Understanding Vitiligo
Vitiligo is often accompanied by social stigma due to its visible nature and misconceptions surrounding the condition. Start here for more resources concerning Vitiligo.
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What is Vitiligo?
Vitiligo is a skin condition characterized by the loss of pigment in certain areas, resulting in white patches on the skin. It occurs when melanocytes, the cells responsible for producing pigment, are damaged or destroyed. While the exact cause is not fully understood, factors like genetics, autoimmune response, and environmental triggers may contribute.
Signs & Symptoms
What are the symptoms:
Symptoms: The primary symptom is the presence of white or depigmented patches on the skin. These patches may vary in size and shape and can occur on any part of the body, including the face, hands, feet, and genitals.
Diagnosis
How do doctors diagnose vitiligo?
Dermatologists typically diagnose vitiligo based on a physical examination, medical history, and sometimes a skin biopsy. Wood's lamp examination or blood tests may also be used.
Treatment
What are the treatments for vitiligo?
There is no cure for vitiligo, but various treatments aim to manage the condition and improve skin appearance. These may include topical corticosteroids, phototherapy, and in some cases, surgical procedures.
Impact on Daily Life
Vitiligo can have various impacts on individuals, both physical and psychosocial. Here are some aspects to consider:
Psychosocial Impact:
Emotional Well-being: Vitiligo's visible nature can impact an individual's self-esteem and emotional well-being. Dealing with the stigma associated with altered appearance may lead to anxiety and depression.
Quality of Life: The psychosocial impact can significantly influence overall quality of life, affecting daily activities, relationships, and mental health.
Understanding the multifaceted impact of vitiligo is crucial for providing holistic support to individuals affected by the condition. Medical professionals, mental health experts, and community resources play essential roles in addressing the diverse aspects of living with vitiligo.
Roughly 1.9 million people are diagnosed with vitiligo in the United States. However, medical researchers believe that the number of actual cases may be closer to 2.8 million because many patients are undiagnosed.
FAQs
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LIGHT THERAPYUltraviolet light therapy (a part of sunlight) is the treatment of choice for patients with widespread vitiligo. It can also be used patients who fail topical therapy. There are several types as described below.
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NARROWBAND ULTRAVIOLET BNarrowband Ultraviolet B (UVB) treatment is widely used all over the world. It involves exposing the skin to UVB light two to three times a week, with average treatments lasting between 10 weeks and 2 years. It may take 30 or more treatments for a response to become apparent. Unlike PUVA (see below) with which the medication (psoralen) is taken orally or applied to the skin, UVB treatment is strictly a light therapy. It is proven to be more effective than PUVA and without the potential side effects of psoralen. The majority of patients (80%) that undergo ultraviolet light treatments will get a response, but individual degree of response varies. The typical response is seen as islands of freckles in the affected skin that will grow in size. Occasionally, the edges of the white area will tan and fill inwards. About half of the patients that respond to ultraviolet light will keep the new color.
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PUVAPsoralen + Ultraviolet A or PUVA (pronounced pooh-vuh) is sometimes used in patients who do not respond to narrowband UVB. PUVA involves taking an oral or topical medication (psoralen) followed by being placed in a light booth and exposed to ultraviolet A light. Patients are treated two to three times a week. It may take 30 treatments or more to see a response.
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EXCIMER LASERThe excimer laser is a form of ultraviolet B laser phototherapy that allows for targeted treatment of localized vitiligo areas. It is generally used for patients when vitiligo is localized to less than 10% of body surface (very small area). Excimer laser can be used as the only form of treatment for localized vitiligo, but better results have been observed when it has been used with other medical therapies, such as Protopic or topical corticosteroids (see above).
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DOES INSURANCE COVER THESE TREATMENTS?Treatment costs will vary based on the fee structure of the clinic or medical institution providing the service. You should check with your health insurance provider to determine if a particular treatment is covered. Ask your provider to give you the associated codes so you can call your insurance company to verify PRIOR to starting therapy.
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WHERE ARE LIGHT TREATMENTS AVAILABLE?You should check with your dermatologist on the location near your area.
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WHAT ABOUT BLEACHING CREAMS?Prescription bleaching creams are an option for those who have extensive involvement (80% or more of the body covered by vitiligo) and/or who do not respond to treatment. The skin with any remaining pigment can be bleached with bleaching creams; it usually takes 6-9 months of treatment (but can take 1-2 years) to have a noticeable result. This will result in the PERMANENT loss of any pigment in the skin. Your dermatologist should be consulted before attempting this option.
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WHAT OTHER TREATMENTS ARE AVAILABLE?Skin transplantation or grafting is another option available to individuals with stable vitiligo that only involves a small portion of the skin. This is called MKTP, or melanocyte-keratinocyte transplantation procedure. Surgical treatment for vitiligo is invasive and not without risks; however, it can be an excellent option for patients who fail non-surgical therapy. Ask your dermatologist if you are a candidate for surgical treatment. There are also oral medications that can be taken to assist with return of color. Gingko biloba and alpha lipoic acid are the two that are most recommended. These medications can be found over the counter (a prescription is not needed) and are taken 1-2 times per day. These are often combined with other therapies above for the best response. Ask your provider for a list of accepted brands.
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WHAT ABOUT TANNING TO RESTORE PIGMENTATION?It is recommended that individuals with vitiligo wear sunscreen to avoid sunburn. The white skin of vitiligo has no natural protection from the sun and is very easily sunburned. You must not treat vitiligo using tanning parlors. The light sources in tanning parlors are different from those used in the medical treatment of vitiligo. Furthermore, you do not receive any medical supervision in tanning parlors needed to control the amount of light and proper evaluation of your skin that you normally would receive in a medical institution.
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WHAT ARE SOME ALTERNATIVES FOR IMPROVING APPEARANCE?Cosmetic makeup, self-tanning compounds or dyes may be practical and quick options for some people to camouflage their skin color variations. Please note that this will not treat or stop progression of the condition. Dermablend, CoverFX, and CoverBlend are good brands of makeup often used by patients with vitiligo to even out skin coloration.
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IS THERE A CURE FOR VITILIGO?Unfortunately, no. While much progress has occurred in the treatment options for vitiligo, currently, there is no cure. Responses to treatment may vary and several types of treatments may be needed to get a response. Please consult your dermatologist to discuss your condition and treatment options.
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WHERE CAN ONE GET MORE INFORMATION?For general vitiligo information, you may also contact your local dermatologist or click below for more information for The Global Vitiligo Foundation The Vitiligo Research Foundation VITFriends Vitiligo Support International.
FDA Approves New Vitiligo Treatment, Ruxolitinib (Opzelura)
In September, the FDA approved topical ruxolitinib cream (Opzelura, Incyte) as the first JAK inhibitor to treat AD. Del Rosso noted its list of indications could expand in the near future. Recently released Phase 3 clinical trial program data shows positive outcomes for this JAK inhibitor in treating vitiligo and AA.