What Triggers Vitiligo?

Vitiligo is a skin condition that changes pigmentation. Triggers include autoimmune disease, neurogenic factors, genetics, sunburn, stress, and chemical exposure.

About 1% of the global population is affected by vitiligo. While viewed as a cosmetic problem, it’s a medical condition that can put you at risk for other health issues. Recognizing symptoms and understanding the causes can help you seek appropriate treatment.

What is vitiligo?

Vitiligo is a disease that affects the skin’s pigmentation, causing the loss of pigment cells (melanocytes) and resulting in depigmentation, or white areas.

This disease occurs equally in all genders and races, but is more noticeable in people with darker skin. The depigmentation varies depending on the type of vitiligo.

The two main types of vitiligo are:

• Segmental vitiligo: Patches and spots occur on one side of the body, such as the hands or face. Depigmentation usually starts and stops within a year.
• Non-segmental (general) vitiligo: Multiple parts of the body are affected, with depigmentation occurring off-and-on over time.

The main subtypes of vitiligo are:

• Localized: A few spots or patches of depigmentation are limited to one or two areas of the body.
• Generalized: Patches and spots of depigmentation are scattered all over the body.
• Universal: Almost all of the skin has depigmentation.

Signs and symptoms

A loss of natural pigmentation on the body is the clearest sign of vitiligo. It can occur anywhere, and some people may experience itchy or painful skin where the patches are. Other symptoms include low self-esteem and depression due to its impact on physical appearance.

Causes

Doctors are still trying to understand the root cause of vitiligo. Possible theories include:

• Autoimmune disorders where the immune system attacks melanocytes.
• Neurogenetic factors affecting the nervous system.
• Genetics playing a role, especially if a close relative has vitiligo.
• An acute event like severe sunburn, stressful life event, or chemical contact.

Diagnosing vitiligo

If you suspect vitiligo, see a dermatologist for a confirmed diagnosis. They’ll ask about your medical and family history and perform a physical exam. A blood test may also be done to check your thyroid gland’s health.

Diagnosing and treating vitiligo accurately is important to prevent risks such as severe sunburn, vision problems, hearing loss, autoimmune diseases, anxiety, and depression.

Treatments

Consult with your dermatologist to choose the right treatment. Options include:

Topical medication: Use of multiple medicines, such as potent corticosteroids, to restore color. They work best for people with darkly pigmented skin.

Light treatment: Sessions in a lightbox or excimer laser treatments to restore pigmentation. Results can disappear if treatment is stopped.

PUVA light therapy: Combination of UVA light and psoralen medication to effectively restore color in specific areas.

Surgery: Recommended for adults and those not prone to scarring. Involves removing skin with natural color and placing it in depigmented areas.

Depigmentation: Removing pigment from all skin, leaving completely colorless skin. Can take one to four years using a daily cream.

Alternative therapies: Use of vitamins, minerals, amino acids, enzymes, and herbs like ginkgo biloba to restore pigmentation. Further testing is needed to prove their effectiveness.

No treatment: Some choose not to use any options, especially children. Cosmetic options like makeup and self-tanners can temporarily even out skin tone.

Vitiligo is usually treated with a combination of these interventions. Discuss the best approach with your doctor.

IMAGES

American Academy of Dermatology Association: "Is Vitiligo a Medical Condition?"

American Academy of Dermatology Association: "Vitiligo: Diagnosis and Treatment."

American Academy of Dermatology Association: "Vitiligo: Signs and Symptoms."

American Academy of Dermatology Association: "Vitiligo: Who Gets and Causes."

American Osteopathic College of Dermatology: "Vitiligo."

American Journal of Clinical Dermatology: "Vitiligo: A Manifestation of Apoptosis?"

American Journal of Clinical Dermatology: "Vitiligo: Pathogenesis and Treatment."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Vitiligo."