Vitiligo is a chronic skin condition characterised by the loss of pigment, leading to white patches on the skin. This occurs when melanocytes, the cells responsible for producing melanin, are destroyed or stop functioning. Vitiligo can affect any part of the body, including the face, hands, feet, and even mucous membranes. While it is not harmful or contagious, vitiligo can have a significant psychological and emotional impact due to its visible appearance.
Vitiligo is categorised into several types based on the distribution and extent of depigmentation:
- Segmental Vitiligo:
- Affects one side of the body or a single segment, often appearing in a dermatomal pattern.
- Typically develops at a younger age and progresses rapidly within the first year before stabilising.
- Focal Vitiligo:
Limited to a few small patches in a specific area, without spreading for several years.
- Non-Segmental Vitiligo (Generalised):
- The most common form, with symmetrical white patches appearing on both sides of the body.
- Commonly affects the face, hands, and areas around body openings like the mouth or eyes.
- Universal Vitiligo:
A rare form where most of the skin loses pigment, resulting in widespread depigmentation.
The exact cause of vitiligo is not fully understood, but several factors may contribute to its development:
- Autoimmune Response: The immune system mistakenly attacks melanocytes, leading to their destruction.
- Genetic Factors: A family history of vitiligo or autoimmune diseases increases the risk.
- Environmental Triggers: Stress, skin trauma (e.g., cuts or sunburn), or chemical exposure may act as triggers.
- Oxidative Stress: An imbalance of free radicals and antioxidants in the body may damage melanocytes.
- Neurogenic Hypotheses: Abnormal nerve signals may contribute to melanocyte destruction in certain cases.
The choice of treatment depends on the extent and location of depigmentation, as well as the patient’s preferences.
While there is no definitive cure for vitiligo, various treatments can help restore pigment, manage symptoms, and improve quality of life.
At-Home Care:
- Sun Protection: Use broad-spectrum sunscreen (SPF 50+) to protect depigmented areas, which are more prone to sunburn.
- Camouflage Products: Use makeup or self-tanning lotions to blend depigmented patches with surrounding skin.
Medical Treatments
- Topical Medications: Corticosteroids or calcineurin inhibitors (e.g., tacrolimus) to reduce inflammation and encourage repigmentation.
- Phototherapy: Narrowband UVB (NB-UVB) therapy is a common and effective treatment to stimulate melanocyte activity.
Advanced Options
a)Depigmentation Therapy: For extensive vitiligo, depigmentation of the remaining normal skin may create a uniform appearance.
b)Surgical Treatments: Skin grafting or melanocyte transplantation may be options for stable, localised vitiligo.
c)Biologics and Emerging Therapies: New treatments targeting the immune system, such as JAK inhibitors, are showing promise in clinical trials.
Lifestyle and Support
a)Stress Management: Stress may worsen vitiligo, so relaxation techniques like yoga or mindfulness can help.
b)Psychological Support: Counselling or support groups can address the emotional impact of vitiligo.
Ongoing Care
Vitiligo management requires a combination of treatments and consistent follow-up with a dermatologist to monitor progress and adjust therapies. Early intervention can help improve outcomes and slow the spread of depigmentation.
For personalised advice and effective treatment options, organise a referral from your GP to streamline a consultation with our dermatology team today. Let us support you on your journey toward healthier, more confident skin.
