White Patches on Skin
Vitiligo, as defined by the Mayo Clinic, ‘is a condition in which your skin loses melanin, (pigment that determines the color of skin, eyes and hair). Vitiligo appears when the cells that produce melanin die or no longer create melanin, resulting in slowly growing white patches of irregular shapes to appear on your skin’.
Michael Jackson had Viligio, although he never publicly revealed his condition – it was only confirmed after his death
- Vitiligo affects people of all races.
- Approximately 65 million people in the world, have Vitiligo.
- In the United States, about 1 – 2 million people have the disorder.
- Vitiligo often first appears between the ages of 10 and 30, although it can start at any age.
- About half the people develop Vitiligo before the age of 20, others will develop the condition after 40.
- Vitiligo tends to be an inherited condition.
- The condition can be localized to one area, or it can affect several different areas on the body.
- Vitiligo is not painful nor is it contagious.
- There is no known cure for Vitiligo.
- The goal of most treatments plans is to slow, or stop the progression of pigment loss and restore color to the skin.
What Causes Vitiligo?
The exact cause of Vitiligo is not known, however, medical experts believe it is an autoimmune condition whereby the body’s immune system attacks and destroys melanin cells in the body. This results in white patches that appear on the skin in different parts of the body. Similar patches also appear inside the mouth and nose, the retina (the inner layer of the eyeball). Hair that grows from affected areas can sometimes turn white.
Some people claim that Vitiligo was triggered by a single event such as an emotional event or a bad sunburn, however there is no scientific research to support these claims.
Symptoms of Vitiligo
The first sign of Vitiligo is the appearance of white patches (depigmentation) on the skin. These patches most often appear on skin that is exposed to the sun, like hands, feet, arms and face, although, it can appear in the armpits, the groin, navel area, around the mouth, eyes, nose, and genitals. There can also be a premature whitening or graying of the hair on the scalp, eyelashes, eyebrows or the beard of men. People with dark skin may notice a loss of color inside the mouth.
Vitiligo usually appears in one of three patterns:
- Focal pattern – white patches limited to one or two areas
- Segmental pattern – white patches that develop on one side of the body. This type tends to occur at a younger age and may develop for one or two years, then stop.
- Generalized pattern – white patches appear on many parts of the body – often symmetrically. This is the most common pattern of development.
The natural course of Vitiligo can be hard to predict. Patches can stop forming without treatment, however, in most cases, pigment loss spreads and can eventually involve most of the surface of the skin.
Diagnosing and Treating Vitiligo
A proper diagnosis of Vitiligo is made by a medical doctor. He or she will conduct a physical examination, review medical history, and order/perform laboratory tests which may include a biopsy of the affected skin to confirm the absence of pigment-producing melanocytes.
Since there is no cure of Vitiligo, the main goal of treating Vitiligo is to improve appearance of the skin. The choice of therapy depends on the number of white patches, the location and size of the patches, and how widespread the condition is.
There is no single treatment or protocol that works for everyone. Each person may have a different response to therapy, and the same treatment may not work for everyone. Current treatment options include either medication or surgery, or a combination of the two.
Treatment protocols include topical treatments such as:
Topical Steroids – Steroid creams can help to return color to the white patches (repigmentation) and is most effective when treating the early stages of the condition. Corticosteroids (steroid creams) are applied to the white patches for at least 3 months before seeing any results. Steroid therapy is not without its side effects. The strength of the cream and the skin itself should be closely monitored by your doctor. Steroid creams can damage the skin, especially in areas where the skin is thinner, such as the face, armpits, or the genital area.
Psoralen Photochemotherapy (PUVA) – This is an ultraviolet therapy often referred to as PUVA and is possibly the most effective treatment for Vitiligo. Psoralen is a drug that contains chemicals that react with ultraviolet light to cause darkening of the skin. An oral form of the drug is taken by mouth or a topical form is applied to the skin. This is followed by timed exposure to sunlight or UVA light that comes from a special lamp. PUVA therapy does not come without side effects. Known side effects of oral Psoralen include sunburn, nausea, vomiting, itching, abnormal hair growth, hyperpigmentation and photosensitivity. It is especially important to minimize exposure to sunlight after treatment since the skin will be extremely photosensitive.
Narrowband Ultraviolet B (UVB) Therapy. Narrowband UVB, which is a special form of UVB light, an alternative to PUVA. While this therapy is similar to PUVA, there is no drug (Psoralen) involved. Because of that, narrowband UVB is a more popular treatment option. Narrowband wavelengths of light can be delivered to smaller areas of affected skin which makes it an effective treatment of Focal Vitiligo.
Excimer Laser. This type of laser delivers controlled beams of special UVB light to the skin. Excimer laser is proving to be an especially effective treatment for dark-skinned patients with Vitiligo and it is ideal for treating small areas of Vitiligo. This therapy can be used in combination with topical drugs. Side effects of Excimer Laser can include redness and blistering.
Depigmentation. Depigmentation is the fading the (good) pigmented skin to match the areas that are white. For those with Generalized Vitiligo, where the condition covers more than 50% of the skin, this is considered the best course of treatment. A specially formulated topical treatment of hydroquinone is applied to pigmented skin twice a day until the skin tone matches. Care to avoid contact with other people after applying this topical cream is important. Side effects include inflammation of the skin, dryness, or itching. Depigmentation is permanent and the treatment leaves the skin very sensitive to sunlight.
Manufacturers like ColorTration offer the best makeup for covering vitiliginous patches on the skin. It easily hides, covers and conceals the depigmentation of Vitiligo on the face and on other body parts which clothing can not hide. This liquid camouflage makeup can set without powder.
The Dinair Airbrush System is another great alternative for covering the signs of Vitiligo. Dinair offers a wide range of colors to match all skin types. Their coverage system totally neutralizes and naturalizes the look of the white patches – that’s because the product is sprayed on, rather than rubbed on. This means it easily camouflages the sharp edges of white patches. In addition, the airbrush can be easily and precisely regulated to match areas that are darker and those that are lighter.
Resources for Those with Vitiligo
If you suspect you have Vitiligo, you should visit your doctor or Dermatologist for an evaluation and diagnosis. In the meantime, we have provided a list of resources where you can find more information about the condition. We hope you find these links helpful.