Vitiligo is a skin condition that has white patches on the skin. Every area of the body can have it and most white patches appear in many areas of the body. In addition to the skin, white spots can also occur on the hair and the inside of the mouth. Usually, hair and skin color is determined by melanin.
Vitiligo is a skin disease that occurs when cells that produce melanin die or stop functioning. This skin discoloration can occur on all skin types, but may be more visible in people with dark skin. This condition is classified as not dangerous or contagious. But it might make you feel insecure.
Vitiligo consists of two main types, including:
- Vitiligo Non-segmental
This type is among the most common, symptoms usually appear on both sides of the body such as symmetrical white patches.
- Vitiligo Segmental
While this type is rare, white patches only appear in one area of the body. Usually this condition is more common in children.
White patches on the skin can even occur throughout the body, known as universal or complete vitiligo.
Causes of Vitiligo
Melanin is a pigment that gives skin a distinctive color. Vitiligo is a condition caused by loss of pigment in the skin, due to damage to the forming pigment cells known as melanocytes. The cause of damage to these cells is not known with certainty.
One reason might be that the immune system destroys cells, as in other autoimmune conditions. Parts of the affected skin become brighter or whiter than the surrounding skin.
Although it is unknown why pigment cells are damaged or dead. But vitiligo disease may be related to the following conditions:
- autoimmune disorders, when the immune system attacks and destroys melanocytes in the skin
- Family history (heredity)
- Imbalance of genetic oxidative stress
- Tense events
- Burning sun exposure
- Exposure to industrial chemicals
- Nerve disorders
- Critical Injury
Its main characteristic is the loss of skin color evenly. Usually, discoloration first appears on sun-exposed skin, such as the face and lips, hands, arms, and legs.
The symptoms of vitiligo include:
- White patches on the skin
- Gray hair on head, eyelashes, eyebrows or beards
- Color loss in the tissue lining the inside of the mouth and nose (mucous membranes)
- Loss or discoloration of the inner lining of the eyeball (retina)
It’s hard to predict how this skin disease will develop. Sometimes patches stop forming without treatment. In most cases, pigment loss can spread and eventually occur in most skin. Skin color back as before was classified as rare and difficult.
When to see a doctor?
If the area of skin, hair or eyes has lost its color, consult a dermatologist immediately. Although vitiligo does not have a cure. But treatments can help stop or slow down the process of discoloration and restore some skin tone.
White patches on the skin do not develop into other diseases, but people who have this condition are more likely to experience disorders:
- A sunburn that feels painful
- Changes in vision and tear production
- Hearing disorders
A person with vitiligo is more likely to be at risk of having other autoimmune disorders, such as thyroid problems, Hashimoto’s thyroiditis, Addison’s disease, type 1 diabetes, or pernicious anemia. Although most do not have this condition, but tests can be done to eliminate it.
White patches on the skin will be known with certainty through several tests to diagnose vitiligo.
- Medical History and Examination
If the doctor suspects that you have vitiligo, he will ask you about your medical history, do an examination and try to rule out other medical problems, such as dermatitis or psoriasis. Your doctor can use special lights to illuminate the skin with ultraviolet light to determine whether you have this type of skin disease.
- Skin Biopsy and Blood Test
In addition to collecting your personal and family medical history and examining your skin, your doctor can:
- Take a small sample (biopsy) of skin affected by white patches
- It draws blood and then tests it in a laboratory to look for an underlying autoimmune condition, such as anemia or diabetes.
There are many ways to treat vitiligo or treatments to help restore skin tone or even skin tone. The results vary and cannot be predicted. Some treatments have serious side effects, so your doctor may recommend that you first try to improve the appearance of the skin by tanning (the process of tanning the skin) or using makeup.
If the doctor recommends using drugs, surgery, or therapy, the process may take months to assess its effectiveness. Not just one, the treatment may have to try more than one approach or combination of approaches before finding the most suitable treatment.
If the treatment is successful for a while, the results may not last long or even white patches may reappear.
There is no drug that can stop the process of loss of pigment cells. But certain medications or with light therapy, can help restore skin tone.
- Medications that affect the immune system. Ointments containing tacrolimus or pimecrolimus may be effective for white spots on the face and neck. This drug has fewer side effects.
- Cream that controls inflammation. Applying corticosteroid cream to the affected skin can help restore color, especially if you use it early in symptoms. This type of cream is effective, but has side effects, such as thinning of the skin or the appearance of lines on the skin.
Some therapies that can be done to restore skin color include:
- Combining psoralen and light therapy. A treatment that combines psoralen (substances from plants) with light therapy (photochemotherapy) to restore skin tone. After using psoralen by mouth or applying it to the skin, you are exposed to ultraviolet A (UVA), UVB or excimer light. This therapy has better results. Treatment can be done three times a week for six to 12 months.
- Remove the remaining color (depigmentation). This therapy is an option if vitiligo is widespread and other treatments are unsuccessful. Depigmenting agent is applied to skin that has no spots. It gradually brightens so that it is faint with areas that change color. This therapy is done once or twice a day for nine months or more. Side effects include redness, swelling, itching and dry skin.
How to treat vitiligo surgically might be an option if light therapy is not effective for you. Surgery can also be done with therapy. Here are some techniques to even out skin tone or restore skin tone:
- Skin Transplantation. This procedure removes small portions of normal pigmented skin and attaches them to the area that has lost pigment. This method is sometimes used if you have small white patches. Risks include infection to scarring.
- Blister Transplantation. This procedure makes blisters on pigmented skin, usually by suctioning. The doctor then removes the upper part of the blister and transplants it to an area of skin that changes color. The risk might be to cause scarring.