Vitiligo is a condition that is quite common, yet very misunderstood. It effectively means that pigmentation in the skin is lost over time. Around 2% of the world’s population actually suffer from it. The condition causes the melanocytes to be destroyed, turning the skin white. This is most often found in body folds, such as armpits and groin, as well as in body orifices and exposed areas, mainly the face and hands. If a person with vitiligo is injured, this area will often also be affected.
So what is vitiligo? The condition tends to develop before the age of 20, although it can occur later as well. It is often associated with various other conditions, in particular diabetes and thyroid disease. However, those who do have it tend to be in good general health and find that the loss of pigmentation is the only symptom they have.
It isn’t known what causes the condition, but is believed that a number of factors play a part. These include:
• Autoimmune disease
• Physical trauma
• Stress and anxiety
Important: Vitiligo is not contagious!
The Emotional Impact
The biggest problem with vitiligo is cosmetic. People with dark skin in particular can find that the condition can really affect their psychology. They often develop depression and low self-esteem and it is not unheard of for them to be discriminated against in the work place. Because of this, it is important to recognize that the condition changes people’s lifestyles, creates barriers in their social capital and stops their opportunities to be contributing members of society. This is why treatment is so important.
Usually, the condition is managed rather than treated. A dermatologist will look into how bad the person is affected and recommend treatment based on that. Common options include:
• No treatment, generally recommended to those with fair skin. However, SPF30+ sunscreens must be used when in the sun.
• Camouflage, which includes things such as foundation or self-tanning lotion. Some people choose micro-tattooing, which is quite a good option for small areas of the skin.
• Active re-pigmentation, which can be done in a number of ways. Firstly, there is the medical way, using mainly light therapy. This is somewhat successful in 75% of the cases. However, it is extremely rare for complete re-pigmentation to occur. Secondly, there is the surgical option, which is almost never recommended. This is only if all other avenues have been tried and were unsuccessful and if the vitiligo is no longer progressing. Lastly, there is laser treatment, which has not been overly successful as of yet.
• De-pigmentation, which is used in those who have already lost pigmentation in at least 80% of their skin. This treatment takes a very long time, averaging at two years, and therefore often not a treatment of choice.
Some people are also looking into natural treatment for vitiligo, but it seems that this is based more on reducing flare-ups and slowing down progression. Using natural remedies to be less stressed, for instance, is generally a good idea.
Unfortunately, there is no cure for vitiligo. This is also due to the fact that they don’t yet know what the vitiligo causes are either. Although scientists are beginning to understand what the impact of vitiligo is, both on a physical and psychological level, they still don’t understand exactly how it works. This, in turn, means that there is currently no way to prevent vitiligo either. Progress during treatment is very slow and often has to be maintained throughout life. This means that patients have to be motivated to take part, which is often hard if they are psychologically impacted by their skin problem. This is why most sufferers are also provided with counselling from trained psychologists and psychotherapists to teach them how to cope with vitiligo.