Vitiligo is a continual and long-term skin problem that produces patches of white depigmentation that develop and enlarge in certain sections of the skin.
The patches appear when melanocytes within the skin die off. Melanocytes are the cells responsible for producing the skin pigment - melanin - which gives skin its color and protects it from the sun's UV rays.1
The total area of skin that can be affected by vitiligo varies greatly from individual to individual. Vitiligo can also affect the eyes, inside of mouth and hair. In the majority of cases, the affected areas remain discolored for the rest of the person's life.
Contents of this article:
Fast facts on vitiligo
Here are some key points about vitiligo. More detail and supporting information is in the main article.
- Vitiligo can affect people of any age, race or gender
- Currently, there is no cure for vitiligo
- Vitiligo affects melanocytes that produce the pigment melanin
- The exact cause of vitiligo is not known, but some researchers believe it to be an autoimmune disorder
- Some scientists think that vitiligo might be caused by a virus
- You cannot catch vitiligo from another person
- Vitiligo is split into two categories: non-segmental and segmental vitiligo
- Exposure to UVA or UVB light can help some individuals with the condition
- If more than 50% of the skin is affected, depigmentation might be an option
Causes of vitiligo
Surprisingly, the causes of vitiligo are yet to be precisely established, but most of the research so far points to the following:
- An autoimmune disorder - the patient's immune system becomes overactive and destroys the melanocytes2
- Genetic oxidative stress imbalance
- A stressful event
- Harm to the skin due to a critical sunburn or cut
- Exposure to some chemicals
- A neural cause
- Heredity - family link
- A viral cause.
Vitiligo is not transmittable; in other words, it is not contagious, people cannot catch it from each other.
Less than 1% of the population are affected by the appearance of vitiligo in their skin.3 It has no age, sex or ethnic discrimination, but studies have concluded that a larger percentage of cases seem to start around the age of 20.
Vitiligo signs and symptoms vary considerably from person to person. It is more pronounced in people with dark or tanned skin. Some may only acquire a handful of white dots that develop no further while others develop larger white patches that join together affecting larger areas of the skin.
Types of vitiligo
Scientists separate vitiligo into two types: non-segmental, and segmental vitiligo.
Non-segmental vitiligo is the most common type of vitiligo.
Non-segmental vitiligo is the most common type of vitiligo and occurs in up to 90% of people who have the disorder.
In non-segmental vitiligo, the patches often appear equally on both sides of the body, with some measure of symmetry. The symmetrical patches most commonly appear on skin that is exposed daily to the sun, such as the face, neck and hands, but can also appear in other areas:
- Backs of the hands
Non-segmental vitiligo is further broken down into sub-categories:
- Generalized vitiligo: no specific area or size of patches, this is the most common type
- Acrofacial vitiligo: mostly on the fingers or toes
- Mucosal vitiligo: depigmentation generally appears around the mucous membranes and lips
- Universal vitiligo: depigmentation covers most of the body, this is very rare
- Focal vitiligo: one, or a few, scattered white patches in a discrete area. Most often occurs in young children.
Segmental vitiligo has a different form; this condition spreads more rapidly but is considered more constant and stable than non-segmental. It is much less common and affects only about 10% of people with vitiligo.
Segmental vitiligo is more noticeable in early age groups, affecting about 30% of children diagnosed with vitiligo.
It is non-symmetrical and usually tends to affect areas of skin attached to nerves arising in the dorsal roots of the spine. It is more stable, less erratic and responds well to topical treatments.
Symptoms of vitiligo
The only symptom of vitiligo is the appearance of flat white spots or patches on the skin. Generally, the first white spot that becomes noticeable is on an area of the body that is exposed continuously to the sun.
Initially, the vitiligo starts as a simple spot, a little paler than the rest of the skin. But gradually, as time passes, this spot will become much paler until it becomes white.
The shape of these patches are completely irregular, and, at times, the edges can become a little inflamed with a slight red tone, sometimes resulting in itchiness. Other than the appearance of the spots and occasional itchiness, vitiligo does not cause any discomfort, irritation, soreness or dryness in the skin.
Vitiligo is photosensitive; patients should avoid exposing the skin to direct sunlight for a prolonged period.
Predicting whether vitiligo will spread, and by how much, is particularly difficult. The spread of white patches might occur in a matter of weeks for some, and for others, they might stabilize, not growing for months or even years.
If the first symptoms of the white patches are symmetrical (non-segmental vitiligo), the development is much slower than if the patches are in only one area of the body (segmental vitiligo).
On the next page, we look at treatment options for vitiligo, possible future cures and complications.