Vitiligo causes your skin to become less pigmented, and as a result, your skin develops light-coloured spots called macules. Usually, it first appears on the patient's face, hands, and forearms. Around 0.5-2% of people worldwide suffer from vitiligo, and even though it's not required, you can choose to treat the condition if you're unhappy with how your skin tone has changed. It is possible to treat vitiligo and get spotless skin, but it may take some time. 

It is difficult to say if and how much the patches will spread, and sometimes, the patches may stay constant for several years or months. Experts say that individuals with darker skin tones typically have lighter spots that are more noticeable. 

What is Vitiligo?

Vitiligo is a condition where certain patches of skin lose their colour; over time, the discoloured spots often enlarge. The illness may impact any area of the body, and even the interior of the lips and scalp may be impacted. Normally, melanin determines skin and hair colour, and vitiligo occurs when melanin-producing cells are killed off or cease to function. People with dark skin may notice vitiligo more than others; however, it impacts people with all skin tones. The illness is not communicable or life-threatening, but it may leave you feeling self-conscious because most people want spotless skin.

The skin affected by vitiligo may regain its colour with treatment, but treatment does not stop a recurrence or complete recovery of skin tone. Each person experiences vitiligo differently in terms of the overall area of skin affected. In some cases, people get the skin pigmentation back without treatment, but these cases are rare.  

Types of Vitiligo

Vitiligo may be classified into many categories based on how the patches look, how much of the body they cover, and how widely they have spread. Vitiligo treatment depends on the type of vitiligo the patient has and how advanced the condition is. 

1. Nonsegmental Vitiligo

In this type, patches appearing on both sides of the body indicate nonsegmental vitiligo. However, its growth is slower than the patches limited to one body location. The patches frequently have some symmetry and occur evenly on both sides of the body. Furthermore, they usually show up on certain areas of the skin, like the hands, neck, and face, that are often exposed to the sun. This is the most prevalent kind of vitiligo, according to some researchers. Nonsegmental vitiligo can be subdivided into the following types: 

• Acrofacial vitiligo primarily affects the face, the area surrounding the genitalia, fingers, and toes.

• Mucosal vitiligo is mostly seen on the lips and mucous membranes.

• Generalised vitiligo has no particular patch size or location, resulting in sporadic patches on various bodily parts.

• Universal vitiligo causes the majority of the body to be depigmented and is a rather uncommon form of the disease.

• Indifferent vitiligo is also uncommon, but it may result from both segmental and nonsegmental vitiligo.

2. Localized Vitiligo

If a tiny region of the body is covered in only a few patches, a doctor may diagnose it as a localised vitiligo. These patches may appear on the body in a few different locations, but the total affected area is small.

3. Segmental Vitiligo 

Segmental vitiligo can result in a sudden loss of pigment on one side of the body and is less predictable than nonsegmental vitiligo. It may consistently grow for six to twelve months, but many persons with segmental vitiligo do not grow new patches once that period ends. A review paper states that only around 3% of vitiligo sufferers have segmental vitiligo, making it a less frequent condition. In addition, it usually manifests earlier than nonsegmental vitiligo only impacts a single body part, and usually reacts positively to vitiligo treatment. Typically, segmental vitiligo affects the skin in proximity to nerves that originate from the dorsal roots of the spine. 

Vitiligo Symptoms 

The development of flat, lighter-coloured spots or patches on the skin is a defining sign of vitiligo, and the first visible white spot is often the result of an injury or sunburn. It could seem like a plain patch at first, a shade lighter than the surrounding skin, but with time, it will get whiter and paler until it goes white. The patches have different sizes and shapes, and there may be instances when the spots' margins get inflamed, making them itchy.

Despite being more prone to sunburn, it doesn't result in any pain, soreness, or dryness in the skin. Each person experiences vitiligo differently, and many people might have a few little white spots that don't grow much bigger. In contrast, others can have larger white patches that connect and cover greater skin sections. In addition, some persons may also have pigmentation loss in the eyes, but that is uncommon.

What Is the Treatment for Vitiligo?

In recent years, there have been breakthroughs in the cure for white spots on the skin that have been immensely beneficial for vitiligo patients. However, vitiligo poses no health risks, so there is no need for treatment if you do not wish to go through the process.  If you wish to receive treatment, your healthcare provider can assist you in finding a treatment option to achieve a uniform skin tone if you have extensive vitiligo.  

Light Therapy

Your skin can be treated with light therapy or phototherapy to help restore its colour. For a brief period of time, your doctor may use light boxes, ultraviolet B (UVB) lamps, or medical-grade lasers to cure white spots on the skin. Multiple light treatment sessions may be necessary to notice considerable improvements in skin colour. UVA light therapy combined with oral psoralen medicine cures vitiligo in significant portions of the skin. Those with vitiligo on their neck, upper arms, and legs might benefit from this therapy.

