Vitiligo is a condition in which the skin loses
its normal color. Its cause is not known but it is suspected to develop as a
result of an autoimmune process in which cells from the immune system destroy those
which produce melanin which is the pigment that gives skin its color.
Genes are also thought to play a role since a
good number of patients also have relatives with vitiligo.
Symptoms of Vitiligo
The main symptom of vitiligo is patches of
white skin which gradually increase in size. These patches are not itchy or
scaly. Though vitiligo can affect skin on any part of the body, these patches often
begin on the face, hands and feet.
Other symptoms of vitiligo include premature whitening
of the scalp hair, eyebrows and beard. Vitiligo can also cause psychological
effects like emotional stress, low self-esteem and depression especially when it
affects the face and private parts.
Vitiligo Tests
The diagnosis of vitiligo is made after the doctor
listens to the symptoms and examines the skin. The doctor may also perform a skin
biopsy by removing a small piece of the affected skin and sending it to the laboratory to be examined.
Blood tests like blood glucose and thyroid
function tests may also be requested to look for other autoimmune diseases.
Medical Treatment of Vitiligo
The treatment of vitiligo can be challenging
due to the absence of a medication that works on all patients. Most patients
therefore have to try different treatment options before they discover the one
that works for them.
Medications used to treat vitiligo include:
1. Corticosteroid creams
Steroid containing creams like Triamcinolone are
applied on the skin to help with repigmentation or the restoration of normal skin
color.
2. Immunomodulator creams
Creams which affect the functioning of the
immune system like Tacrolimus are also used to treat vitiligo.
3. Topical PUVA
Topical psolaren plus ultraviolet A (PUVA) involves
the application of a chemical known as a psolaren which makes the skin more
sensitive to ultraviolet (UV) light. After around 30 minutes, the skin is
exposed to UVA light.
4. Oral PUVA
Oral psolaren plus ultraviolet A (PUVA) involves
taking a tablet containing a psolaren and then exposed the skin to UVA light
after around 2 hours.
5. Depigmentation
For patients who have vitiligo patches covering
more than half their skin, depigmentation or removing the remaining pigment is another
option. This is usually done by the application of the monobenzone ether of
hydroquinone twice a day to the normal skin until it also loses its color.
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Supportive Therapies for Vitiligo
Supportive therapies for vitiligo include the
use of:
1. Sunscreen
Sunscreens that offer protection from UVA and UVB
light should be applied on all areas affected by vitiligo to prevent sunburns
and skin cancer. These sunscreens should have a SPF of at least 30.
2. Camouflage cosmetics
Camouflage cosmetics like foundations can be
used to cover affected areas on the face. Self-tanning lotions can also be used
to mask larger depigmented patches on the legs and other parts of the body.
3. Psychological treatment
Counseling and cognitive therapy is important since
it helps improve the coping mechanisms of those who are psychologically affected
by the spreading white patches on their faces, hands, genitals and other parts
of their body.
