Since vitiligo affects a person’s appearance, it can be upsetting. But, it is not dangerous, nor is it a form of skin cancer. It’s not an infection like MRSA. And it’s not contagious, so you can’t catch it from someone else. Most people who have vitiligo are every bit as healthy as everyone else.
It helps to understand how the skin gets its color in the first place. Melanocytes are cells that determine skin color. They generate melanin, which gives skin its color and helps protect it from the sun.
You get your skin color not by how many melanocytes you have, but by how active the cells are. Dark people have cells that produce a lot of melanin, while light people produce much less.
Sometimes, the skin seizes to produce melanin. Primarily, this may lead to a macule that is lighter in color than the skin around it. In time, these white patches may spread and grow to cover a more substantial portion of the body. Sometimes, these white patches spread fast at first and then remain stable for years. Other times, the spread is slower, occurring over a more extended period.
Although vitiligo affects people of all races, the spots tend to be more noticeable on darker skin.
Types of Vitiligo
There are three types of vitiligo, depending on how many patches someone has and where they are on the body:
Focal vitiligo – a few spots in a single area.
Generalized vitiligo – many patches all over the body. They tend to affect the right and left sides of the body in a symmetrical pattern, like a mirror image. It is the most common type of vitiligo.
Segmental vitiligo – patches on one part or side of the body and usually nowhere else. It is the least common type of vitiligo.
Vitiligo can happen anywhere on the body, but it’s more likely to develop in some areas:
- skin exposed to the sun, such as the face or hands
- skin that has folds, such as the elbows, groin, or knees
- skin around the eyes, nostrils, belly button, and genital areas
Because pigment cells give color to hair as well as skin, some teens with vitiligo may notice graying of the hair or a loss of color on the lips.
Causes of Vitiligo
Experts do not know what causes vitiligo, but they do have theories. Some think it is the immune system attacking healthy melanocytes. Others believe it is genetic.
Scientists are not sure if the risk of developing vitiligo increases in people with a family history of alopecia and diabetes.
Do I have vitiligo?
A dermatologist can usually tell if someone has vitiligo by looking for the telltale white patches. On people with fair skin, they use a unique tool called a Woods lamp. This lamp uses ultraviolet light in a dark room to illuminate areas of damaged skin that would otherwise be hard to see with the naked eye.
The doctor also may do a blood test to check for diabetes and thyroid problems, since they can increase the risk of vitiligo.
In rare occasions, a doctor may perform a biopsy to check whether there are pigment cells in the skin. If the biopsy shows there are no pigment cells, this may confirm a case of vitiligo.
Is there a cure for vitiligo?
There is no cure for vitiligo. Sometimes, patches go away on their own. But when that does not happen, doctors can prescribe treatments that might help even out skin tone. Some of these treatments are things you can try at home.
People and conditions are different, so what works for one person may not work for another. And no vitiligo treatment is likely to be 100% effective at making the spots disappear altogether.
Home Care Treatment for Vitiligo
Sunscreen. Use a good sunscreen every day. Because vitiligo spots have no melanin, they cannot tan. Without sunscreen, vitiligo patches may burn or scar. Getting a tan on the rest of your body will only highlight the white spots, especially if you have light skin.
Cosmetics. Many different kinds of concealers are available, both over-the-counter and through a dermatologist. Ask your doctor for recommendations and try different brands until you find the one that works best for you.
Medical Treatment for Vitiligo
Some of the more common medical treatments for vitiligo include:
Corticosteroid creams. When applied to white patches very early in the disease, corticosteroids may help bring some color back to the skin.
PUVA. A medication called psoralen is either applied to the white patches of skin or taken by mouth. The skin is then subjected to ultraviolet light, sometimes from the sun, but more often from an artificial source like a UVA lamp. It turns the affected skin pink, which in time tends to fade to more natural color. You will want to ask your dermatologist about side effects of PUVA treatment.
Narrow-band ultraviolet B (UVB) therapy. This treatment is more popular than PUVA. It is similar, except that the ultraviolet light used is UVB instead of UVA. UVB treatment does not require psoralen, eliminating some of the risks associated with PUVA.