Vitiligo is a condition in which areas of skin lose their normal pigment and so become white. It is common, and affects about 1% of the world’s population.
What causes vitiligo?
The pigment that gives your skin its normal colour is melanin, which is made by cells known as melanocytes. The cause of vitiligo is not yet fully known but many think that it is a disease in which the body makes antibodies to its own melanocytes, and in doing so destroys them. After that, the skin cannot make melanin properly, and vitiligo is the result. In support of this idea is the way that people with vitiligo are more likely than others to have diseases, caused in much the same way, of other organs such as the thyroid.
It affects men and women of all races equally, but is most easy to see in people with dark skins. It is not catching.
Is vitiligo hereditary?
Only about a fifth of people with vitiligo know of someone in their family who has it; but the exact type of inheritance has not yet been worked out. One problem here is that so many people have no idea if their relatives are hiding vitiligo under their clothing.
If you have vitiligo, it does not follow that your children are sure to get it too.
Diet. There is no medical evidence of any dietary link and vitiligo. Therefore no dietary changes are recommended.
What are the symptoms of vitiligo?
These fall into two groups:
The sun burns the pale areas very easily. This is sore, and when the burn has settled down, the pale areas of vitiligo will stand out, more strikingly than before, against a background of tanned skin.
Many people become embarrassed or depressed by the look of their vitiligo, and by the questions that other people ask them about it.
What does vitiligo look like?
The most common sites for vitiligo are:
The exposed areas – vitiligo often begins on the hands and face.
Around body openings: the eyes, nostrils, mouth, umbilicus, and genitals.
In body folds: the armpits and groin.
Anywhere your skin has been damaged, for example by a cut or a burn.
Areas around pigmented moles (as part of “halo naevi”).
In one rare (segmental) type, vitiligo crops up on just one part of the body.
Although vitiligo not more common in people with a dark skin is it much more obvious. Premature greying of the scalp hair can accompany vitiligo.
Course of the disease. Vitiligo can start at any age, but about half of those who get it do so before they are 20. Its course is hard to predict, but it tends to progress slowly, with periods of stability, often lasting several years. The patches slowly change their shape and size, and the skin around them may be darker than normal. The hairs growing out of a patch of vitiligo may keep their normal colour or turn white too.
Some pigment comes back in a few patients but seldom does so completely. If it returns via the hair follicles, the areas do not look much better when they turn from white to speckled.
How will vitiligo be diagnosed?
The diagnosis is usually easy to make on the basis of the look of the patches (white with a normal skin texture) and the fact that the areas of vitiligo on the left side of the body roughly mirror those on the right. An ultraviolet light (Wood's lamp) can help to show up white areas that could have been missed in a pale-skinned person.
Once the diagnosis of vitiligo has been made, your doctor may want to check you for thyroid disease, and for other autoimmune conditions that are more common than usual in people with vitiligo.
Can vitiligo be cured?
Vitiligo occasionally goes away by itself, and some treatments may slow its progress, but a cure cannot be guaranteed.
For information about available treatments please visit this page on the website of the British Association of Dermatologists
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