Condition: Vitiligo

Vitiligo is a chronic autoimmune disease that causes a loss of pigmentation in patches of skin leaving them white. Patches are most common on the face, neck, hands, and in skin creases, but any area of the body can be affected.

The sizes of the patches and the speed at which they widen and spread can vary. If vitiligo affects areas of the skin with hair, the hair may also lose pigmentation, turning white. This condition can affect all skin types but can be more noticeable in people with darker skin. Vitiligo is not life-threatening or contagious.

Vitiligo occurs when melanocytes, the cells that produce pigment, die or stop producing melanin. It’s not clear exactly what causes this to happen but it may be linked to:

• Autoimmune conditions – If the immune system isn’t functioning as it should, it may start attacking healthy cells and tissue.
• Genetics – Vitiligo can be hereditary, and it can also develop as a result of changes in inherited genes.
• A trigger event – Stress, skin trauma, severe sunburn or contact with a strong chemical such as phenol can bring on vitiligo.

Vitiligo is diagnosed by reviewing medical history and examining the skin in natural light. A ‘Wood’s Lamp’ may then be used to see patches more clearly and help differentiate them from other skin conditions.

Signs and symptoms of vitiligo include:

• Loss of pigment in patches of skin.
• Head hair, eyelashes, eyebrows or facial hair whitening or greying prematurely.
• Patches may feel itchy. It’s rare to feel pain or discomfort.
• If vitiligo affects the eyes it can cause changes in eye colour.
• If melanocytes in the inner ear are affected, vitiligo can cause hearing loss.

Vitiligo can develop at any age, but 95% of people will be affected before age 40.

• Corticosteroid creams – Applying a corticosteroid cream to the affected areas may increase pigmentation with improvements seen after several months of use
• Corticosteroid pills or injections – These may be used in cases that are progressing quickly to aid with repigmentation and to slow down pigment loss
• Phototherapy – Various types of light therapy may help in slowing down the loss of pigment and restoring some skin colour. These are often more effective when used in conjunction with steroid creams
• Surgery – If other treatments are ineffective, a skin graft or cell transplant may be performed to re-pigment the skin