How Vitiligo Affects Skin Pigment

The Science Behind Vitiligo: Causes, Symptoms, and Management

Vitiligo is more than a skin condition. It can impact one’s self-image, confidence and overall well-being. It is one of the most common causes of depigmentation. In this, your skin loses pigmentation in patches, leaving lighter areas.

Knowing what causes the characteristic skin changes in vitiligo can help you understand the condition better.

What is vitiligo?

Vitiligo is a chronic skin disorder in which the cells that produce melanin, known as melanocytes, are destroyed or stop functioning. Melanin gives skin, hair and eyes their colour. When these cells are absent, lighter patches begin to appear on different parts of the body. Vitiligo affects all skin types but tends to be more visible in people with darker skin tones.

This condition can develop at any age, although it is most commonly diagnosed before age 30. It does not cause any pain, but it can be a source of emotional distress due to its visible nature. There are different types of vitiligo, with segmental (localised to one side of the body) and non-segmental (more common and often symmetrical) being the most common.

What are the risk factors of vitiligo?

Several factors can increase the risk of developing vitiligo. Here are the factors to look out for:

• Family History: One of the most significant risk factors is a family history of the condition. According to various studies, approximately 30% of vitiligo cases are linked to genetics.
• Autoimmune Disease: People who have autoimmune diseases, such as thyroid disorders, type 1 diabetes or alopecia areata, are more likely to develop vitiligo.
• Environmental Factors: Environmental triggers such as severe sunburn, emotional stress or exposure to industrial chemicals may contribute to the onset of vitiligo in susceptible people. You may also develop vitiligo from physical trauma to the skin in some cases.

What are the main symptoms of vitiligo?

The most noticeable symptom of vitiligo is the appearance of white patches or spots on the skin. These patches often begin on areas exposed to the sun, such as the face, hands, arms and feet. Other symptoms include:

• Premature greying of the hair on the scalp, eyebrows, eyelashes or beard
• Colour changes in the inside of one’s mouth or nose
• A clear boundary between pigmented and depigmented skin
• Itchy skin before developing depigmentation

Although it spreads slowly, experts are not sure about the pattern and speed of its progression. For some people, it may spread quickly to their whole body, while others may face slow progression.

What Causes Vitiligo?

The exact cause of vitiligo is not fully understood, but doctors believe that it involves a combination of genetic, autoimmune and environmental factors. However, experts believe that your immune system mistakenly attacks and destroys melanocytes, the cells responsible for producing skin pigment.

Genetic research suggests that changes in several genes related to immune function and skin pigmentation may contribute to vitiligo. Environmental and other combined factors lead to the loss of pigment and the characteristic white patches associated with vitiligo.

What are the treatment options for vitiligo?

Vitiligo is neither life-threatening nor contagious. However, treatment can help improve your skin and slow disease progression. Doctors determine treatment plans depending on location and the number of white patches. Moreover, they will also consider your preference and response to past treatments. Common treatment options are as follows:

• Topical Treatments: These include corticosteroids and calcineurin inhibitors, which help restore pigment in some cases. Doctors typically use them as a first-line treatment. It can reduce inflammation and immune system response, helping you regain pigmentation.
• Light Therapy: Doctors commonly use narrowband ultraviolet B (NB-UVB) phototherapy to stimulate melanocyte activity. You have to get it two or three times a week from a dermatologist to promote repigmentation.
• Surgical Options: Doctors recommend surgical treatment for people with stable vitiligo who do not respond to other treatments. These procedures include skin grafting and cellular grafting techniques. They transplant melanocytes from unaffected areas to the depigmented areas with the goal of repigmenting the affected skin.

In addition to medical treatments, you should use sunscreen regularly, avoid tanning beds and consider cosmetic cover-ups or self-tanners to manage the cosmetic impact. Support groups and counselling can also help you cope with the emotional challenges associated with vitiligo.

Vitiligo results from a complex mixture of genetic, autoimmune and environmental factors, leading to the loss of pigmentation in certain areas of the skin. This condition affects about 1% of people worldwide. While the condition is not harmful, it can have a deep impact on one's quality of life. With various treatment options available, managing vitiligo and improving your skin's appearance is more achievable than ever.

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