Vitiligo – causes, symptoms, treatment [WE EXPLAIN]

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Vitiligo (or albinism) is a chronic skin disease involving its depigmentation. The cause of the disease is the dying off of the cells responsible for the color of the skin. A symptom of depigmentation is the appearance of discolored, white spots on the body.

Vitiligo – Definition

Vitiligo is the acquired loss of melanocytes leading to the development of discoloration. It affects about 2% of the population and affects all races. Thyroid gland disorders occur in 30% of vitiligo patients.

Vitiligo can be linked to many diseases:

1. thyroid diseases (both hyperthyroidism, e.g. Graves’ disease, and hypothyroidism, e.g. Hashimoto’s goiter);
2. other endocrine disorders (Addison’s disease, diabetes mellitus type 1 and 2);
3. autoimmune diseases (pernicious anemia, lupus erythematosus, systemic sclerosis, myasthenia gravis, Crohn’s disease, primary biliary cirrhosis, Sjögren’s syndrome and alopecia areata);
4. may appear in the course of malignant melanoma.

As a result of depigmentation, the skin loses its original color and lighter patches begin to appear. Vitiligo usually affects the skin, but it can also appear in other pigmented areas (hair may lose color as well). In addition, in some people vitiligo can attack the color of the mouth or the structure of the iris / retina.

Vitiligo is a disease that is not life-threatening, but has a large impact on the patient’s psyche. Very often, due to embarrassing spots on the skin, patients avoid contact with people, they feel undervalued and inferior. The problem is exacerbated if you have albinism on your face. For this reason, depigmentation can even lead to depression. Vitiligo is an incurable disease.

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Vitiligo – causes

The cause of vitiligo is unknown. Genetic conditions are taken into account (frequent family history, but the mode of inheritance is not specified). There are three theories regarding the mechanisms of melanocyte destruction: autoimmune, neurochemical and toxic. In half of the cases, vitiligo affects people under 21 years of age and often accompanies them for the rest of their lives. This disease affects women as well as men.

Oczywiście a greater risk of developing vitiligo applies to people who have a family member who struggles with this ailment or other autoimmune disease, e.g. Hashimoto’s disease or alopecia areata.

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Vitiligo – the development of the disease

Vitiligo occurs when the melanocytes responsible for the correct color of hair and skin die. So far, it has not been possible to find an answer to the question of why these cells die. As for generalized vitiligo, it can develop on an autoimmune basis, when the body misdiagnoses its own melanocytes (as foreign cells). There is an overproduction of antibodies that destroy the melanocytes.

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Vitiligo – symptoms

Vitiligo initially develops small white spots ranging in size from a few millimeters to several centimeters, the number of which is usually small. Vitiligo lesions are sharply delimited, and the surrounding skin is often discolored.

Over time, the number of vitiligo-related lesions increases and they coalesce to form larger patches on the backs of the hands and feet, genitals, armpits, nipples, face, and neck. Sometimes hair color is lost (acquired graying). 40% of patients with vitiligo have retinal pigmentation defects (usually asymptomatic), and 15% have onset of deafness.

The first symptoms of vitiligo can be noticed between the ages of 10 and 30 and these are the hypopigmentation spots. It happens that the skin of patients with vitiligo may be completely whitened. Many patients do not deal with any symptoms of this disease and their condition is very good, while some develop severe itching of the skin.

Loss of skin pigmentation is affected by stress and a decrease in self-esteem due to depigmentation, especially if the symptoms of vitiligo are visible on the face. Pictures of vitiligo skin can be found on the internet.

Fig.31.10. Vitiligo

Vitiligo – types and types

Types of Vitiligo:

1. generalized vitiligo (mixed, ordinary) – this is the most common type of vitiligo. It attacks both sides of the body, eg right and left knee; right and left hand. Usually, the symptoms of vitiligo appear first on the fingers, wrists, hands, but also on the face, around the mouth and eyes. In the initial stage of depigmentation, the patient quickly loses the hair pigment, and then the process stops for a while (later the color is lost again). Depigmentation in generalized vitiligo begins to attack larger and larger areas of the skin over time, until it becomes very visible;
2. segmental vitiligo (limited) – occurs only in one place on the human body, e.g. on the face or hands. In half of the cases, the color of hair, eyelashes and eyebrows is lost. Segmental albinism attacks at a young age, develops for a year, then stops.

Types of Vitiligo:

1. generalized vitiligo – it is characterized by depigmentation located all over the body, it appears in most cases of the disease;
2. Vitiligo limited in the concentrated form – they are characterized by one or more spots that are located on one or more areas of the body;
3. total vitiligo – they are characterized by the loss of most of the pigment, but it is extremely rare.

The lost pigment is very rarely recovered. Depigmentation may develop, stop and remain in this form for many years.

Vitiligo – diagnosis and treatment

In order for the doctor to be able to determine whether we are dealing with vitiligo, it is necessary to carefully analyze the entire medical history of the patient and obtain information whether this type of ailments is present or has occurred among family members. In order for the diagnosis of vitiligo to be well established, the doctor performs a physical examination and carefully observes the individual birthmarks.

In addition, additional blood tests may be needed to determine how the thyroid works, as vitiligo patients often struggle with immune-mediated thyroid disease. Both diseases should then be treated. In the course of vitiligo, proper education about the disease the patient is struggling with is also important. This helps in choosing the right treatment and therapy that will improve the quality of life.

Therapy in people with vitiligo is aimed at regaining the lost skin pigment. The type of treatment depends on the age, health of the patient and the places where pigment has been lost. The types of treatment are as follows:

1. the use of appropriate cosmetics instead of pharmacological treatment,
2. surgery,
3. use of topical preparations,
4. PUVA therapy,
5. treatments with the use of light.

How should people with vitiligo behave?

1. Patients with vitiligo should protect their skin from the sun, as the skin with pigment deficiencies tans quite easily, and sunburn is not conducive to treatment, but it only worsens the symptoms of the disease. You should use sunscreen, ideally when you put on selected parts of your body a quarter of an hour before sunbathing or going outside. A well-chosen sunscreen protects against UVA and UVB radiation, it is also important that it is waterproof. It is advisable that patients should lubricate themselves every two hours, even if the sky is overcast, as well as after swimming or excessive sweating.

2. Patients should also invest in clothing that will protect the body against solar radiation.

3. Patients with vitiligo are not allowed to use the solarium, because they may severely burn.

4. People with vitiligo should also not get tattoos on their bodies, because the so-called the Köbner effect, which means that loss of skin pigment (vitiligo) can appear at the site of tattooing after about two weeks.

5. There are cosmetics that safely help to even out the skin tone, without the need to use a solarium or sunbathing. These are all kinds of self-tanners, make-up cosmetics or special dyes. For example, we recommend the EPTA VTLG Vitiligo Skin Emulsion available on Medonet Market at a promotional price.