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Vitiligo is an autoimmune condition of the skin, resulting in patches of skin where skin has lost its pigmentation. It usually begins in childhood, with most cases starting before age 25. Up to 1% of the general population has vitiligo. Family members of patients with vitiligo have a higher incidence of vitiligo, autoimmune thyroid disease and autoimmune alopecia (hair loss)
There are several patterns of vitiligo, but involvement is usually symmetrical. Commonly affected body areas are the face, upper chest, backs of the hands, underarms
and groin. Vitiligo also tends to occur around the eyes, nose, mouth, and ears, as well as areas that are commonly traumatized (elbows, knees).
Does vitiligo negatively affect my general health?
Though vitiligo is considered to be an autoimmune disease, it generally does not affect a person`s general health. Uncommonly, vitiligo is associated with eye abnormalities. Vitiligo may also uncommonly be associated with other autoimmune disorders including diabetes, thyroid disease, dysfunction of the adrenal gland and a form of autoimmune hair loss called alopecia areata.
Are there other causes of vitiligo?
Occupational exposure to chemicals including thiols, phenolic compounds, catechols, mercaptoamines and quinines can produce occupational vitiligo. For example, individuals whose jobs require them to wear rubber garments and gloves containing monobenzyl ether of hydroquinone may develop white patches of skin at sites of contact with the chemical.
Will my pigment return to normal over time?
Unfortunately, spontaneous repigmentation only occurs in approximately 20% of cases.
How is vitiligo treated?
Treatment of vitiligo is difficult. Medical strategies include:
- Topical corticosteroids
- Tacrolimus ointment (non-steroid ointment)
- Calcipotriene (vitamin D-based treatment)
- Narrow-band ultraviolet B light
- 8-MOP (photosensitizer) with ultraviolet A light
- Surgical options (e.g. grafting)
Because the major concern of vitiligo is cosmetic, other strategies for the management of vitiligo include:
- Cover-up (skin-matched concealers)
- Self-tanning creams containing dihydroxyacetone
What can be done if most of my skin is depigmented?
If greater than 50% of the body surface area is depigmented, the pigmented skin can essentially be bleached with a bleaching agent called monobenzyl ether of hydroquinone 20%.
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