Vitiligo 101: Some Basic Facts
With Chantelle Brown-Young appearing on America’s Next Top Model, the skin condition vitiligo has received a lot of media attention of late. However, there are still many misconceptions about vitiligo and I thought I’d take the opportunity to clear some of them up.
So what is vitiligo? It is a condition in which pigment cells are destroyed, resulting in white patches on the skin. Any part of the body where pigment cells are present may be involved, but the most common sites are:
1. Exposed areas such as the face and neck
2. Body folds (e.g., armpits, groin)
3. Site of injury (e.g., cuts, scrapes, burns)
4. Hair (i.e., early greying)
5. Areas surrounding moles
Vitiligo affects 1 - 2% of the total population. Commonly patients experience the loss of pigment before reaching 20 years of age. There is also often a family history of a similar disorder. Patients with vitiligo are otherwise in good health.
The cause of vitiligo is still unknown. Many people report a pigment loss shortly after suffering emotional stress or physical injury. One theory as to the cause is that an autoimmune process destroys the pigment cells. That is to say, the patient forms antibodies against his or her own pigment cells. However, there are other theories as to the cause of vitiligo and though much research is being done there is not yet a consensus on the cause of the disease.
The severity of pigment loss will vary from person to person. There is no way to predict how much pigment an individual will lose, however illness and stress can result in more pigment loss. It is possible to lose all of the colour from the skin, however, this is rare. Cycles of pigment loss followed by periods of stability may continue indefinitely or the process may not progress after the initial loss, and in some cases there may be spontaneous recovery.
Vitiligo patients should take extra precautions from the the sun to prevent burning in the white areas and darkening of the normal areas, which would exaggerate the contrast between the two colours. Patients should wear a sun block (SPF 30 or higher) on the normal skin as well as the vitiligo-affected skin.
When it comes to treatment for vitiligo, we cannot cure the disease but only offer forms of control. One treatment method is utilizing narrowband UVB therapy to stimulate the reformation of pigment. Usually a trial of at least three months of treatment is needed to see if the pigmentation will return. If the pigment returns with treatment there is a very good chance of it remaining, however, new areas of vitiligo might appear in the other sites at any time. Other treatments include the use of potent topical steroid creams or topical tacrolimus ointment (protopic).
Although there is currently no cure for vitiligo, research is continuing and there is an increasing understanding of the disease, which ultimately will lead to better treatments. In the mean time, people with vitiligo should be inspired by role models like Chantelle Brown-Young.