What is Vitiligo
Vitiligo is characterized by white areas of skin caused by the loss of melanin, a pigment that contributes significantly to skin colour. Melanin is generated by melanocytes, which are damaged in persons suffering from vitiligo. Although the aetiology of vitiligo is unknown, research suggests that it is an autoimmune condition in which the body's immune system incorrectly targets and harms these particular cells.
Vitiligo can affect the skin in a variety of ways, from mild to major. It may be hardly apparent in some persons, while it is evident in others. Vitiligo patches are more visible in dark-skinned persons because they contrast with normal skin. Light-skinned persons may have fewer aesthetic issues, but because unaffected skin tans while vitiligo skin does not, patches lacking pigment might become visible in the summer.
Around 1% to 2% of the population is affected with vitiligo. Vitiligo runs in the family for about 30% of those who have it. Around half of persons with vitiligo develop symptoms before the age of 20.
Vitiligo patients are more likely to develop autoimmune illnesses such as autoimmune thyroid disease and type 1 diabetes. In addition, persons with certain disorders are more likely to develop vitiligo.
Symptoms
Vitiligo is characterized by white areas of skin that are frequently symmetrical (even), with dark or red borders. The patches can appear anywhere, but the backs of the hands, the face, and regions with skin folds, such as the armpits and genitals, are the most often afflicted. Vitiligo is also frequent in body openings like the lips, eyes, nipples, and anus, as well as sunburned regions.
Vitiligo can develop in bursts, causing large regions of skin to rapidly lose their pigment in the early stages of the disease, but then abruptly stop growing for months or years.
Diagnosis
Vitiligo results in a pattern of skin changes that can generally be identified by a doctor. If your skin changes are occurring in a pattern that implies another disorder, your doctor may prescribe a skin biopsy to confirm your diagnosis. A biopsy is a procedure in which a tiny sample of skin is taken and analyzed in a lab. Vitiligo is generally diagnosed without a biopsy.
Expected Timeframe
Some or all of the pigment returns on its own in 1 out of every 5 to 10 persons, and the white spots fade away. If vitiligo is not treated, however, the whitened skin patches usually remain longer and become bigger. Vitiligo is a condition that lasts a lifetime.
Prevention
It is impossible to avoid vitiligo.
Treatment
Vitiligo is a tough condition to treat, and the results vary. The most essential therapy is to keep vitiligo regions out of the sun. It's quite simple to become burnt in regions where there isn't much pigment. Skin cancer is more likely as a result of this. Apply sunscreen with a sun protection factor (SPF) of at least 30 to vitiligo-affected regions and/or wear sun-protective clothes.
If vitiligo causes mental or social discomfort, further therapies might be tried. The purpose of treatments is to decrease the colour contrast between your regular skin and pigmented skin spots.
If you are light-skinned, part of your therapy may include wearing sunscreens with a sun protection factor (SPF) of at least 30 to protect your normal skin from tanning.
Topical treatments may be beneficial in certain individuals. These are immediately administered to the skin. For several months, steroid creams or ointments are used once daily. These medicines are not always effective, and prolonged usage might cause skin thinning. Additionally, tacrolimus (Protopic) and pimecrolimus may be beneficial (Elidel).
Ultraviolet B light therapy is effective in treating vitiligo in several individuals. For smaller regions of skin, ultraviolet light can be supplied using a hand-held lightbox. Individuals with extensive skin involvement can be treated by donning goggles and standing for several minutes within a closet-sized lightbox. The therapy must be done often, typically three times a week for a minimum of six months. Side effects include itching, discomfort, and sunburn, as well as an increased risk of skin cancer, which should be addressed extensively with your dermatologist.
UV and psoralen A light treatment (commonly known as PUVA) have slightly more severe side effects than ultraviolet B light therapy, but it is still a viable option for vitiligo treatment. Psoralens are medicines that, when exposed to ultraviolet A light, darken the skin. They are available as a cream or as tablets. You are exposed to UV light after taking the psoralen medication. The PUVA therapy is not recommended for pregnant women, nursing mothers, or children under the age of ten. There's also a higher chance of skin cancer.
Psoralen in combination with UV
Although phototherapy (often referred to as PUVA) has slightly more severe side effects than ultraviolet B light therapy, it is another option for treating vitiligo. Psoralens are a class of medicines that darken the skin when exposed to ultraviolet A radiation. They can be administered topically or taken orally. You will be exposed to Uv light, after taking the psoralen medication. PUVA therapy is not recommended for pregnant women, nursing mothers, or children under the age of ten. Additionally, there is an increased risk of skin cancer.
Oral immunosuppressive medications can occasionally allow normal pigment to return. Oral steroids are occasionally used instead of topical steroids for patients who have extensive skin regions affected. Because of the possible adverse effects of oral steroids, this therapy is rarely utilized.
Depigmentation can erase the colour from normal skin in persons with severe vitiligo, resulting in all of the skin being the same white hue. For up to 12 months, a bleaching solution is administered every day. You may not see any effects for two or three months. Within a year, around 95% of people will be depigmented, and they must then carefully avoid sun exposure. Skin redness, dryness, itching, and burning, particularly on the face, can occur in up to half of the individuals who are treated. Because skin without pigment is more sensitive to UV damage, this therapy is rarely utilized.
Skin grafting and other procedures to implant healthy melanocytes into vitiligo-affected skin are examples of surgical therapies. These alternatives may not be suitable for all individuals; for example, those who tend to develop a lot of scar tissue in their skin should avoid them.
“Cosmetic camouflage” may be the best solution for many. When vitiligo affects the skin in highly visible regions like the hands, cheeks, or neck, spray tanning treatments and foundation-based cosmetics are frequently advised.
When Should You See a Professional?
If you detect white patches on your skin, schedule an appointment with your doctor. If treatment can be begun while only a small patch of skin is afflicted, it may be most beneficial. Wearing sunscreen to protect the regions affected by vitiligo is critical, as these areas are more vulnerable to sunlight and skin cancer.
Prognosis
Vitiligo is a disease that, for the most part, worsens over time without therapy or necessitates ongoing treatment.
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