Vitiligo is a chronic skin condition characterized by a loss of melanin, or skin pigmentation, due to damage inflicted to the skin’s pigment-producing cells called melanocytes. The occurrence of vitiligo is impossible to predict and affects men and women of all ages, skin types and skin tones.
Vitiligo symptoms are most likely to initially show up on body areas that are most frequently exposed to the sun, such as the face and lips, arms, hands and feet. In areas affected by vitiligo, you will see noticeable lightening in patches of your skin as pigmentation decreases. Sometimes, hypopigmentation that occurs due to vitiligo may extend to the eyes, mucous membranes and facial hair.
Patches of skin hypopigmentation may also conform to a loosely defined pattern, depending on which of the three types of vitiligo you present with.
Non-segmental or general vitiligo is the most common form of vitiligo and is characterized by widespread, symmetrical pigment loss across the entire body, whereas segmental vitiligo involves pigment loss in skin patches on only one side of the body. Focal vitiligo is the least severe form of vitiligo and tends to cause pigment loss in just a few patches of skin on your body.
The causes of vitiligo are largely unknown, however researchers believe that vitiligo may be an autoimmune disorder influenced by heredity, as about 30 percent of patients suffering from vitiligo have family members who also have the condition.
Vitiligo has been associated with three systemic autoimmune disorders, including Addison’s disease, hypothyroidism and pernicious anemia, however, the relationship between vitiligo and these diseases is unclear.
Emotional distress or trauma is also sometimes considered to be a possible vitiligo trigger.
Vitiligo may be reversible if it is diagnosed and effectively treated in its very early stages, but generally, there is no cure for vitiligo. Some treatments or combinations of treatments may help reduce the appearance of skin discoloration caused by vitiligo, including topical medications, oral medications and light-based therapies.
Topical medications prescribed for vitiligo treatment include:
- Corticosteroid creams (not for use on the face or genitals)
- Calcineurin inhibitor creams – Protopic (tacrolimus) or Elidel (pimecrolimus)
- Vitamin D analogue ointments – Vectical (calcitriol) or Taclonex (betamethasone & calcipotriene)
- Repigmenting agents – Oxsoralen (methoxsalen)
- Depigmenting agents – TriLuma (hydroquinone)
Oral repigmenting medications used to treat vitiligo may include Trisoralen (trimethylpsoralen) and Gleevec (imatinib mesylate), a drug that is typically used for leukemia treatment but may also have repigmenting effects on the skin.
Light therapy using an Excimer Laser or IPL device may also be an effective vitiligo treatment, however light therapy combined with psoralen, a topical medication derived from certain plants, in a treatment called PUVA is often even more effective.
Vitiligo may also be treated surgically via skin grafting and can also be masked with cosmetic tattooing it no other vitiligo treatment options are sufficient or affordable.
Before a vitiligo treatment protocol may be recommended, your skin must be evaluated and the magnitude and severity of your condition assessed.