Vitiligo (vit-ill-EYE-go) is a disorder in which white patches of skin appear on different parts of the body. This happens because the cells that make pigment (color) in the skin are destroyed. These cells are called melanocytes (ma-LAN-o-sites). Vitiligo can also affect the mucous membranes (such as the tissue inside the mouth and nose) and the eye.
What Causes Vitiligo?
The cause is not known. Vitiligo may be an autoimmune disease. These diseases happen when your immune system mistakenly attacks some part of your own body. In vitiligo, the immune system may destroy the melanocytes in the skin. It is also possible that one or more genes may make a person more likely to get the disorder.
Some researchers think that the melanocytes destroy themselves. Others think that a single event such as sunburn or emotional distress can cause vitiligo. However, these events have not been proven to cause vitiligo.
Who Is Affected by Vitiligo?
In the United States, two to five million people have the disorder. Most people with vitiligo develop it before their 40th birthday. The disorder affects all races and both sexes equally.
People with certain autoimmune diseases (such as thyroid disease) are more likely to get vitiligo than people who don’t have any autoimmune diseases. Scientists do not know why vitiligo is connected with these diseases. However, most people with vitiligo have no other autoimmune disease.
Vitiligo may also run in families. Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it.
What Are the Symptoms of Vitiligo?
White patches on the skin are the main sign of vitiligo. These patches are more common in areas where the skin is exposed to the sun. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:
- The armpits and groin (where the leg meets the body)
- Around the mouth
- Eyes
- Nostrils
- Navel
- Genitals.
People with vitiligo often have hair that turns gray early. Those with dark skin may notice a loss of color inside their mouths.
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Will the White Patches Spread?
There is no way to tell if vitiligo will spread. For some people, the white patches do not spread. But often the white patches will spread to other areas of the body. For some people, vitiligo spreads slowly, over many years. For other people, spreading occurs quickly. Some people have reported more white patches after physical or emotional stress.
How Is Vitiligo Diagnosed?
The doctor will use a family and medical history, physical exam, and tests to diagnose vitiligo. The doctor may ask questions such as:
- Do you have family members with vitiligo?
- Do you or your family members have any autoimmune diseases?
- Did you have a rash, sunburn, or other skin problem before the white patches appeared?
- Did you have some type of stress or physical illness?
- Did your hair turn gray before age 35?
- Are you sensitive to the sun?
The doctor will do a physical exam to rule out other medical problems.
Tests might include:
- Taking a small sample (biopsy) of the affected skin to be examined
- Blood tests
- An eye exam.
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How Is Vitiligo Treated?
Treatment may help make the skin look better. The choice of treatment depends on:
- The number of white patches
- How widespread the patches are
- The treatment the person prefers to use.
Some treatments are not right for everyone. Many treatments can have unwanted side effects. Treatments can take a long time, and sometimes they don’t work.
Current treatment options for vitiligo include medical, surgical, and other treatments. Most treatments are aimed at restoring color to the white patches of skin.
Medical treatments include:
- Medicines (such as steroid creams) that you put on the skin
- Medicines that you take by mouth
- A treatment that uses medicine plus ultraviolet A (UVA) light (PUVA)
- Removing the color from other areas so they match the white patches.
Surgical treatments include:
- Skin grafts from a person’s own tissues. The doctor takes skin from one area of a patient’s body and attaches it to another area. This is sometimes used for people with small patches of vitiligo.
- Tattooing small areas of skin.
Other treatments include:
- Sunscreens
- Cosmetics, such as makeup or dye, to cover the white patches
- Counseling and support
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What Can People Do to Cope With Vitiligo?
- When you have vitiligo, you may be upset or depressed about the change in your appearance. There are several things you can do to cope with the disorder:
- Find a doctor who knows how to treat vitiligo. The doctor should also be a good listener and be able to provide emotional support.
- Learn about the disorder and treatment choices. This can help you make decisions about your treatment.
- Talk with other people who have vitiligo. A vitiligo group can help you find a support group (check your local listings). Family and friends are another source of support.
Some people with vitiligo have found that cosmetics that cover the white patches improve their appearance and help them feel better about themselves. A person may need to try several brands of concealing cosmetics before finding the product that works best.
What Research Is Being Done on Vitiligo?
Research on vitiligo has increased in recent years. A large study of families with vitiligo is looking for genes that might cause the disorder. Researchers continue to look for the causes of and new treatments for vitiligo.
