Frequently Asked Questions about Vitiligo
1. What is vitiligo?
Vitiligo is a skin disease that causes patients to develop white lesions on the skin that vary in size and location. The white lesions occur
when pigment cells, called melanocytes, are destroyed and the pigment, melanin, cannot be produced. Melanocytes are normally found
throughout the skin, hair follicles, mouth and eyes. With vitiligo, pigment can be lost in any of these areas resulting in the white lesions.
2. How many people have vitiligo?
Vitiligo affects approximately 0.5 to 1 percent of the population. While vitiligo is more noticeable in people with dark skin, the disease
affects all ethnic groups with the same frequency regardless of race or gender.
3. What causes vitiligo?
The exact cause of vitiligo is unknown, but evidence suggests that it is a combination of genetic, immunologic and environmental factors.
This means that some people may have a greater tendency to develop the disease when exposed to certain triggers.
4. Is vitiligo hereditary?
About a third of people with vitiligo know of someone in their family who has it; but the exact type of inheritance has not yet been worked
out. It is not necessary that the children of parent/s having vitiligo may develop the disease
5. What does vitiligo look like?
The most common sites for vitiligo are:
a. The exposed areas – vitiligo often begins on the hands and face.
b. Around body openings: the eyes, nostrils, mouth, umbilicus, and genitals.
c. In body folds: the armpits and groin.
d. Anywhere your skin has been damaged, for example by a cut or a burn.
e. Areas around pigmented moles (as part of “halo naevi”).
f.
Segmental type, vitiligo crops up on just one part of the body.
Vitiligo is more obvious, but not more common, in people with a dark skin. Premature greying of the scalp hair can accompany vitiligo.
Vitiligo can start at any age, but about half of those who get it do so before they are 20. Its course is hard to predict, but it tends to progress
slowly, with periods of stability, often lasting several years. The patches slowly change their shape and size, and the skin around them may
be darker than normal. The hairs growing out of a patch of vitiligo may keep their normal colour or turn white too. Some pigment comes
back spontaneously in a few patients but seldom does so completely.
6. How will vitiligo be diagnosed?
The diagnosis is usually easy to make on the basis of the look of the patches (white with a normal skin texture) and the fact that the areas of
vitiligo on the left side of the body roughly mirror those on the right. A Wood’s (ultraviolet) light can help to show up white areas that
could have been missed in a pale-skinned person. Once the diagnosis of vitiligo has been made, your doctor may want to check you for
thyroid disease, and for other autoimmune conditions that are more common than usual in people with vitiligo.
7. How can vitiligo be treated?
Pigment in vitiligenous skin can be brought back by
a. Using a strong corticosteroid cream. This gets some pigment back in new and early patches - but long term and unsupervised use may
lead to adverse effects
b. Phototherapy.
PUVA treatment. In this, you will be given a Psoralen tablet to take by mouth, and then be exposed to Ultra Violet light of type A - hence the
word PUVA. You will have to attend a skin department regularly and frequently, and probably for at least a year.
Localised small patches of vitiligo may be treated with a psoralen gel, paint, or cream, in combination with ultraviolet light of type A.
Narrow band ultraviolet light of type B is the latest advancement in the treatment of vitiligo. It involves exposing the body to measured
amount of narrowband ultraviolet B radiation
c. Sunscreens. The use of a sunscreen with a sun protection factor of 25 or higher helps to prevent burning of the white patches of vitiligo.
In light skinned individuals, it also minimises pigmentation of the skin around the patches of vitiligo.
d. Surgical procedures. Skin grafting and melanocyte transfer surgeries are done after the disease has stabilised. Various surgical
procedures help in almost complete cosmetic correction of the disease
8. What care should be taken by a patient having Vitiligo?
a. Avoid the sun; use sunscreens and protective clothing.
b. Keep your self-confidence high by making your skin look as normal as possible. Learn about the right way to hide the white areas with
cosmetics. Good modern ones come in a range of colours, are hard to rub off, and can be waterproof.
c. Don’t waste time changing your diet - this never does much good.
9. Can Vitiligo be completely Cured?
Just as with conditions such as diabetes and high blood pressure, vitiligo as a disease can be controlled but not cured. Research has
advanced our understanding of the underlying factors including genetic, immunological and environmental, but more research is required
to fully understand the factors involved and to find ways to reverse or block them. In near future gene therapy may help us in actually
reversing the disease process and effect complete cure
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