Vitiligo - What Are The Causes, Symptoms & Treatments For It!

Vitiligo is a skin disorder where white patches of depigmentation develop on the skin and keep enlarging. This disorder is long term and continuous in nature. The patches appear due to the death of melanocytes within the skin. Melanocytes are skin pigment producing cells, which produce melanin. Vitiligo can affect the skin of several areas, including the eyes, hair, lips, breasts, etc.

Causes:
The causes of this disease are as follows:

1. Autoimmune disorders in which the immune system of a patient becomes over reactive and the melanocytes are destroyed.
2. Damage to the skin from burns or injury also leads to vitiligo.
3. Exposure of the skin to several harmful chemicals may be a cause.
4. Neural disorders are also responsible for white patches.
5. Vitiligo may be hereditary and passed on from family members.

Symptoms:
Vitiligo has only one major symptom. White, flat spots and patches develop on the surface of the skin. The earliest of these white patches appear on the parts of the body which are exposed to the sun continuously.
It starts off as a simple spot in the beginning and gradually, the spot starts getting pale and finally turns white. The patches have irregular shapes, and in some cases the edges get inflamed and are red in color. Itchiness may be sometimes experienced in some of the affected areas. Symmetrical patches of vitiligo can also occur.

The two major types of vitiligo are:

• Non segmental vitiligo, which affects the back of the hand, the arms, knees, elbows, feet, mouth.
• Segmental vitiligo, which is more stable than non segmental type but spreads faster. It is usually distributed in the areas of the skin, which are supplied by the same nerves.

Treatment:
The different methods of treatment for vitiligo are: Plastic surgery & medical line of conservative treatment.

Plastic Surgery Treatment for Vitiligo:

Indications: Surgery is very much helpful in stable vitiligo patches. Especially in marriage age group patients, if there is very slow or no response to medical treatment, then cosmetic plastic surgery is a better and quicker option.

Contraindications for surgery: In children & in active unstable vitiligo patches.

Outcome varies with the body areas involved such as lips, genitals, eyelids, bony prominences, etc.The various plastic surgical options are as below:

1) Non-cultured Autologous Melanocyte transfer technique for Vitiligo:

This surgery involves taking partial thickness skin graft from normal pigmented donor areas of patient and processing it in laboratory for 2 hours to make melanocyte-keratinocyte suspension. This suspension can then be transferred on to the depigmented & dermabraded recipient Vitiligo pathed. Melanocytes present in suspension will be taken up into the dermabrasion sites and will start producing pigment in 2 to 6 months period and patches will become near normal skin colour.This technique allows larger areas to be treated in a single session using relatively smaller donor site. Also color matching of treated areas is excellent.

2) Autologous Skin Grafts:

This is most commonly used surgical method. Plastic Surgeon harvest skin grafts from the normal, pigmented skin of patient and places these grafts on the dermabraded surface of depigmented areas of Vitiligo or leucoderma.

Such skin grafts are used as sheets of graft or as small stamp grafts with Meek Micro-grafting technique. Sheets of split skin grafts produce uniform pigmentations with no cobblstoning.

Medical or conservative line of treatment:

Phototherapy with UVB and UVA light: Exposing the affected area of the skin to UVB lamps is a popular cure for vitiligo. This treatment can be performed easily at home under guidance of a dermatologist. UVA treatment incorporates taking of a drug which makes the skin more sensitive to ultraviolet light and then the skin is exposed to high doses of UVA light.

Skin Camouflage: Cosmetic creams and makeup can be used to camouflage affected areas of the skin. These topical creams are waterproof.

Depigmentation: Depigmentation is used to treat very widespread areas affecting most of the body by vitiligo. The skin color of the unaffected areas is reduced in order to match the affected areas. It is done using topical ointments.

Vitiligo is a skin disease, the major causes of which are still to be discovered. Proper care and treatment should be taken for skin areas affected by vitiligo.