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Vitiligo - Symptom, Treatment And Causes

Last Updated: Oct 04, 2021

What is Vitiligo?

Vitiligo is a disease caused by the destruction of the skin’s melanocytes in certain areas of the body. Patients suffering from this disease are seen with small white spots on the skin in any location of the body. Vitiligo can be localized and focal in one area, or it may be found in different areas on the body.

Vitiligo is a dermatological condition that is characterized by white patches of skin on several parts of the body. The condition is caused due to the destruction of melanocytes which are the cells that are responsible for skin pigmentation. It may also be due to autoimmune thyroid disease.

The condition may be mild with one or two spots or may be severe with depigmentation in larger areas of skin. It is common in people with autoimmune disorders, is not contagious, and is not always progressive in the affected persons. Vitiligo is a long-term skin condition that cannot be cured.

What are the causes of Vitiligo?

Although the exact cause for this skin depigmentation malady is still unknown, it is believed that this illness happens, when the patient’s immune system mistakenly attacks and destroys certain cells within its own body. Hence this disease arises out of an autoimmune condition in the patient’s body.

Generally, people develop this illness prior to their age of 40, and out of the half of the people develop this condition even before they are in their 20s. Experts say that this disease can have a genetic component in it since it has been observed that vitiligo run on members of the family.

However, experts on this disease are also of the opinion, that vitiligo can also occur because of associated medical conditions, like dysfunction of the thyroid glands.

Can Vitiligo spread overnight?

Medical experts are still going through the time duration between the development of disease and how long it takes to show up on the surface of the patient.

One can see the appearance of the symptoms at any time of the day or night. So yes, one may see Vitiligo exist or spread after a happy sleep time.

What are the symptoms for Vitiligo?

  • White patches on the skin mostly on the foot, face, hands, lip and several places.
  • Sensitivity to sunlight
  • Emotional and psychological distress
  • Small white spots on navel, armpits, groin, genitals and near the rectal area

Is Vitiligo a genetic disease?

There are many reasons which can trigger the occurrence of Vitiligo, genetic abnormalities are one of them. It is rare and only seen in about 1/5th of the people but in some cases, Vitiligo can be passed through by your ancestors.

At what age Vitiligo starts?

Depending on the root cause of the occurrence, Vitiligo can occur at any stage of life. However, research has shown that most of the cases occurred between 10-30 years of age.

Furthermore, the development of this medical condition is quite rare in infancy and old age.

How to diagnose Vitiligo?

It has been observed that there is no way by which the doctors can predict whether this depigmentation of the skin will remain confined in one location or spread all over the patient’s body.

  • Skin Biopsy: Small tissue of the affected area is taken and sent for biopsy to verify the problem.
  • Blood Test: Little amounts of blood is collected to perform lab tests for the final confirmation.
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What are the various types of Vitiligo?

Vitiligo is classified into two types:

  • Segmental vitiligo: It is less common and more noticed in early age groups. This type of vitiligo is non-symmetrical. Non-segmental vitiligo occurs in 90 per cent of the affected persons and is symmetrical and are more common in areas that are regularly exposed to the sun.
  • Non-Segmental vitiligo: While non-segmental vitiligo may not respond to topical treatments, the more stable and less erratic segmental vitiligo responds quite well to topical treatments.

What is the best treatment for vitiligo?

There a number of treatments available to restore the colour of the skin. But the results vary under different situations and sometimes are unpredictable. Some of the treatments can have various side effects and if your doctor has prescribed you any drug, surgery or therapy then the process takes months to show its effectiveness.

Sometimes if the treatment is successful then also the patches can come back or new patches may reappear. There are no medications that can treat vitiligo or bring back the pigment cells called melanocytes. But the skin tone can be restored by using some of the creams or by doing light therapy.

Skin tone restoration

  • Cream controlling inflammation:

    To bring back colour in the skin tone corticosteroid cream can be applied but in the starting of the disease. This process takes time and there may not be any change in the skin colour for several months. There can be a side effect on the skin like skin thinning or appearance of lines.

  • Medicines affecting the immune system:

    Cream or ointment which contains tacrolimus or pimecrolimus may be effective for the small area patches like and especially for face and neck.

