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Wednesday 20 March 2019
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All Things Vitiligo

What is vitiligo?

Vitiligo pronounced as (vit-ill-eye-go) is a skin disorder in which pale patches appear on the skin. The American Academy of Dermatology (AAD) describes vitiligo to be more than just a cosmetic problem but as a health issue that needs medical attention.

Vitiligo is the result of the skin’s melanocytes being ruined. Melanocytes are cells within the skin that produce melanin, which is gives skin its color. White patches on the skin are the main sign of vitiligo. Many people can be affected by vitiligo, regardless of age and race even though it is more evident in people with darker skin tones and white patches are likely to appear in one’s twenties and thirties.

Different types of vitiligo

There are two types of vitiligo namely non-segmental vitiligo and segmental vitiligo. Non-segmental vitiligo is where the initial white patches appear to be symmetrical. The patches often appear equally on both sides of the body. They commonly appear on areas of the skin that is mostly exposed to the sun such as arms, face, neck, knees, elbows, mouth and eyes.

Non-segmental vitiligo is also broken into sub-types. Generalised, which is where there is no specific area or size of patches is the most common type. Acrofacial appears mostly on fingers and toes, mucosal occurs mostly around mucous areas and lips, universal is where depigmentation occurs on most parts of the body, which is quite rare. Lastly focal type, where one or a few scattered white patches begin to develop in a discrete area.

Segmental vitiligo spreads more quickly but is considered more constant and stable and less irregular than the non-segmental type

Causes

Even though the exact cause of vitiligo is not completely clear, there are various factors that trigger the condition, such as a genetic stress imbalance, a stressful event, harm to the skin due to critical sunburn or exposure to some chemicals. It may also be heredity or due to a virus.

Cure and treatment

There is no ‘cure’ for vitiligo as it is a lifelong condition, however some patches do go away by themselves. According to medicalnewstoday.com, in 2013 research announced that a new compound had been found that may possibly provide a cure for the loss of pigmentation associated with vitiligo. Participants in this study appeared to have recovered pigmentation in their skin, eyelashes and in their hair. Doctors are able to prescribe treatments that may help to even out the skin tone. The AAD recommend using a sunscreen as the lighter patches of skin are sensitive to sunlight and they’re prone to sunburn. Treatments include phototherapy with UVB light which requires exposure to ultraviolet B (UVB). It can be performed in the comfort of ones home as it requires a small lamp and allows for daily treatment, which makes it more effective. If this treatment is undergone in a clinic, it may take longer. In the event that there are white spots across large areas of the body, UVB phototherapy may be used. This involves full-body treatment, which is done in a hospital.

UVB phototherapy in combination with other treatments can have a positive effect even though it is not guaranteed that the treatment will re-pigment the skin.

Another treatment method includes skin camouflage, which is common in cases of mild vitiligo where the patient can camouflage some white patches with cosmetic products that match their own skin tone. These cosmetic products include serums/creams and make-up products such as foundation and concealer.

When the affected area is widespread, covering 50% or more of the body, depigmentation can be an option. This reduces the skin color in unaffected parts to match the whiter areas. Furthermore, the depigmentation treatment is achieved by applying strong topical lotions or ointments, such as monobenzone and mequinol.

The treatment is permanent, however the downside is that it can make the skin more fragile or sensitive. Long periods of exposure to the sun needs to be avoided. This treatment method can take from a year up to 14 months. Skin grafting as a treatment method is the process where a surgeon cautiously removes healthy patches of pigmented skin and uses them to cover the affected areas.

This procedure is not very common, because it is a timely process and it can also result in scarring. Similarly, blister grafting includes producing a blister on normal skin using pressure. The top of the blister is then removed and placed on an area where pigment has been lost; this procedure has lower scarring risks.

Challenges

Individuals with vitiligo are most likely to suffer from severe sunburn and possibly hearing loss and challenges with their vision.

They have to cope with the stigma that awaits them majority of the time. It can lead to low self esteem, depression, anxiety and subsequently result in going to high lengths to cover up any exposed areas of white patches. People with vitiligo also may cover it up with make up and lie that they do not have it or call their mild vitiligo birthmarks to avoid the stigma.

The way in which these interpersonal challenges can be overcome are support groups, awareness organisations with the aim to break the stigma and educating members of society so that they do not bully, ridicule or diminish individuals with this skin conditions.

Supermodel Winnie Harlow has done an outstanding job on attempting to break stigma by defending herself on social media when called demeaning names such as ‘cow’ and by confidently strutting the runway in bikinis and other revealing clothing that expose all her patches from head to toe.

When public figures such as her shamelessly live their day-to-day life owning their skin condition it can help overcome the social challenges that are faced by people with vitiligo, every day.




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