What You Need To Know About Vitiligo: From Ointments to Surgery

Vitiligo is a rare skin condition that occurs when the immune system starts attacking pigment-producing skin cells (melanocytes). As a result, patches of white and or pink appear on the skin. These patches can unfortunately affect the self-esteem of the people who have it due to social beauty standards and the pressure to fit in. While the condition is neither contagious nor life-threatening, vitiligo treatments do exist in the form of topical ointment, light therapy, and surgery.

What Causes Vitiligo?

The specific cause of vitiligo is unknown. However, research suggests that it can stem from genetic factors, disorders of the immune system, or skin trauma. This can include severe burns or contact with a harsh chemical.

Nonsegmental vitiligo is the most common type of vitiligo, accounting for 80 percent of cases. Here, there are symmetrical spots on both sides of the skin. For example: If there is a spot on one cheek, there is often a matching spot on the other.

This type of vitiligo can have different patterns and show up in various parts of the body, such as the hands and feet (acrofacial vitiligo), lips and fingertips (lip-tip vitiligo), or large portions of the back and chest (generalized vitiligo). There’s also universal vitiligo (the pattern covering 80 percent of the body) and inflammatory vitiligo (wherein an itchy, pink border forms around the white spot).

Meanwhile, doctors refer to vitiligo that appears after a skin injury (scratch, scrape, burn, or cut) as the Koebner Phenomenon.

A second type is segmental vitiligo, which appears on one side of the body without crossing the middle. This spreads faster than nonsegmental vitiligo and starts to cover the body within six months to a year. Segmental vitiligo doesn’t respond well to usual forms of vitiligo treatment unless they start very early. However, it is very responsive to surgical melanocyte-keratinocyte transplant.

Symptoms and Diagnosis

Vitiligo can start at any age, though it usually shows up before a person reaches the age of 30. Symptoms of vitiligo include:

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

If you observe any abnormal discoloration in your skin, visit your dermatologist for further assessment.

To diagnose vitiligo, dermatologists examine the skin using a special lamp and review the patient’s medical history. A blood test and/or skin biopsy are also useful in confirming a diagnosis.

Vitiligo Treatment

There is no cure for vitiligo; however, there are optional preventive treatments to lessen the loss of pigment in the skin. It is important to note that responsiveness to treatment greatly depends on the person and the type of vitiligo. The size of the affected area also affects one’s chances of successful vitiligo treatment.

Topical Vitiligo Treatment

Corticosteroid Creams. These creams decrease inflammation. As a result, some color can return to the white patches.

Calcineurin Inhibitor Ointments. Creams such as tacrolimus (Protopic) or pimecrolimus (Elidel) can slow down the loss of pigment in the skin.

Light Treatments for Vitiligo

Ultraviolet B Light Treatment. For vitiligo in small areas of the skin, ultraviolet B light treatment can be administered with a handheld device. However, people who need treatment in several areas of the body can stand inside a closet-sized lightbox for several minutes while wearing goggles. This treatment usually requires several sessions over a period of six months.

Ultraviolet A Light with Psoralen. Psoralen from plants is a chemical that makes you more sensitive to light. This can be taken orally or topically when your skin is exposed to ultraviolet A light from the sun or artificial sources.

Surgical Vitiligo Treatment

Cellular Suspension Transplant. The doctor takes an affected part of your skin and puts the pigment cells (melanocytes) in a solution. The melanocytes are transplanted 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. Doctors creates blisters in your healthy skin so that they can transplant the tops of the blisters to the areas of the skin that are losing color.

Depigmentation. Depigmentation refers to the removal of the remaining pigment of the skin. This leaves the person with completely white skin. Dermatologists may suggest this to people with universal vitiligo.

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