Therapies

  • Light and psoralen combination:

    This is the treatment which combines substances derived from a plant known psoralen with light therapy which returns colours to the patches. After taking psoralen by applying it to the skin or by taking it by mouth you are exposed to the ultraviolet rays (UVA or UVB), thus giving better results to the medicine.

  • Depigmentation

    If vitiligo is widespread then this treatment is useful. An agent for depigmentation is applied to the pigmented area of the skin which then gradually brightens and blends with the skin. This is done for 9 months and should be repeated once or twice in this time period. There can be side effects like swelling, itching, irritation, redness, and dry skin.

Surgery

  • Skin Grafting

    A small section of normal skin is taken out by the doctor and then it is attached to the skin which has lost the pigmentation. This procedure is done when there are small patches of vitiligo.

  • Blister grafting

    In this process blisters are created by the doctor on your skin by the suction process then the top of the blisters are removed and they are transplanted to the discoloured skin.

Who would need a vitiligo treatment?

Anyone who has been diagnosed with the condition can undergo treatment for vitiligo. Vitiligo is a continual skin problem and differs in the intensity and magnitude of each patient.

An expert should be consulted before deciding on the treatment option. Although a complete cure for the condition is not possible the treatments can be opted for to minimize the visible effects of the skin condition.

As in any illness or medical condition treating early will give pronounced results, vitiligo too, if treated early can be kept under control. Especially children and young adults should be given treatment on a diagnosis of the condition.

Who is not eligible for the treatment?

Vitiligo is likely to affect 1 per cent of the global population, and the condition may run in families. While the topical treatments and phototherapy can be offered to adults and young adults of all gender, the surgical options must be thought about before undergoing the treatment.

The surgeon will assess the patient’s conditions before suggesting the surgical treatment of vitiligo. The surgical treatment is not a good option for children and for those who can scar easily.

For children, topical treatments can safely be opted for after a consultation with a dermatologist. Phototherapy with UVA radiation can be administered to a child of over 12 years of age. However, the risks and benefits are carefully weighed before going for the treatment.

Can Vitiligo go away?

Since it is an autoimmune disorder, it does not go away as the root cause of the disease is your immune system only.

One can treat the medical condition with the help of extensive treatment but it will keep on coming if not taken care of.

What are the side effects of vitiligo treatment?

Different side effects have been reported with different treatment options. In the case of topical corticosteroids and other topical creams, a possible serious side effect is skin atrophy. The skin becomes very thin, dry, and fragile and hence, the usage of topical creams has to be discontinued after the prescribed period.

Also, the patients need to be regularly monitored by the medical practitioner. The oral medication, psoralen that increases the skin sensitivity to UV radiation may affect the eyes. Hence, eye examinations before and after the treatment are essential. Possible side effects of surgical treatment include cobble-stone like skin and infection.

What care is necessary after vitiligo treatment?

In general, anyone with vitiligo must avoid being in the hot sun. Wearing protective clothing and use of high-factor sunscreen will be of help. Avoid getting skin injury as white patches tend to increase in the injured area.

Other than these, there are no specific measures to be taken care of post any treatment for vitiligo. However, regular monitoring of Autoimmune conditions and thyroid function is necessary. Also, care is to be taken in the case of psychological depression.

How long does it take to recover?

Vitiligo is not completely curable, and treatments can only minimize the visible white patches and improve the skin conditions. Hence, continual monitoring is required, and the treatments are to repeated according to the advice of a dermatologist.

How long does Vitiligo last?

The presence of the disease is permanent within an individual, although its surface symptoms do have a recovery date.

Depigmentation due to Vitiligo can last up to 12-14 months. The time duration also depends on the cause, skin tone, environmental factors, and treatment method.

Note: The treatment of Vitiligo often makes the skin more fragile making it more prone to have a long duration if it comes back.

What is the price of the vitiligo treatment in India?

While the cost of topical treatments would be quite minimal, a phototherapy treatment may cost between Rs. 2000 to Rs. 5000. Surgical procedures may be a little expensive and can vary between Rs. 20000 to Rs. 40000 for treatment of white patches on the patient’s hands.

