Vitiligo

Vitiligo is a chronic skin disease that causes loss of pigment, resulting in irregular pale or white patches of skin. Common areas of the skin losing pigment are the face, lips, hands, arms, legs, and genital areas. Vitiligo occurs when the melanocytes die or are unable to function. However, the precise cause of vitiligo is complex and not fully understood. Today, about 0.5 to 1 percent of the world’s population has Vitiligo. Most of the people who have vitiligo develop it before age 40; half the people develop it before their 20th birthday. Vitiligo affects individuals of all ethnic origins and both sexes; however, it is much more easily noticed on darker skin.

There are at least three theories about the underlying mechanism of vitiligo:

• Nerve endings in the skin release a chemical that is toxic to the melanocytes
• Melanocytes simply self-destruct
• It is type of autoimmune disease in which the immune system targets the body's own cells and tissues.

Vitiligo patches often occur symmetrically across both sides on the body. Occasionally small areas of the body may repigment as they are recolonised by melanocytes. Vitiligo may also be caused by stress that affects the immune system. The disturbed immune system may lead the body to react and start losing skin pigment. Vitiligo on the scalp may affect the color of the hair, leaving white patches or streaks and so affect facial and body hair.

When the pigment producing cells, the ‘melanocytes’ are attacked and destroyed, it may affect the skin, mucous membranes, eyes, inner ear or hairs leaving white patches. The usual type of vitiligo is called ‘Vitiligo Vulgaris’, meaning common vitiligo. It is often believed that vitiligo is an autoimmune disorder during which the bodies own immune system turns on itself. Certain white blood cells cause the death of melanocytes. People with vitiligo are also somewhat more prone to other autoimmune diseases. These diseases may include alopecia areata, autoimmune thyroid disorders, Addison’s disease, pernicious anemia, and diabetes mellitus.

Half the patients first notice vitiligo before they turn 20. The disease often starts appearing on the hands, feet or face, and frequently pigment loss is progressive. However, the degree of pigment loss can vary within each patch. The areas of minor injury or sunburn are more prone to it. There is some evidence suggesting that Vitiligo is caused by a combination of auto-immune, genetic, and environmental factors. Typical vitiligo shows an area of milky-white skin, but there may be different shades of pigment in a patch, or a border of darker skin may circle an area of light skin.

Vitiligo often begins with a rapid loss of pigment, leaving marks and may continue until the process stops. However, cycles of pigment loss may continue indefinitely. The marks may grow, shrink, or remain constant in size. It is rare for skin pigment in vitiligo patients to return on its own and to its normal. Some people who believe they no longer have the disease actually have lost all their pigment and no longer have marks of contrasting skin color. Although the patient’s skin is all one color, they still have vitiligo. The location of vitiligo affected skin changes over time; some patches may re-pigment and others may remain affected.

Most people with vitiligo are in good general health. But, it may occur with other autoimmune diseases such as thyroid disease. The duration and severity of pigment loss differ with each person. Light-skinned people usually notice the contrast between vitiligo affected areas and suntanned skin in the summer. There is no way to predict how much pigment an individual will lose; however, those with severe cases can lose pigment all over the body.

Though the change in appearance caused by Vitiligo can affect a person’s emotional and psychological well-being, yet there are several strategies help them cope with this disease. It is important to find a good doctor who takes the disorder seriously and provides emotional support. Individuals need to let their doctors know if they are feeling depressed. Doctors and other mental health professionals should be able to help patients deal with depression. Of the interest is the fact that some people with vitiligo have found cosmetics helpful overcoming their depression and embarrassment.

Cosmetics that cover the white patches may improve your appearance and help them feel better about themselves. But, before finding the product that work best, you may need to experiment with several brands of concealing cosmetics. It is also strongly suggested that patients should try to learn as much as possible about the disorder and treatment choices so that they can participate in making important decisions about medical care.