An autoimmune condition called vitiligo is characterized by the appearance of white skin patches. The white color is caused by the immune system interfering with normal skin cell function. Usually the white color is the only symptom, which is more noticeable in darker skinned people. The irregularly shaped white patches usually
appear on the face and other exposed parts of the body, but are not
associated with other symptoms. The cause is unknown, and the goal of
treatment is to slow down the loss of skin pigmentation. The white skin patches can spontaneously clear for no known reason. The condition is not contagious or harmful in healthy individuals. It can spread in a limited number of cases. Treatment can last for an extended period, lasting from months to years."
About one out of a hundred people in the US has vitiligo. What exactly causes vitiligo is unclear, but it appears to be linked to an autoimmune process of destruction of melanocytes, which are cells that produce the brown pigment in the skin. The skin problem is also associated with other autoimmune disorders such as hyperthyroidism, pernicious anemia, and Addison’s disease. A hereditary factor may be involved because some have reported that there is an increased incidence within families.
The sudden or gradual appearance of irregularly shaped white skin spots or patches in the face, arms, hands, other exposed body parts and even the genitals are characteristic of vitiligo. The doctor may ask about a family history of any autoimmune disorder, a previous history of skin sensitivity or sunburn, premature hair graying, and physical or emotional stress.
A Woods lamp may be used to show the white patches of skin that glow under the handheld ultraviolet light. Blood tests may be done to look for signs of autoimmune disease such as autoantibodies or thyroid dysfunction. A skin biopsy may also be helpful in ruling out other disorders such as melanoma (skin cancer).
Milky white patches on skin that feels normal is more noticeable in dark-skinned people because of the contrast in skin color. However, vitiligo can occur in any race and at any age, more commonly between 10 and 30 years.
Loss of pigmentation of the skin (depigmentation) occurs initially on sun-exposed areas but may spread rapidly or gradually to other areas including the back, armpits, and genitals. Depigmentation may occur in a focal, segmental, or generalized pattern, affecting small or large areas of skin.
Affected individuals do feel any other symptoms or discomfort related to the skin changes except for premature graying of the hair, eyebrows, eyelashes,or beard and depigmentation of the inner lining of the mouth.
In some people, loss of skin color may halt or slow down for some time, but the original skin color does not come back. However, in a few, skin color may return without treatment.
The condition is not a threat to health and is not contagious. The goal of treatment is to slow down depigmentation and to improve the appearance of the skin.Self-care treatments, such as applying protective sunscreen and camouflage cosmetics such as Olay Pro-x, may improve the skin appearance. Fair-skinned individuals should avoiding tanning to make the white patches less noticeable.
Individuals who want to restore their skin color or lighten the remaining dark areas in order to even out the skin tone may seek medical treatment. This may last for 6-18 months and may involve more than one type of treatment, including phototherapy, photochemotherapy, topical creams and ointments and surgical skin grafting.