Medications

While there isn't a particular prescription that will stop vitiligo from harming your skin, several medications can:

• Help melanocytes rebuild

• Slow down the rate at which pigmentation is lost

• Restore colour to your skin

The most common drug used to cure vitiligo is ruxolitinib.

Surgery 

Surgery is an option that can make the vitiligo-affected portion of the skin match the natural pigmentation. There are two types of surgery options: skin grafting and blister grafting. 

• In skin grafting, the vitiligo-affected area of your body is covered with skin removed from the unaffected area. 

• In blister grafting, your healthcare professional will suction a blister onto your skin and then cut off its top to fuse it to a vitiligo-affected part of your skin. 

Wrapping Up

Vitiligo is not harmful; thus, treatment may not be required in every case. However, skin pigmentation changes caused by vitiligo frequently cause people to feel uncomfortable or uneasy, which can lower their self-esteem. Although there isn't a cure for vitiligo, there are treatments that can manage the condition and increase the pigmentation level of the affected skin. 

If you or someone in your family suffer from vitiligo, speak to an expert dermatologist at a super-specialty hospital as soon as possible. The doctor will give you the best treatment options for your specific condition. 

FAQs

1. Is vitiligo contagious?

No, vitiligo is not contagious. It cannot be transmitted through physical contact, shared items, or proximity to someone with the condition.

2. Can vitiligo be completely cured?

There is no definitive cure for vitiligo, but treatments like phototherapy, topical medications, and depigmentation therapy can help manage and improve its appearance.

3. Does diet affect vitiligo?

While no specific diet cures vitiligo, a balanced diet rich in antioxidants, vitamins, and minerals may support skin health and improve overall well-being.

4. How long does it take to see results from vitiligo treatments?

The timeline varies based on the treatment and individual response. Some people may see improvements within weeks, while others might require months of consistent therapy. 

5. Can vitiligo affect mental health?

Yes, living with vitiligo can impact self-esteem and lead to anxiety or depression. Counselling and support groups can help individuals cope effectively. 

Citations

Allam, M., & Riad, H. (2013). Concise review of recent studies in vitiligo. Qatar Medical Journal, 2013(2). https://doi.org/10.5339/qmj.2013.10

Chen, J., Li, S., & Li, C. (2020). Mechanisms of melanocyte death in vitiligo. Medicinal Research Reviews, 41(2), 1138–1166. https://doi.org/10.1002/med.21754

Hann, S. K., & Lee, H. J. (1996). Segmental vitiligo: Clinical findings in 208 patients. Journal of the American Academy of Dermatology, 35(5), 671–674. https://doi.org/10.1016/s0190-9622(96)90718-5

Jan, N. A., & Masood, S. (2023, August 7). Vitiligo. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559149/

Joge, R. R., Kathane, P. U., & Joshi, S. H. (2022). Vitiligo: A Narrative review article. Cureus. https://doi.org/10.7759/cureus.29307

Mahajan, V., Vashist, S., Chauhan, P., Mehta, K. S., Sharma, V., & Sharma, A. (2019). Clinico-epidemiological profile of patients with vitiligo: A retrospective study from a tertiary care center of North India. Indian Dermatology Online Journal, 10(1), 38. https://doi.org/10.4103/idoj.idoj_124_18

Salama, A. H., Alnemr, L., Khan, A. R., Alfakeer, H., Aleem, Z., & Ali-Alkhateeb, M. (2023). Unveiling the Unseen Struggles: A comprehensive review of vitiligo’s psychological, social, and quality of life impacts. Cureus. https://doi.org/10.7759/cureus.45030

Seneschal, J., & Boniface, K. (2023). Vitiligo: current therapies and future treatments. Dermatology Practical & Conceptual, e2023313S. https://doi.org/10.5826/dpc.1304s2a313s

Vitiligo - Symptoms & causes - Mayo Clinic. (2024, February 1). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/vitiligo/symptoms-causes/syc-20355912#:~:text=The%20condition%20is%20not%20life,skin%20color%20or%20a%20recurrence.

Kubelis‑López, D., Zapata‑Salazar, N., Said‑Fernández, S., Sánchez‑Domínguez, C., Salinas‑Santander, M., Martínez‑Rodríguez, H., Vázquez‑Martínez, O., Wollina, U., Lotti, T., & Ocampo‑Candiani, J. (2021). Updates and new medical treatments for vitiligo (Review). Experimental and Therapeutic Medicine, 22(2). https://doi.org/10.3892/etm.2021.10229