Jacob Wolff, MPA-C
June 25th is World Vitiligo Day. It has been celebrated around the world since 2011 to recognize the over 100 million people around the world living with vitiligo, bring awareness to the disease, and work toward finding a cure. According to the Vitiligo Research Foundation, there is an estimated 3.7 million people with vitiligo in the U.S. alone. So, what is vitiligo, and what is it like living with it?
Vitiligo is a chronic disorder that causes patches of skin to lose pigment or color. This is caused by the loss of pigment cells (melanocytes) that have been attacked by a person’s immune system, creating these milky-white patches of skin. The condition is generally asymptomatic, and it can be associated with other autoimmune disorders such as thyroid disease, diabetes, eczema, and hair loss.
It can affect any part of the body and occurs equally in people of all skin colors and races. Some of the most common sites are areas of exposed skin (face, neck, eyelids, hands, and toes), body folds, such as armpits and groin, and previous sites of skin injury. It is most pronounced on people with dark or tanned skin.
Vitiligo can vary widely from person to person, but it is often symmetric (affecting both the right and left sides of the body equally.) It can be just a few patches on some people that may not develop any further, and on others, the lesions will merge and cover significant areas of the body.
Diagnosing Vitiligo
There is no specific test for vitiligo. The diagnosis is typically clinical based on the appearance of the skin and pattern. It is essential that you consult with a trained Dermatology Provider to help you with your diagnosis and treatment. White patches on your skin may be vitiligo or one of several skin conditions with similar symptoms.
Once you are diagnosed with vitiligo, your Dermatologist will establish which type your symptoms fall under. The two basic types are Generalized Vitiligo (also known as Non-Segmental) and Segmental Vitiligo. Ascertaining the type will allow your Provider to individualize your treatment for better results.
Generalized Vitiligo is the most common type. This is the symmetric type and often begins with a rapid loss of color, then stops for a while. This stop and grow cycle can go on for the person’s lifetime. Color loss also tends to expand and cover large areas of the body.
Segmented Vitiligo appears on one body segment, such as the face, leg, or arm. About half of patients will also lose hair color, either on the head, eyelashes, or eyebrows. This type seems to begin at an earlier age and often progresses for a time and then stops.
Vitiligo Treatments
There is no cure for vitiligo, but the positive news is that it is not life-threatening or contagious. The goal of most treatments is to restore skin color. To this end, your Provider may choose to use more than one treatment, depending on your specific case. It is best to remember that treatments take time, and not everyone responds to them the same way. The following are some of the treatments that we use at Advanced Dermatology & Skin Surgery:
- Topical steroids and non-steroid topicals – these treatments are best for smaller areas and aim to return skin color to the affected areas.
- Medically directed UV light therapy – can be used on larger areas of the body. Patients will typically need several treatments a week for some time.
- Specialty lasers such as XTRAC® Therapy – lasers can be directed more effectively to a specific area. Most people see visible results after a few sessions.
Researchers are studying the genes that involve vitiligo to see if they can ascertain what is causing the loss of melanocytes and gain the knowledge to find a way to permanently stop the skin from losing its color.
Living with Vitiligo
As with any type of skin condition visible for the world to see, vitiligo can be difficult to live with. Many diagnosed with the disorder suffer from low self-esteem, depression, and anxiety. Having the information and some tools available may help you gain some control over vitiligo. Outside of medical therapy, there are various things that you can do to help manage your condition.
- Protect Your Skin from the Sun
Having vitiligo causes your skin to become even more susceptible to the sun’s UV radiation. The skin has lost its natural color, making it easier to get a sunburn. Some report a tingling, burning sensation when they go outside; plus, sunburn will only make your condition more noticeable if you have fair skin.
Use sunscreen daily! It is best when applied at least fifteen minutes before going outside. Use a broad-spectrum sunscreen of at least 30 SPF or higher and reapply every two hours. Always avoid any intense sun exposure and seek shade whenever possible.
Stay away from artificial sources of UV light. Sun tanning beds and sun lamps will also damage your skin.
- Wear Protective Clothing
Another effective strategy is to wear protective clothing such as long-sleeve shirts, broad-brimmed hats, and long pants. You may also want to look for clothing with a UPF (Ultraviolet Protection Factor) label. This factor indicates how much UV radiation a fabric allows to reach the skin. The Skin Cancer Foundation recommends fabrics with UPF of 30 or higher, with a factor of 50+ offering excellent protection.
- Take Advantage of Cosmetic Cover-Ups
You can safely add some color to your skin by using products readily available over the counter. There are some great self-tanning products, plus there are also concealers, dyes, and make-up that can help you even out your skin tone. It is best to look for products that are waterproof that will stay on your skin longer, and you can try different brands to see which one works best for you.
- Avoid Tattoos
Getting a tattoo causes damage to your skin and may cause a reaction called the Koebner phenomenon. This causes a new patch of vitiligo to appear, usually within two weeks of getting a tattoo.
- Connect with Others Who Have Vitiligo
Coping with this skin condition can be very difficult. Connecting with others who know exactly what you are going through can help. Reach out to a vitiligo support group in your area or online.
If you would like to connect with one of our highly-trained and qualified Providers at Advanced Dermatology & Skin Surgery, please reach out by making an appointment at one of our locations. They can help with any questions you may have about vitiligo and will work together with you to diagnose and treat your condition.
ABOUT THE AUTHOR
Jacob Wolff, MPA-C – Jake is a certified physician assistant specializing in medical dermatology and skin cancer treatments. He brings over 15 years of diverse physician assistant experience, including interventional radiology, emergency medicine, and dermatology. Jake grew up in the Inland Northwest, and he still has that passion for the outdoors, enjoying hiking, biking, and skiing with his family.