitiligo|
There is no way to predict how much color a person will lose. Color loss can remain unchanged for years. Some people see patches enlarge and new patches appear. On a rare occasion, the skin regains its lost color.
Images 1, 2, and 3 used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.Image 4 used with permission of Journal of the American Academy of Dermatology. (J Am Acad Dermatol 2010; 62:945-9)
References:Halder RM, Taliaferro SJ. “Vitiligo.” In: Wolff K, Goldsmith LA, Katz SI, et al. editors. Fitzpatrick’s Dermatology in General Medicine, 7th ed. United States of America, McGraw Hill Medical; 2008. p.616-21.Mazereeuw-Hautier J, Bezio S, Mahe E et al. “Segmental and nonsegmental childhood vitiligo has distinct clinical characteristics: a prospective observational study.” J Am Acad Dermatol; 62: 945-9.Ortonne JP, “Vitiligo and Other Disorders of Hypopigmentation.” In: Bolognia JL, Jorizzo JL, Rapini RP, et al. editors. Dermatology, 2nd ed. Spain, Mosby Elsevier; 2008. p. 913-20.Vitiligo can affect hair: The white hair near this 22-year-old man's part is due to vitiligo.
Millions of people worldwide have vitiligo. Nearly half get it before they reach 21 years of age. Most will have vitiligo for the rest of their lives. It is very rare for vitiligo to disappear.
Vitiligo occurs about equally in people of all skin colors and races. About half the people who get vitiligo are male and half are female.
The risk of getting vitiligo increases if a person has:
Vitiligo develops when cells called melanocytes (meh-lan-o-sites) die. These cells give our skin and hair color.
Scientists do not completely understand why these cells die. One type of vitiligo, non-segmental vitiligo, may be an autoimmune disease. An autoimmune disease develops when the body mistakes a part of itself as foreign. If the body mistakes these cells as foreigners, it will attack and kill these cells.
Studies suggest that the other type of vitiligo, segmental vitiligo, has a different cause. This type seems to develop when something in the body’s nervous system goes awry.
References:Gawkrodger DJ, Ormerod AD, Shaw L et al. Guideline for the diagnosis and management of vitiligo. Br J Dermatol 2008; 159: 1051-76.Halder RM. “Vitiligo.” Forum presented at the 2011 American Academy of Dermatology Annual Meeting: New Orleans. February 2011.Mazereeuw-Hautier J, Bezio S, Mahe E et al. Segmental and nonsegmental childhood vitiligo has distinct clinical characteristics: a prospective observational study. J Am Acad Dermatol; 62: 945-9.
If your dermatologist suspects that you have vitiligo, your dermatologist will:
You also may need a blood test to check the health of your thyroid gland. People who have vitiligo often have an autoimmune thyroid disease. A blood test will tell whether your thyroid is healthy. If you have thyroid disease, treatment can successfully control it.
If you have vitiligo, you should discuss treatment options with your dermatologist. There are many treatment options. The goal of most treatments is to restore lost skin color.
Here are some key facts about treatment options to help you start a conversation with your dermatologist. The type of treatment that is best for you will depend on your preference, overall health, age and where the vitiligo appears on your body. Some people choose not to treat vitiligo.
It is not possible to predict how a patient will respond to treatment. It is important to keep in mind that no one treatment works for everyone. Results can vary from one part of the body to another. Combining two or more treatments often gives the best results.
A: Yes, but some treatments are not appropriate for children. The following may be an option for a child:
Yes. They are studying the genes involved in vitiligo. Researchers believe that by identifying all of the genes involved in vitiligo, they will learn what destroys the cells that give skin its color. With this knowledge, it should be possible to develop better treatments. One of the key goals of this research is to develop a treatment that will permanently stop the skin from losing color.
