Vitiligo

Definition

Vitiligo is a health issue in which patches on the skin lose their natural color. The skin on the patches appears pale or white. The patches may be on any part of the body, including the hair, eyes, and mouth.

Causes

The patches are due to melanocyte cells being destroyed. These cells in the skin make pigment. Loss of pigment causes the skin to become lighter. It can look much lighter than the skin nearby. This is why vitiligo is easier to see in people with darker skin.

The exact cause of the pigment loss is not known. Possible causes may be:

• The body’s immune system may destroy the melanocytes (autoimmune)
• Melanocytes may destroy themselves
• Nerve cells may start making toxic substances that harm the melanocytes

A genetic issue may make it easier for the cells to be harmed.

Risk Factors

Vitiligo is more common in people between 10 and 30 years of age. Other things that may raise the chance of having vitiligo include:

• Family members with vitiligo or whose hair turns gray early
• Some autoimmune diseases, such as those that affect the thyroid gland

Symptoms

The main symptom is patches on the skin that have lost their natural color. These patches may be any size or place on the body.

• The patches may be only in a few areas or be more widely spread
• The patches may form 2 kinds of patterns
  • Nonsegmental (most common):
    • Appear on both sides of the body
    • More likely to be all over and to spread
    • There may be patches in the hair
    • Linked to an autoimmune health issue or a family history of autoimmune issues
  • Segmental:
    • Appears only on one side of the body
    • May appear fast, but then stop spreading
    • Not usually linked to autoimmune issues

Some common sites of Vitiligo patches include:

• Places that are in the sun such as the face, hands, arms, and upper part of the chest
• Spots near body openings such as the eyes, nostrils, mouth, belly button, and genitals
• Places where clothing or jewelry rub, such as the neck
• Body folds such as the groin and armpits
• Places that may get a lot of minor injuries over time, such as knuckles and elbows
• Sites of injuries, such as scrapes, cuts, and burns
• Around moles

White or prematurely graying hair and hair loss may also happen.

Patches may appear and spread, then stop spreading for several months. That can happen many times in a person’s life.

Diagnosis

The doctor will ask about symptoms and past health. A physical exam and eye exam will be done. The diagnosis is usually made by how the skin looks. A skin biopsy may be done to confirm it. Special UV lamps may be used during the skin exam.

Tests may also be done to check for other autoimmune diseases, such as hypothyroidism orhyperthyroidism.

Treatment

The goal of treatment is to make the patches harder to see. There is no cure for vitiligo. Ways to make the patches harder to see are:

• Replace some skin color in patches
• Slow the loss of color
• Reduce the difference between affected and unaffected skin

The longer the patches have been on the skin, the harder it is to return color to them.

This may be done by:

Prevention

Vitiligo cannot be prevented.