Is It Vitiligo

What is Vitiligo

Vitiligo is quite a common condition which makes the skin, and sometimes the hair, turn white in patches. This is because melanocytes, the cells which give the skin its colour, have been damaged.

Vitiligo is not contagious. You cannot pass it on to someone else by touching them and it is not infectious. Vitiligo is considered to be an ‘autoimmune’ condition in which the immune system attacks the body’s own tissues.

  • Vitiligo affects at least one person in every hundred throughout the world, including in the UK.
  • Anyone can develop the condition, whatever their skin colour or ethnic origin.
  • Vitiligo can begin at any age but about 50% of people develop it before the age of twenty

The most common form of vitiligo appears in symmetrical form (generalised vitiligo) affecting both sides of the body. In some cases only one half of the body is affected (segmental vitiligo); this type has limited progression and is more difficult to treat. Vitiligo can spread to cover the entire body surface (universal vitiligo) but this type is not common.

The way the condition develops varies from one person to another and it is unpredictable. Some people may not notice a change in their condition for many years whilst for others it can spread quite quickly. In some cases, the white patches can regain their colour without the person having any treatment. This is more likely with children. However, it is very unusual for the condition to be resolved completely without treatment.

There is, at present, no 100% cure. Established treatments can be effective in re-pigmenting the skin, sometimes completely. However, at present, there are no treatments that can prevent vitiligo developing again.

What are the causes of vitiligo?

The causes of vitiligo are not fully understood. Pigment producing cells (melanocytes) are not functioning properly in the white patches, although some of them survive, both in the skin and in the hair follicles there. There are a number of theories to explain the loss of pigment; the most popular being the ‘autoimmune’ theory which suggests that the body’s own immune system is attacking the pigment cells.

The causes of vitiligo seem to be a mixture of genetic and environmental factors. People with a particular combination of genes are more likely than others to develop vitiligo, but it is believed that some form of external trigger causes the initiation of the disease, such as:

  • Hormonal changes in the body, for example during adolescence.
  • Damage to the skin, for example from a cut or sunburn.
  • Extreme stress.
  • Contact with certain chemicals.

These factors could also play an important role in the development and progression of vitiligo. Products which contain phenol (also known as carbolic acid or phenic acid) are possible triggers for vitiligo and they can be found in:

  • adhesives
  • deodorants
  • disinfectants
  • duplicating paper
  • germicidal detergents
  • insecticides
  • latex gloves
  • paints
  • photographic chemicals
  • printing inks
  • soap antioxidants
  • synthetic oils
  • varnish and lacquer resins

Diagnosis of vitiligo

If you have white patches of skin, it is important to go to your doctor for a diagnosis. The commonest type of vitiligo is symmetrical, with the patches often on the hands, on folds of skin at the armpit and groin, and around the body’s ‘openings’ – mouth, eyes and genitals. There are other conditions which can be mistaken for vitiligo, so you need a medical diagnosis to be sure.
When you see the doctor, it may be helpful to:

  • write down questions before you go. This may help you to make sure your concerns are dealt with.
  • take a trusted person with you, who can listen and help you to make sense of the information afterwards.
  • ask for information to take away with you. You may want to find out more about vitiligo before making any decisions, and
  • arrange another appointment to discuss treatment options. Do not feel you have to commit yourself to a course of action if you are not ready to do this yet.

Vitiligo is not a physically ‘harmful’ or painful condition, so you may find that the doctor’s approach is to reassure you that having the condition is not ‘so bad’. You may find this reassurance helpful. However, people have different reactions to hearing that they have vitiligo. You may feel that focusing on the physical aspect of the condition does not take account of the emotional impact vitiligo can have. Having a changed appearance can be very distressing for many people – if this is how you feel, it is an understandable and normal reaction.

What Next?

Your feelings will probably be affected by where the patches are on your body, how noticeable they are, your age, family situation and so on. It may not be very noticeable so you may regard it as a nuisance rather than anything else. For some people, the diagnosis can come as a shock, with some people feeling a sense of detachment, or time standing still. This is a common response often associated with shock. For many people, doing something practical can help with these feelings.

What Can You Do?

  • Inform yourself: get information about vitiligo from the Vitiligo Society website and ask your doctor about available treatments and services. Good information will help you to make treatment decisions and may give you a better sense of control over your condition.
  • Share experiences with others: it can be reassuring to know that you are not alone in dealing with vitiligo. As well as giving support, other people can also be a significant source of information. The Vitiligo Society offers opportunities for you to meet other people with the condition.
  • Reduce stress: ask yourself if there are immediate changes you can make in your life that would decrease stress (and make them, if at all possible). Ask for support from your family or friends to help you do this.
  • Talk about your feelings: this may be with your family and friends. If you find this difficult, a ‘neutral person’ like a counsellor may be able to help.

Many thanks to the Vitiligo Society for their permission to share this information.