Is Vitiligo curable or not?

Vitiligo is a disease which can affect the people of any group and it is said that there is no cure for this disease and is a lifetime condition. Vitiligo is most of the times genetic and the exact cause of the disease is unknown it an autoimmune disorder or caused by a virus, but there are treatment options available for this disease. Vitiligo or small white spots on the skin can be identified when there is a loss of colour tissues from the body.

What are the alternatives to vitiligo treatment?

Certain alternative therapies are available apart from conventional medicine. Homoeopathy and Ayurveda promise relief from the condition, however, it may take considerable time to notice visible results.

Is sun good for Vitiligo?

No, since Vitiligo can make your skin sensitive, one may get more vulnerable to skin damage in case they go out without any sunblock. In the case of Vitiligo, the melanin which is responsible for skin protection against UV light becomes low, resulting in more damage.

It is advisable to avoid direct contact with sun rays and if one has to go out, using products like sunscreen and other protective products is a must, especially if you have fair skin.

Does exercise help Vitiligo?

Direct effects of exercise on Vitiligo are still under the shades. Research is not sure whether it is helpful or degrading for an individual to indulge in some physical activity.

However, it is advisable to have a moderate fitness regime to maintain the overall fitness of the body. Exercise can help you have a better immunity system which prevents further damage caused by skin sensitivity. It will also uplift your mood and helps you deal with psychological issues.

Can you stop the spread of vitiligo?

This is the biggest concern of the people suffering from Vitiligo that how it can be stopped from spreading. Vitiligo is a disorder that is seen in the due course of time and is a visible disease.

Vitiligo can also spread in hair and vitiligo affected area in the hair turns white in colour. Vitiligo can be hereditary and sometimes it runs in families and this may suggest that genetics also play a major role in this.

These are some of the methods which help vitiligo from stop spreading:

  • Stress and depression can spread vitiligo
  • Milk products or eating non-veg with milk products are responsible for the spreading of vitiligo.
  • Vitiligo can be triggered by the intake of the citrus item in a large amount
  • Deficiency of vitamin B12 another reason for spreading of vitiligo
  • Going swimming in the pool which has chlorinated water can affect vitiligo

What should not eat in Vitiligo?

Since it is an autoimmune disease, there is no specific diet that can cure or boost up the recovery of Vitiligo. Although some patients have shown flare-up in case they consume the following consumables:

  • Wheat products.
  • Citrus fruits like blueberry, gooseberry, pomegranate, grapes, tomatoes, etc.
  • Caffeine.
  • Alcohol.
  • Fermented food products like pickles, and curd.
  • Fish and red meats.

What are the home remedies for vitiligo?

There can be a certain condition of nutrients which are lacking in the body of a human are the cause of vitiligo. But there is no evidence found that by eating some of the food products can stop or improve vitiligo.

People try to do some treatment of vitiligo at home, but no evidence found that it can be cured or not:

  • Gingko Biloba paste
  • Turmeric and mustard oil mixture
  • Lemon and sweet basil extract mixture

Though there is no prescribed diet for vitiligo these things can be eaten for prevention:

  • Fruit- banana, apple
  • Leafy green vegetables like kale or romaine lettuce
  • Chickpeas
  • Root vegetables like beetroots, carrots or radishes
  • Figs and dates

Key Highlights:

  • Safety: Medium
  • Effectiveness: Medium
  • Timeliness: Medium
  • Relative Risk: High
  • Side Effects: High
  • Recovery Time: High
  • Price Range: RS. 2000 - Rs. 40,000
  • Recovery Time: High
  • Price Range: RS. 2000 - Rs. 40,000
Summary: Vitiligo can be described as a medical condition that causes abnormal pigmentation resulting in skin color discoloration in the form of white patches. It is a progressive autoimmune disease that does not cause any physical complications for an individual.

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Written ByDr. Santosh BhatiaMS - General Surgery,M. Ch. (Plastic Surgery),MBBS Bachelor of Medicine and Bachelor of SurgeryCosmetic/Plastic Surgery
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