Vitiligo – about health us

Overview, Causes, & Risk Factors

Vitiligo is a skin disorder characterized by the development of completely white patches of skin.

What is going on in the body?

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.

What are the causes and risks of the disease?

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:

  • Abnormal nerve cells produce toxic substances that damage melanocytes.
  • An autoimmune disorder causes the body to produce antibodies that attack and destroy the melanin pigment.
  • A genetic defect makes the melanocytes more susceptible to injury.
  • Melanocytes self-destruct.

Sunburn and stress may bring on vitiligo.

Symptoms & Signs

What are the signs and symptoms of the disease?

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:

  • Addison”s disease, or decreased function of the adrenal gland
  • alopecia areata, a type of hair loss
  • hyperthyroidism, or increased function of the thyroid gland
  • hypothyroidism, or decreased function of the thyroid gland
  • pernicious anemia, which involves a low red blood cell count
  • uveitis, an inflammation of the eye 

Diagnosis & Tests

How is the disease diagnosed?

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.

Prevention & Expectations

What can be done to prevent the disease?

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.

What are the long-term effects of the disease?

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.

What are the risks to others?

Vitiligo is not contagious. Other family members are at higher risk of developing vitiligo because of shared genetic factors.

Treatment & Monitoring 

What are the treatments for the disease?

Many people, especially those with fair skin, choose conservative measures to treat vitiligo. These measures include the following:

  • applying skin dyes
  • avoiding tanning of normal skin around the vitiligo lesions, to lessen the contrast
  • covering skin lesions with makeup
  • using micropigmentation tattooing for small lesions
  • using self-tanning compounds containing dihydroxyacetone, which doesn’t need melanocytes to cause a tan 

Repigmentation treatment involves measures that return normal pigment to skin lesions. These treatments include:

  • corticosteroid creams
  • PUVA, a combination of a medicine called psoralen and skin exposure to UVA, a type of ultraviolet light
  • skin grafts of normal skin to depigmented skin lesions 

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.

What are the side effects of the treatments?

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.

What happens after treatment for the disease?

Recurrence or new sites of pigment loss are common. The individual may need lifelong treatment for vitiligo.

How is the disease monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

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