Vitiligo is a rare skin disorder characterized by patches on your skin due to loss of skin colour in blotches. It can also affect your eyes, mouth, and nose. It occurs when melanocytes die or stop functioning. Melanocytes are the melanin-producing cells located in your skin. Melanin is a pigment that is responsible for your skin colour. Melanin protects your body from harmful ultraviolet radiation.

The prevalence of vitiligo ranges from 0.4 to 2.0 percent worldwide. The rate and severity of color loss in patients with vitiligo is unpredictable. Vitiligo is not a life-threatening condition and it is not contagious. The treatment for vitiligo may improve the appearance of the affected skin but does not cure the disease.

Types of vitiligo

There are two different types of vitiligo, segmental and non-segmental.

Segmental vitiligo : It has different forms and spreads more rapidly. It affects only one part of the body such as the face or one limb.

Non-segmental vitiligo : It is the most common type of vitiligo, and 90 % of people are affected with this disorder. The patches appear symmetrically on the skin which is exposed to the sun. Mostly, they appear on the back of your hands, arms, eyes, knees, elbows, and mouth.

The primary symptom of vitiligo is the discoloration of the skin (light or white patches on your skin). The other signs and symptoms include:

  • Graying of the hair on scalp, eyebrows, eyelashes, or beard
  • Loss of color in the inner linings of your mouth and nose
  • Change in color of the eyeball (retina)
  • Discolored patches near the armpits, navel, genitals and rectum

It can affect the individuals of any age, but most commonly occurs before the age 20.

The exact cause of vitiligo is unclear. However, it is believed that vitiligo may occur as a result of autoimmune response, which means, your body affects its own cells. It occurs when your body mechanisms destroy the melanocytes. In some cases, it may be due to genetic mutations or may be hereditary.

The autoimmune diseases associated with vitiligo include alopecia, hyperthyroidism, Addison’s disease, and pernicious anemia.

Your doctor starts the diagnosis by a performing physical examination, and taking a medical history. If your doctor suspects vitiligo, following tests are suggested to confirm the diagnosis.

Skin biopsy : A small piece of affected tissue is removed and examined under the microscope.

Blood test : A sample of your blood is tested for the levels of vitamin B12 and thyroid hormones.

Your doctor may refer to an eye specialist to identify any inflammation in your eye. He/she may also recommend you to undergo a hearing evaluation because people with vitiligo may have the risk of hearing loss.

The primary goal of the treatment is to reduce or eliminate the symptoms. Your doctor might suggest any of the following treatments.

Phototherapy with UV light : The UV therapy helps to restore the melanin. The affected area is exposed to UVA and UVB lamps.

Skin camouflage : When the vitiligo is mild, the white patches are camouflaged with cosmetic colored creams and makeup. It can last for 12-18 hours on your face and up to 96 hours for the rest of the body. Most of the topical applications are waterproof.

Depigmenting : This treatment is suggested when the affected area covers more than 50 % of your body. It reduces the skin color in the unaffected area to match with the affected area. Topical ointments or lotions like monobenzone, mequinol or hydroquinone are used.

Topical corticosteroids : Corticosteroids are used to stop the spread of the patches.

Calcipotriene (Dovonex) : It is a form of vitamin D and works by reducing the growth of melanocytes. It may be used in combination with corticosteroids or light therapy.

Surgery : Your doctor might recommend a surgical procedure when the light therapy or the other drugs do not reduce the symptoms. Any of the following surgeries might be recommended:

  • Skin grafting: Your surgeon removes a small section of the normal skin and attaches to the affected area.
  • Blister grafting: Your surgeon creates a blister on your pigmented skin and then removes the top of the blisters and transplants them to the affected area.
  • Tattooing (micropigmentation): The surgery involves the use of a special surgical instrument to implant a pigment into your skin.