What is vitiligo?

 Vitiligo is an autoimmune disease in which pigment cells (melanocytes) are destroyed, resulting in irregularly shaped white patches on the skin.

 Who gets vitiligo?

 It affects 1% to 2% of the world’s population. Thirty percent of these people have someone in their family who has vitiligo.

It is infrequently associated with certain autoimmune diseases, and your health care provider may suggest that you have certain blood tests.

 What causes vitiligo?

 Although the cause of vitiligo is still unknown, one theory is that it results from the body’s immune system making antibodies to its own pigment cells. These antibodies attack the pigment-producing cells of the skin (melanocytes).

 What does vitiligo look like?

Any part of the body may be affected. Common sites are face, neck, eyes, nostrils, nipples, navel, genitalia, body folds (armpits, groin), sites of injury (cuts, scrapes, burns) and around pigmented moles.

The hair may also go grey early on the scalp, eyebrows, eyelashes and body. White hair is called ‘poliosis’. The retina may also be affected.

Occasionally, the spots may have various shades of color and may include dotlike “islands” of repigmentation. Such repigmentation “islands” are a good sign—they mean that the skin is recruiting new pigment cells from the hair follicles and trying to repigment itself.

In dark-skinned people, pigment loss may be observed at any time of year, whereas in light-skinned people, the white spots may be most obvious in the summer, because the tanning effects of the summer sun can intensify the contrast between the light and dark skin.

 How is vitiligo treated?

 Treatment is currently not very satisfactory. Best results are obtained in vitiligo that is recent in onset and when it affects face and trunk.

Topical corticosteroids are occasionally helpful in promoting repigmentation.

The application of tacrolimus or pimecrolimus has been shown some promising results in repigmentation of vitiligo.

Certain ultraviolet treatments, special lasers, and skin grafts, have also helped some people; however, such therapy isn't always effective.

There are cosmetic makeups that are formulated to match a person’s normal skin color  or self-tanning products that contain dihydroxyacetone, that may be very effective at “hiding” the white spots.

Sunscreens can be used to avoid deepening the contrast between normal skin and lesions and to protect the light-colored patches, which are sensitive to the sun.

Depigmentation therapy: If a dark skinned person has vitiligo affecting a large part of the exposed areas, he or she may wish to undergo depigmentation. A cream containing monobenzyl ether of hydroquinone, also called p-(benzyloxy)phenol, is applied to the skin. This can cause all the skin to lose its pigment. Its effect is usually permanent.