What is vitiligo?

Millions of people around the world have vitiligo. Vitiligo causes patches of lighter skin to appear. It can develop anywhere there is pigment on the body, some people lose color in their hair and eyes. Vitiligo is not contagious or life threatening. There are different types: Segmental, or unilateral vitiligo appears on one segment of the body, such as the face, an arm or a leg. It tends to begin at an early age, and may progress for a year, then stop. Non-segmental, also called bilateral vitiligo, or vitiligo vulgaris. It appears on both sides of the body, such as both arms or both legs.

What causes vitiligo?

Everyone of all ethnicities and skin types can acquire vitiligo, male or female, with rates being distributed evenly. Nearly half acquire the condition before 21 years of age, and will have it for the rest of their lives, as it is rare for it to disappear. The risk increase if a close relative has the condition, or if you have an autoimmune thyroid disease. Alopecia areata can also increase the risk. The condition is a result of melanocytes dying, these cells are responsible for pigment. It is not known why these cells die. Non segmental vitiligo may be an autoimmune disease, while segmental seems to be related to the nervous system.

What are the symptoms?

Depigmentation of the skin, hair anywhere on the body, genitals, or even inside the mouth. Affected people often feel physically fine, although some say vitiligo itches or hurts. There are subtypes of vitiligo, such as localized, generalized or universal vitiligo. In localized, a few or just one spot appears, in generalized, scattered patches occur throughout the body, and in universal, most of the pigment is gone. Color loss can remain unchanged for many years, and some people see patches grow larger, or new ones appear. Rarely, the skin will regain color.

How is it diagnosed and treated?

If it is suspected you have vitiligo, your dermatologist at Dermatology of Seattle will review your medical history, and may ask questions such as whether or not any family members have had the condition. A physical exam may be performed, examining the affected skin. A blood test may be needed to check the health of your thyroid, as patients with this condition tend to have an autoimmune disease. There are various treatment options, with skin color restoration as the desired goal.

Some choose not to seek treatment and use makeup to cover up the spots, or skin dye, often recommended for children as it avoids side effects from medicine. Topical medication can be applied, such as a very potent topical corticosteroid, which may be combined with other medications. These medications have possible side effects on the skin, causing it to thin, become fragile, and dry. Light therapy is also an option. Many people see results with this therapy, but the skin may lighten again. PUVA light therapy can be used, with psoralen applied to the skin or taken in pill form. Some choose surgery as an option when other treatments do not work. Depigmentation is a technique which removes the pigment from the remaining skin, to give an even skin color. Very few people opt for this treatment, but it may be useful for those who have already lost most of their pigment.