Vitiligo Treatments: How To Manage This Skin Condition

Vitiligo is a skin condition wherein the cells producing the pigment or color of the skin (melanocytes) are attacked by the immune system. There are several vitiligo treatments available.

Vitiligo is not contagious and it is not life-threatening, however, it can be life-altering. Because vitiligo affects the appearance, it can cause many people to lose self-esteem. Many people might also stay away from people with vitiligo especially if they are not aware of the disease.

0.5 – 1% of the population is affected by vitiligo. The condition occurs in all races but tends to be more noticeable in people with darker skin.

Causes

The specific cause of vitiligo is unknown but what is known is that vitiligo can be caused by:

• Genetics
• Autoimmune disorders, such as thyroid disease

Types of Vitiligo

Nonsegmental Vitiligo

Nonsegmental vitiligo is the most common type of vitiligo, accounting for 80% of cases. In nonsegmental vitiligo, spots on the skin appear on both sides of the body. The spots are usually symmetrical. For example, if there is a spot on the cheek, there is often a matching spot on the other cheek.

There are different types of nonsegmental vitiligo, usually pertaining to where in the body the patches appears in:

• Mucosal Vitiligo – Appears in genital areas, inner nose, lips
• Acrofacial Vitiligo – Face, hands, and feet
• Lip-tip Vitiligo – Lips and fingertips
• Focal Vitiligo – A very small part of the body (but this often spreads quickly, and changes into another form)
• Generalized Vitiligo – Large parts of the body such as the back and chest
• Universal Vitiligo – Vitiligo has spread to more than 80% of the body
• Inflammatory Vitiligo – Patches have a pink border, sometimes with scales forming around the white spot, and is often very itchy
• Koebner Phenomenon – Vitiligo that appears following a skin injury (such as a scratch, scrape, burn or cut)
• Trichrome vitiligo – Vitiligo patch exhibiting three colors: the normal skin color, hypopigmentation, and depigmentation
• Confetti vitiligo – Spotty loss of color on the skin; usually a sign that the disease process is active

Segmental Vitiligo

Segmental Vitiligo is another form of vitiligo that only appears on one side of the body without crossing the middle.

This form spreads faster than the other forms. It rapidly increases in size over 6-12 months, and then remains stable. It is uncommon for segmental vitiligo to cover the entire body.

Signs and Symptoms

Vitiligo can start at any age but it usually shows up before a person reaches the age of 30.

The following are symptoms of vitiligo:

• Loss of color inside the mouth and nose
• Loss of skin color that starts in patches across the skin from the face, hands, genitals, and anywhere in the body
• Patches of hair in the scalp and body starts to grow white or grey at a young age

Diagnosis

If you have observed any abnormal discoloration in your skin, make sure to visit your dermatologist for further assessment.

Your dermatologist will examine your skin using a special lamp (called Wood’s lamp) and ask for your medical history before prescribing any vitiligo treatments. Your doctor might also order a blood test and remove a small sample of your skin for testing.

Vitiligo Treatments

There is no cure for vitiligo however there are treatments and procedures that can be performed to lessen the loss of pigment in the skin.

There are several vitiligo treatments but responsiveness to treatment greatly depends on the person and the type of vitiligo.

The responsiveness of vitiligo to treatment also depends on its location and whether there is affectation of the hair follicles.  For instance, segmental vitiligo can affect the hair follicles, causing patches of white or gray hair. When vitiligo affects the hair, it is less responsive to treatment because the hair follicle is where melanocytes can be found. Other poorly responsive areas are: lip-tip, genitals, mucosal surfaces.

Topical Vitiligo Treatments

• Corticosteroid creams – These creams decrease the inflammation. As a result, some of the color might be brought back to the white patches.
• Calcineurin inhibitor ointments – Creams such as tacrolimus (Protopic) or pimecrolimus (Elidel) affect the immune system and can slow down the loss of pigment in the skin.

Vitiligo Treatments Using Light 

• Ultraviolet B Light Treatment – Healthcare professionals can administer ultraviolet light using a handheld device. For people who need treatment in several areas of the body, they can stand inside a closet-sized lightbox for several minutes while wearing goggles. This treatment needs to be repeated often, about 2-3 times a week for three to six months.

Surgical Vitiligo Treatments

• Cellular Suspension Transplant – The doctor takes a pigmented part and puts the pigment cells (melanocytes) in a solution. They then transplant the melanocytes to the affected area so that skin can grow new melanocytes and show color again.
• Skin Grafting – This procedure is common for those who have small patches of vitiligo. The doctor takes a small section of the healthy skin and transfers it to the area that lost pigment.
• Blister Grafting – The doctor creates blisters on your healthy skin. Then they transplant the tops of the blisters to the areas of the skin that are losing color.
• Depigmentation – Depigmentation is removing the remaining pigment of the skin leaving the person with completely white skin. Only a few people opt for this treatment. Doctors may suggest this treatment for patients with vitiligo covering almost the entire body.

Learn more about Dermatitis here.