Are You Experiencing Vitiligo?
Vitiligo is a common skin disorder that impacts about 1% of the world’s population. Although not considered dangerous, vitiligo does pose some important physical and emotional concerns for those who are experiencing the disorder. Despite its frequency, researchers are still learning the exact causes of vitiligo.
If you or a loved one is suffering from vitiligo, there are treatments available that can reduce the appearance of the characteristic skin discoloration. The team at Buckhead Dermatology can walk you through your options and help you feel good about your skin.
An Overview of Vitiligo
Vitiligo is a disorder that causes patches of depigmentation in the skin. The patches appear as smooth, white spots that vary in size and location. Vitiligo occurs when the body’s immune system attacks its own melanocytes, the pigment-producing cells in the skin. When the melanocytes are destroyed, they no longer output melanin, and the skin loses its pigment in that location.
Vitiligo can appear anywhere on the body, including inside the mouth, nose, eyes and ears. More commonly, it will present on the hands, feet and face. Vitiligo can also cause the hair that grows from the affected skin to turn white. If you notice the appearance of white patches on the skin, consult with a dermatologist to get an accurate diagnosis.
Some of the most common signs of vitiligo include:
- Loss of natural skin color in patterned patches.
- Discoloration of the tissues inside the mouth.
- Loss of skin color in small, medium or large patches.
- Premature whitening of the hair on the eyelashes, beard, eyebrows or scalp.
- Color changes in the iris of the eye.
Types of Vitiligo
Doctors have determined the types of vitiligo based on where and the extent to which it occurs in the body. The two primary types of vitiligo include:
Generalized: This is the most common form of vitiligo. It can appear anywhere on the body, including the face, in mucous membranes and around body cavities such as the nose, mouth and genitals.
Segmental: Often begins at an early age and progresses for about one year. Segmental vitiligo will commonly appear on one smaller area of the body, such as the legs, hands or face.
Who is at Risk for Vitiligo?
Vitiligo can occur in people of all skin types, races, sexes, and ages. In about half of all reported cases, the onset of vitiligo begins between the ages of 10 and 30 years old. Contrary to popular belief, vitiligo occurs in people with light skin and dark skin equally. The misconception comes from the fact that it is usually more noticeable among people with darker skin tones.
Researchers are still learning more about the disorder to determine if it is a hereditary condition. According to the U.S. National Library of Medicine, one-fifth of people who have vitiligo also have a close relative with the skin disorder. However, doctors have found that most cases are not linked to inheritance but could be dependent on any number of factors, including autoimmune diseases, toxins and even stress.
Prognosis and Treatment of Vitiligo
Although there is no cure for vitiligo, it is not considered a life-threatening skin disorder, and it is not contagious. Many people who have vitiligo report experiencing negative emotional effects, including low self-esteem, stress, and depression due to the public’s reaction to their visible skin discoloration.
With treatment, some patients can regain some of their skin’s normal coloration. The treatment prescribed by a dermatologist will vary depending on factors including a person’s health, age and the type of vitiligo they are experiencing. Some of the most common treatments can include:
No Treatment: Some people may choose to camouflage vitiligo symptoms using makeup, hair and skin dyes, self-tanners and sunscreens. This course of treatment is often recommended for children because it is safe and does not require the use of medications. The downside of this option is that it can be time-consuming and takes practice to cover the patches naturally.
Repigmentation Medication: For those who have smaller areas of vitiligo, a dermatologist may recommend corticosteroids, topical Vitamin D or other medications to add color to the skin. Treatment may take several months to see results and can cause adverse side effects such as stretch marks and skin atrophy.
Light Therapy: An effective, but more time-consuming treatment, light therapy uses light and laser treatments to induce skin repigmentation. Depending on the size and scope of the vitiligo, a dermatologist may use therapies such as Narrow Band Ultraviolet B or Excimer Laser. PUVA light therapy is another option; however, this treatment can take up to a year and has the potential to negatively impact the eyes.
Surgery: When other treatments are not effective, some patients may opt for surgery. Most surgical procedures for vitiligo involve removing skin from one part of the body and relocating it to cover the impacted areas. Infection is a possible side effect, and this treatment is not always successful.
How to Care for Your Vitiligo
Natural sunlight can be beneficial. However, the lighter patches are more likely to burn so talk with your dermatologist about how much natural light would be beneficial for you.
Frequently Asked Questions About Vitiligo Treatment
Can vitiligo be reversed, or can skin regain its natural color?
Although there is currently no cure for vitiligo, some treatments can help restore pigment to affected areas of the skin. Prescription topical medications and light-based therapies may stimulate repigmentation, although results vary depending on the location, extent and activity of the condition. Areas such as the face often respond better than the hands and feet. Dr. Straughn evaluates each patient's vitiligo to determine which treatment options may offer the greatest potential for improvement.
What is the best vitiligo treatment for darker skin tones?
Vitiligo affects people of all skin tones, but the contrast between depigmented patches and surrounding skin is often more noticeable in patients with darker complexions. Treatment options may include prescription topical medications, narrowband UVB phototherapy or other therapies designed to encourage repigmentation. The most appropriate approach depends on the extent and location of the affected areas. At Buckhead Dermatology, Dr. Straughn has extensive experience treating skin of color and develops individualized recommendations that consider each patient's skin characteristics and treatment goals.
How long does it take to see results from vitiligo treatment?
Vitiligo treatment generally requires patience because repigmentation develops gradually. Some patients begin noticing small areas of returning pigment after several months of consistent treatment, while others may need six months or longer to evaluate their response. Results depend on the type of treatment, the location of the patches and how long the condition has been present. Regular follow-up appointments allow your dermatologist to monitor progress and adjust the treatment plan when necessary.
Is vitiligo associated with thyroid disease or other autoimmune conditions?
Yes. Vitiligo is considered an autoimmune condition in which the immune system attacks melanocytes, the cells responsible for producing skin pigment. People with vitiligo have an increased risk of certain autoimmune disorders, particularly autoimmune thyroid disease. However, having vitiligo does not mean you will necessarily develop another autoimmune condition. During an evaluation, Dr. Straughn may review your medical history and symptoms to determine whether additional testing or coordination with another healthcare provider is appropriate.
When should I see a dermatologist for new or spreading white patches on my skin?
You should consider seeing a dermatologist if you notice new white patches, areas of skin losing pigment or existing patches spreading to other parts of your body. Although vitiligo is one possible cause, other conditions, including fungal infections and post-inflammatory pigment changes, can produce similar symptoms. An accurate diagnosis is important before beginning treatment. Conveniently located in Buckhead, Atlanta, Buckhead Dermatology provides individualized vitiligo evaluations and treatment recommendations for patients throughout Atlanta, Sandy Springs and Brookhaven.