What is Vitiligo - Diagnosis, Symptoms, Causes and More?

Understanding Vitiligo: Diagnosis, Risk Factors & Care Tips

Vitiligo is a skin condition causing loss of pigment, leading to white patches on the skin. This blog explores how vitiligo is diagnosed, its common symptoms, potential causes, and treatment options. It aims to raise awareness and provide insights into managing this often misunderstood condition effectively.

Introduction

Vitiligo is a long-term skin disorder marked by white patches caused by the loss of pigment-producing cells. While not life-threatening, it can deeply impact self-esteem. It may not be life-threatening or contagious, but they are emotionally distressing for many individuals. This blog delves into vitiligo's symptoms, causes, and diagnosis, offering insights to help readers better understand and manage the condition.

What is vitiligo?

Vitiligo is a skin condition that makes the skin lose its pigment or colour. In this condition, the affected areas of skin appear whiter or lighter than normal skin tone. The areas of skin that lose colour are macules. It is only if they are less than 1 centimetre wide. When the patches are more than 1 cm wide, they are called patches.  

Types of Vitiligo

Here is an overview of the different types of vitiligo that affect individuals at large:

• Generalised Vitiligo: It is the most common form of vitiligo. A person affected by this condition gets widespread patches across different parts of their body. The patches often appear symmetrical in nature.
• Focal Vitiligo: This particular type of vitiligo involves one or a few areas of skin depigmentation and does not necessarily spread across as widely as generalised vitiligo.
• Segmental Vitiligo; It is a rare type and generally affects only one part or side of the body. Generally, this condition starts at a very young age and progresses for a few years before finally stabilising.
• Acrofacial Vitiligo: It affects the facial areas and extremities, like toes, fingers and areas around the eyes and mouth.
• Mucosal Vitiligo: It affects the mucous membranes of the genitals or the mouth area of an individual.
• Trichrome Vitiligo: In this type of vitiligo, a person gets a bullseye with a colourless or white centre, after which there is an area of whiter pigmentation and then a natural area of skin tone.
• Universal Vitiligo: It is a rare type of vitiligo that causes more than 80% of the skin to lose pigment.

Causes and Risk Factors of Vitiligo

The exact cause of vitiligo is still unknown to date. However, there are a few theories which have been proposed:

• Autoimmune Response: It is the most widely accepted theory that vitiligo is a form of autoimmune disorder. In such an instance, the immune system mistakenly attacks and destroys the melanocytes of the body.
• Oxidative Stress: It is an imbalance between the free radicals and antioxidants present in the body. They contribute to the destruction of melanocytes.
• Genetics: About 20%-30% of people who have vitiligo have a family history of this condition. It suggests that there is a hereditary component involved. There are several genes related to the immune system and melanocyte function that have been identified to have a link with vitiligo.
• Environmental Triggers: Genetic predisposition, along with skin trauma, exposure to chemicals, and sunburn, can trigger the condition.

Diagnosis of Vitiligo

The diagnosis of vitiligo occurs through a clinical examination. A dermatologist may use a special UV light called a Wood's lamp to highlight the affected areas. There are some additional tests which a doctor might take. They are:

• Skin biopsy to rule out the other conditions
• Eye exams when there is ocular involvement
• Blood tests to check for any underlying autoimmune diseases or thyroid function
   

An early diagnosis and prompt treatment are important for better recovery.

Symptoms of Vitiligo

The main symptom of vitiligo is the appearance of white patches of skin all over. There are quite a few other symptoms that can show up as well:

• Premature greying of the hair on eyelashes, beard, scalp and eyebrows
• Loss of colour in the mucous membranes inside the nose and mouth
• A change in the colour of the inner layer of the uveal tract (iris, ciliary body, choroid), causing uveitis
   

Treatment Options for Vitiligo

Presently, there is no cure for vitiligo. However, there are a few treatment options which claim that they can restore the skin colour or even out the skin tone. The ultimate choice of treatment depends on the location, extent and activity of the disease. It also depends on an individual's age and preferences.

• Anti-Inflammatory Medications: Anti-inflammatory medications like corticosteroids help to repigment the skin. They are more ideal for use in the early stages. Other medications like pimecrolimus and tacrolimus are usable for neck and facial lesions. They have fewer side effects than corticosteroids.
• Surgical Treatments: Skin grafting is mainly for patients who have stable vitiligo. It involves transplantation of healthy and pigmented skin to the areas affected by vitiligo. Modern techniques focus on melanocyte-keratinocyte transplantation (MKTP) or non-cultured epidermal cell suspension (NCES). These methods transfer pigment cells. Another form of surgical treatment that helps with this condition is melanocyte transplants. They help to transfer melanocytes from the unaffected areas to the affected skin.
• Light Therapy: One such method of light therapy that is used for treating the areas of vitiligo is narrowband UVB phototherapy. This is very effective and involves exposing the skin to particular wavelengths of UV light. Narrowband UVB (NB-UVB) is used as the gold standard for phototherapy
• Cosmetic Cover-Ups: In this process, camouflage makeup can mask the white patches temporarily and is very useful for facial vitiligo. Additionally, there are also self-tanning lotions available out there that even out the skin tone without requiring any exposure to the sun.
• Depigmentation: For individuals who have widespread vitiligo, depigmentation of the remaining pigmented skin can also be an option for creating a uniform appearance. This is generally the last resort and involves topical agents like monobenzone.
   

Living with Vitiligo: A Future Outlook

Living with vitiligo requires strong emotional resilience and proactive skin care. People who have vitiligo need to:

• Use broad-spectrum sunscreen to protect their depigmented skin, which has melanin loss.
• Avoid tanning beds and excessive sun exposure at all costs.
• Wear protective clothing and seek shade when outdoors.
• Practise self-care and consider mental health support if needed.
   

It is very important to educate others about the condition to reduce stigma and misinformation. Awareness campaigns also play a great role in shifting the public's perception and help those with vitiligo by making them feel more accepted.

Final Thoughts

Vitiligo is a complex condition that affects a lot of people worldwide. Even though it poses no such physical threat, it has profound social and emotional effects. With more and more advancements in medical science and an increasing public awareness, individuals with this condition now have more options for support than ever before.