"Speaking of Vitiligo..."

I am a physician-scientist who focuses my clinical and research efforts on vitiligo, and therefore I think about this disease a lot – all the time, in fact. Therefore I thought it would be helpful to share my thoughts with others who are interested in vitiligo as well, particularly the patients who suffer from it and their loved ones. 

My Vitiligo Experience

You may be here because you suffer with - or suspect you might be suffering with - vitiligo. But what is vitiligo, how does it present itself, what treatments are available, and what impact can vitiligo have on a patient's mental health? Let's take a look. 

What is vitiligo?

Vitiligo is an acquired persisting depigmenting disorder of the skin in which melanocytes (pigment cells) are inactive. It causes well-defined milky-white patches of skin, called leukoderma. Vitiligo is considered an autoimmune condition in which the body’s own immune system rejects its own cells, in this case melanocytes. There is a genetic susceptibility, but it is not inherited directly.

The most common sites for vitiligo are the hands, face, around body openings (eyes, nostrils, mouth, umbilicus and genital regions) and within body folds such as underarms and groin. It is usually a clinical diagnosis, and no tests are necessary. 

Vitiligo treatment

There is no vitiligo cure, but treatment may be helpful in restoring the colour, and re-pigmentation may not be permanent. Vitiligo treatment includes:

• Sunscreens - areas of vitiligo will burn easily in the sun, so we advise using SPF 30 or above, daily.

• Topical corticosteroids- potent steroid creams may restore pigment but have side effects, such as thinning skin and stretch marks, which are a risk with continued use. Short courses of oral steroids may be considered.

• Anti-inflammatory creams and ointments such as calcineurin inhibitors and vitamin D analogues.

• Systemic immunosuppressants, such as methotrexate and ciclosporin.

• Phototherapy- exposing affected skin to artificial UV light. Treatment is often prolonged and full re-pigmentation is unlikely.