Overview, Causes, & Risk Factors
Vitiligo is a skin disorder characterized by the development of completely white patches of skin.
Skin and hair color are determined by melanin, a pigment produced in cells known as melanocytes. When the melanocytes are damaged or die, they no longer produce melanin. The skin becomes lighter in color.
Vitiligo occurs in all age ranges and all races. About half of the time, vitiligo develops before age 20. No one knows the exact cause of vitiligo, but there are four main theories:
Sunburn and stress may bring on vitiligo.
The chalk white skin lesions of vitiligo are often found on the face, lips, hands, arms, legs, and genitals. There is no pain or itching with the lesions. The lesions tend to be more prominent over bony areas, body openings, and around folds in the skin. Vitiligo is also more common in areas where the skin has been injured. The lesions are usually uniform in shape and occur on both sides of the body. If hair follicles are involved, the person may have premature graying of head and body hair.
People with vitiligo are generally healthy, but they are more likely to have the following disorders:
Diagnosis of vitiligo begins with a medical history and physical exam. A special exam with a Wood’s light may reveal areas of skin without pigmentation. Blood tests, such as thyroid function tests or blood glucose tests, may also be ordered.
Many times, vitiligo cannot be prevented. Safety measures to avoid cuts and scrapes to the skin can be helpful. Sunscreen products can help prevent sunburns and may slow pigment loss. Stress management may lessen the impact of vitiligo.
The pigment loss of vitiligo may continue and can be disfiguring. However, many people will go for years with stable pigment loss. Pigment can return by itself. Treatment also can help pigmentation come back.
Vitiligo is not contagious. Other family members are at higher risk of developing vitiligo because of shared genetic factors.
Many people, especially those with fair skin, choose conservative measures to treat vitiligo. These measures include the following:
Repigmentation treatment involves measures that return normal pigment to skin lesions. These treatments include:
Depigmentation treatment options may be used if the person has vitiligo over more than half of the body. A chemical called monobenzylether of hydroquinone is applied to normal skin areas. The goal is to change all skin areas to the same overall light color.
PUVA may produce skin burns. Oral medicines can cause stomach upset and allergic reactions. Corticosteroid creams can cause skin thinning and stretch marks. Depigmentation is permanent and may cause severe sun sensitivity. Skin grafts can cause scarring and less than complete repigmentation.
Recurrence or new sites of pigment loss are common. The individual may need lifelong treatment for vitiligo.
Any new or worsening symptoms should be reported to the healthcare provider.