References:Gawkrodger DJ, Ormerod AD, Shaw L et al. “Guideline for the diagnosis and management of vitiligo.” Br J Dermatol 2008; 159: 1051-76.Grimes PE, “Vitiligo.” In: Kelly AP and Taylor SC, editors. Dermatology for Skin of Color, China, McGraw-Hill; 2009. p. 317-23.Halder RM, Taliaferro SJ. “Vitiligo.” In: Wolff K, Goldsmith LA, Katz SI, et al. editors. Fitzpatrick’s Dermatology in General Medicine, 7th ed. United States of America, McGraw Hill Medical; 2008. p.616-21.Linthorst Homan MW, Spuls PI, de Korte J et al. “The burden of vitiligo: patient characteristics associated with quality of life.” J Am Acad Dermatol 2009; 61: 411-20.Nicolaidou E, Antoniou C, Stratigos A et al. “Narrowband ultraviolet B phototherapy and 308-nm excimer laser in the treatment of vitiligo: a review.” J Am Acad Dermatol 2009; 60: 470-7.Ortonne JP, “Vitiligo and Other Disorders of Hypopigmentation.” In: Bolognia JL, Jorizzo JL, Rapini RP, et al. editors. Dermatology, 2nd ed. Spain, Mosby Elsevier; 2008. p. 913-20.Whitton ME, Ashcroft DM, Gonzalez U. “Therapeutic interventions for vitiligo.” J Am Acad Dermatol 2008; 59: 713-7.
Dermatologists share the following tips with their patients who have vitiligo.
Everyone who has vitiligo can benefit from sun protection. Here’s why:
To protect your skin from the sun, dermatologists recommend:
Generously apply sunscreen every day to skin that will not be covered by clothing. Use a sunscreen that offers:
Be sure to apply it at least 15 minutes before going outdoors.
If you will be outdoors, be sure to reapply the sunscreen:
Skin covered by clothing that has a high SPF does not need sunscreen. Not all clothing offers high SPF. A long-sleeve denim shirt has an SPF of about 1,700. A white t-shirt only has an SPF 7, and a green t-shirt has about an SPF 10.
You can boost the SPF of clothing, by adding a product that increases the SPF of clothing during the wash cycle. You add this product to the wash machine. The increase in SPF is usually good for about 20 washings.
This is especially important when your shadow is shorter than you are. That’s when the sun’s damaging rays are at their strongest and you are likely to sunburn.
These are not safe alternatives to the sun. These, too, can burn skin that has lost pigment.
If you want to add color to your skin, consider using a cosmetic.Cosmetics can safely add color to your skin if you want to add color without undergoing treatment. Cosmetics that can add color are self-tanners, dyes, and makeup. Here are some tips that dermatologists offer their patients:
Getting a tattoo can cause something called Keobnerization or the Koebner phenomenon. What this means is when you wound your skin, which getting a tattoo does, a new patch of vitiligo can appear about 10 to 14 days later.
Knowledge often improves a person’s quality of life. It helps to know about treatment options so that you know what is possible. Learning more about vitiligo can help you decide what feels right for you. You may want to treat it, camouflage with cosmetics, or just let it be. Only you can decide what’s right for you.
If you decide not to treat vitiligo, it’s still important to see a dermatologist for an accurate diagnosis and physical. Vitiligo is a medical condition, not just a cosmetic concern.
The emotional aspects of having vitiligo are often overlooked, but they are real. If a child has vitiligo, other children may tease and bully. People can stare. Studies conclude that many people who have vitiligo have a decreased quality of life.
Connecting with others who have vitiligo can help. You will find links to support groups below:
Vitiligo Support InternationalMessage boards for major cities, local support groups that meet monthly giving you the opportunity to meet others living with vitiligo, and the chance to share support and experiences in person.Vitiligo FriendsAn online community where people living with vitiligo, their family, and their friends can share information and stay in touch. Can meet people worldwide.Vitiligo support groupDiscussions and articles on the DailyStrength website.
References:American Academy of Dermatology. “Dermatologists encourage consumers to be “clothes” minded when it comes to selecting summer wardrobe.” News release issued May 2, 2005.Halder RM. “Vitiligo.” Forum presented at the 2011 American Academy of Dermatology Annual Meeting: New Orleans. February 2011.Linthorst Homan MW, Spuls PI, de Korte J et al. “The burden of vitiligo: patient characteristics associated with quality of life.” J Am Acad Dermatol 2009; 61: 411-20
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