Vitiligo

What is vitiligo?

Vitiligo (pronounced vi·tuh·lie·go) is a skin condition characterised by white patches on your skin. It’s classified as an autoimmune disorder, but genetic and environmental factors can contribute to its development. Around 0.5-2% of the world population are thought to have vitiligo, and it can affect all ages, genders and ethnicities.^[1] (Although it will be more apparent in those with a darker complexion.)

Vitiligo isn’t contagious, and doesn’t usually cause any health problems.

It also isn’t painful, but it can have emotional or psychological effects. This is when getting treatment can be beneficial. Currently, there is no actual cure for vitiligo, so treatments often include restoring lost skin colour or stopping it from spreading to unaffected areas of your body.^[2]

There are other conditions that can have the same visual characteristics as vitiligo. Pityriasis alba is another depigmenting skin condition, but its cause is different.^[3] It’s important to differentiate between vitiligo and other skin conditions because they need to be treated differently.

Who gets vitiligo?

Vitiligo is a condition with no one cause, which can happen to anyone at any time. It can affect people of all ages, but it’s more common to develop patches before the age of 20.

Here are some factors that can play a role in its onset:

• Genetic Mutations. Since vitiligo is an autoimmune condition (when your immune system attacks your cells), mutations in genes that produce the immune response can have an effect.^[4]
• Heritage. One fifth of people diagnosed with vitiligo also have a family member diagnosed with the condition. The risk also increases if you have a family history of autoimmune conditions.^[4] However, this doesn’t mean that if your parents have it, you will too. Inheritance is more complicated than that.
• Environmental factors such as stress or exposure to certain chemicals can be triggers for vitiligo. Other triggers can include hormonal changes and childbirth. For a lot of people, these triggers are unknown.^[5]

What are the types of vitiligo?

There are two main types of vitiligo: segmental (SV) and non-segmental (NSV).

Segmental vitiligo only affects one area on one side of the body and is less common than other types. The most common SV is uni-segmental, which is characterised by colour loss on one area of the body that spreads very quickly, but only for 6-12 months before stopping.^[6]

Non-segmental vitiligo is the more common type of vitiligo. It can occur on the face, neck, arms and scalp and can be symmetrical on both sides of the body.^[4]NSV is commonly caused by autoimmune loss of melanocytes. Results of one study show, approximately 83% of patients who had NSV had an autoimmune condition.^[7]

What causes vitiligo?

Vitiligo is a multifactorial disease, this means many things can result in the development of it. Genetics, environmental factors and autoimmune disorders all contribute to the loss of functional melanocytes.^[1] Melanocytes are cells that contain a pigment called melanin. When melanin is packed into melanosomes, it’s transferred to keratinocytes (cells in the outer layer of your skin). Keratinocytes then deposit melanin into your skin layers, resulting in skin colour.^[2] If you have vitiligo, the melanocytes are attacked by an autoimmune reaction. This results in the loss of melanin and the appearance of white patches.

What are the symptoms of vitiligo?

Symptoms of vitiligo include patches of lighter skin that eventually turn white. The lighter patches can be present inside the mouth and nose, too. Some people may also develop whiter or lighter-coloured hair on their scalp, body and eyelashes. When vitiligo spreads, the affected areas may feel itchy. In some cases, the loss of colour may also affect your vision and eye colour as well as cause hearing loss.^[3] The lighter areas of skin may also increase sensitivity to the sun, so it’s good to wear sunscreen to avoid sunburns.

Vitiligo doesn’t have early symptoms except for the development of lighter-coloured patches on the skin. These patches can spread or remain localised. Even though vitiligo isn’t physically painful, it’s best to visit a doctor to check for other conditions.

What does Vitiligo look like?

Vitiligo looks different for everyone but on all skin tones it will be characterised by whiter or lighter patches on any area of the body. It can also appear differently depending on the subtype you have.

Can vitiligo lead to other problems?

Since vitiligo is an autoimmune disorder, it can lead to other autoimmune conditions such as thyroid disorders, Addison’s disease or type 1 diabetes. If you have vitiligo it’s good to get a blood test to check for these conditions.