Vitiligo

Vitiligo is a long-term condition that causes patches of skin to lose their colour, and usually, these patches become bigger over time. The condition can affect anyone, but it usually develops before the age of 30 and may be more noticeable in people with darker skin tones.

Overview

Vitiligo can affect the skin on any part of the body, as well as the inside of the mouth. It can also affect the scalp and hair, causing a change of colour.

The condition varies significantly from person to person – while some people may present with a few small patches; others might develop much bigger white patches that join up across large areas of their skin.

While vitiligo itself isn’t generally a serious health risk, the condition can mean that secondary issues require additional precautions – for example, vitiligo patches require additional protection from the sun’s harmful ultraviolet (UV) rays.

Many patients find that vitiligo can be stressful or negatively impact their self-confidence – particularly as there has historically not been a lot of information widely available about the condition, and in some patients, it is more visibly evident than in others.

It may be reassuring to those who suffer from vitiligo to know that there are online support resources that may be helpful, like the Vitiligo Society; Changing Faces, and Vitiligo Support UK. Several celebrities – including internationally renowned model Winnie Harlow - have shared their own vitiligo stories to help destigmatise the condition.

Sometimes people with vitiligo might have already tried some over the counter products to help match the discoloured patches of skin but may find other treatments to be helpful. Usually, a GP would refer a patient with vitiligo to a dermatologist, who specialises in the treatment of skin disorders.

In some cases, treatment can restore colour to skin affected by vitiligo, but it usually cannot prevent its recurrence or the conditions development over time.



There are different types of vitiligo, and depending on the type a person has, it can appear differently.



Symptoms of Vitiligo

Vitiligo usually starts as a patch of pale skin that gradually becomes completely white.

Often the patch is lightest in the centre, with paler skin around it, and if blood vessels are under the skin, the patch may be slightly pinkish.

In its initial stages, some signs of Vitiligo include;

  • A patchy loss of colour in the skin, usually appearing first on the face, hands, wrists, groin or genitals;
  • Premature whitening or greying of the hair, whether on the scalp, or in the eyelashes, eyebrows or beard area; and,
  • Loss of colour in the mucous membranes inside the mouth and nose.

The condition varies significantly from person to person - some people only get a few small white patches, but others get bigger patches that join up across large areas of their skin. Unfortunately, it is impossible to predict how an individual’s skin will be affected by vitiligo, and the white patches are usually permanent.

Vitiligo can also develop in the skin of the scalp, or in other areas that produce hair. When this occurs, the lack of melanin in the skin can cause the hair in the affected area to become white or grey.

A vitiligo patch may have edges that are smooth or irregular, and they can sometimes be red and inflamed or be discoloured with a brownish colour – this is known as hyperpigmentation.

Although the condition does not typically cause pain, dryness or other discomfort, vitiligo patches can occasionally be itchy.

Segmental vitiligo usually affects people from an early age, and presents in one area and on one side of the body, for example, the side of the mouth. Typically, segmental vitiligo will spread quite quickly from the onset but slow down around a year after it first appears. Segmental vitiligo is not usually associated with autoimmune issues.

The second type is non-segmental vitiligo, which is autoimmune. Typically, non-segmental vitiligo will appear on the hands or wrists; around the eyes or mouth; or on the feet, before later spreading to other areas, such as the neck, chest, knees and legs. Non-segmental vitiligo does progress, but each individual presents with different cycles and rates of spreading and of stability. All forms of vitiligo are considered non-segmental vitiligo.

The types of non-segmental vitiligo are;

In this most common form of the condition, the areas of the skin that are discoloured progress in a similar pattern and at a similar rate on both sides of the body, meaning they are symmetrical in appearance.
In this form, white patches appear only on a few areas, rather than widespread across the body. It may also be called focal vitiligo.
This form of the condition affects the face and the hands, and may also appear in areas such as under the arms or in the groin region.
This is the term for when what was previously considered to be segmental vitiligo later progresses into the autoimmune condition non-segmental vitiligo.
In this rarest form of the condition, the discolouration affects over 80% of the skin. Patients with universal vitiligo may also have other health conditions such as thyroid problems, rheumatoid arthritis, diabetes, or alopecia areata.

Patients with vitiligo might be at increased risk of complications arising from the condition. These complications might include;

  • Mental health issues;
  • Sun sensitivity and burns;
  • Problems with vision; and
  • Hearing loss.

While research has shown that there is not an increased risk of skin cancer as a result of vitiligo, it is important to note that this does not mean no risk, and patients with vitiligo must be cautious about getting sunburns, which can increase the risk of precancerous lesions.

Causes of Vitiligo

Melanin is naturally produced by cells within the skin known as melanocytes, which are present in most people.

Melanin produces the pigment that gives the skin, eyes and hair its colour. Vitiligo occurs when melanocytes either die or stop functioning normally.

Researchers cannot say with 100% certainty what causes these melanocytes to malfunction or die, but vitiligo is commonly associated with disorders of the immune system, also known as an autoimmune condition. Additionally, genetics may play a role, meaning that if a parent has vitiligo, it is possible that their child may also develop the condition.

Sometimes, vitiligo can be triggered by an event, like trauma to the skin from an accident, a chemical burn, or even a sunburn. Vitiligo might also appear after a period of prolonged or severe stress.

Treatment of Vitiligo at Derma

The first step in treating vitiligo is identifying the type and what’s caused it. Your appointment will begin with a skin check and medical history, followed by recommended treatment options.

Some treatments for vitiligo might include; creams, lotions, tablets, or phototherapy, dependent on the type. In some individuals, it might be suitable to have a small area of skin removed through excision, but this is usually a last resort for people who do not respond to other forms of treatment, and it’s less commonly performed now than historically.

The dermatologist will explain all of the potential side-effects, to enable you to select the best treatment option for you. Please note that not all patients are suitable for all treatments, and in some instances, tests and follow-up appointments will be required to manage the treatment.

At Derma, we have seen and treated all types of vitiligo, so you can be assured of access to the very best care, the latest research and the most effective treatments.

For more information, or to book an appointment with Derma, please call the clinic or contact us via email here

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