Vitiligo is a relatively common skin disorder, in which white spots or patches appear on the skin. These spots are caused by destruction or weakening of the pigment cells in those areas, resulting in the pigment being destroyed or no longer produced. In most cases, vitiligo is believed to be an autoimmune-related disorder. Although researchers
are not exactly sure what causes the autoimmune response, more is being learned every year. In vitiligo, only the color of the skin is affected. The texture and other skin qualities remain
normal.
People who develop vitiligo usually first notice white patches or spots (depigmentation) on their skin. The skin remains of
normal texture, and there is usually no itching or other symptoms. These patches are more obvious in sun-exposed areas, including the hands, feet, arms, legs,
face, and lips. Other common areas for white patches to appear are the armpits and groin and around the mouth, eyes, nostrils, navel, and genitals. Vitiligo generally appears in one of three patterns. In
one pattern (focal pattern), the depigmentation is limited to
one or only a few areas. Some people develop depigmented patches on only
one side of their bodies (segmental vitiligo). But for most people who have vitiligo, depigmentation occurs on different parts of the body (generalized vitiligo), often similar on each side of the body. In addition to white patches on the skin, some people with vitiligo may experience white hair growing in on the scalp, eyelashes, eyebrows, and beard. In extremely rare cases, vitiligo can affect eye color or the pigment of the retina.
Most people with vitiligo have neither
parents, nor children, nor siblings with vitiligo. Many have no other relatives with vitiligo. Vitiligo does appear to be hereditary, that is, it can run in families. Children whose
parents have the disorder are more likely to develop vitiligo. There is no question about that. However, most children will not get vitiligo even if a parent has it, and most people with vitiligo do not have a
family history of the disorder. So the chances of your
child developing vitiligo appear to be very small. Nevertheless, there are sufficient numbers of families where vitiligo does appear among siblings,
parents and children, such that we can assume a genetic factor.
The beginning of Vitiligo and the severity of pigment loss differs with each patient. Light skinned people usually notice the pigment loss during the summer as the contrast
between the vitiliginous skin and the suntanned skin becomes distinct. People with dark skin may observe the onset of Vitiligo at any
time. Individuals who have severe cases will lose pigment over their entire body surface. There is no
way to predict how much pigment an individual will lose, Illness and stress can result in more pigment loss. The degree of pigment loss can also vary within each Vitiligo patch, and a border of abnormally dark skin may encircle a patch of depigmented skin.
Vitiligo frequently begins with a rapid loss of pigment which may be followed by a lengthy period when the skin color does not change. Later, the pigment loss may resume — perhaps after the individual has suffered physical trauma or stress. The loss of color may continue until, for unknown reasons, the process stops. Cycles of pigment loss, followed by periods of stability may continue indefinitely. It is rare for a patient with Vitiligo to repigment or regain skin color spontaneously. Most patients who say that they no longer have Vitiligo may actually have become depigmented and are no longer bothered by contrasting skin color. While such patients appear to be “cured”, they really are not. People who have Vitiligo all over their bodies do not look like albinos because the color of their hair may not change — or it can be dyed — and eye color does not change.
Most individuals with Vitiligo are upset because of the uneven skin color. It is difficult for those who do not have Vitiligo to appreciate the significance of this problem to the victim.
If a person has Vitiligo over more than half of the exposed areas of the body, he or she is not a candidate for repigmentation. Rather, such a person may want to try depigmentation of the remaining pigmented skin. The drug for depigmentation is monobenzylether of hydroquinone. Many patients with Vitiligo are at first apprehensive about the idea of depigmentation and reluctant to go ahead. However, patients who achieve complete depigmentation are usually satisfied with the end results. Some people become allergic to the medication and must discontinue therapy. This therapy takes about a year to complete. The pigment removal is permanent.
Patches of vitiligo skin have no natural protection against the sun’s rays. This is because vitiligo skin is white as the melanocytes which produce melanin (skin pigment) are not active. The effect of the sun is normally to increase melanin production and to turn the skin
brown; this is a protective mechanism to prevent the skin from being damaged by burning. Therefore, the most important reason for protecting your skin is to prevent sunburn. Not only is this painful, but damage to the skin, including sunburn, can stimulate the vitiligo to spread in some people.
Most of the people that suffer from this disease have a hard
time with people either not believing them about their condition, or just people giving them a hard
time about it, especially when they are African American.
