What percent of the population is affected by vitiligo?
Vitiligo is a skin condition that changes pigmentation. Vitiligo triggers include autoimmune disease, neurogenic factors, genetics, sunburn, stress and chemical exposure.
Vitiligo is a skin condition that affects about 1% of the global population. It's often viewed as a cosmetic problem since it affects your appearance, but vitiligo is a medical condition. While most people with this disease are healthy overall, it can put you at risk for other health problems. Understanding the signs and causes of vitiligo can help you recognize symptoms and get the appropriate treatment.
What is vitiligo?
Vitiligo is a disease that affects the skin's pigmentation. When you have vitiligo, the skin starts to lose pigment cells (melanocytes). This results in a loss of skin color, or depigmentation, which changes into smooth, light or white areas.
This disease occurs equally in all genders and races, but it's much more noticeable in people with darker skin. The amount of depigmentation varies from person to person and depends on the type of vitiligo you have.
The two main types of vitiligo are:
- Segmental vitiligo: This type of vitiligo causes patches and spots only on one side of your body and in a few places, like the hands or face. The progression of depigmentation usually starts and stops within a year or so.
- Non-segmental (general) vitiligo: This is the most common type of vitiligo where multiple parts of your body are affected. It usually appears on both sides of your body, and depigmentation continues off-and-on over time.
The main subtypes of vitiligo are:
- Localized: This subtype of vitiligo usually has a few spots or patches of depigmentation that are limited to one or two areas of your body.
- Generalized: This subtype is the most common and features patches and spots of depigmentation scattered all over your body.
- Universal: This subtype is rare and occurs when almost all of your skin has depigmentation.
Signs and symptoms of vitiligo
A loss of natural pigmentation on the body is the clearest sign of vitiligo. This can occur anywhere on the body, including:
- Skin
- Hair
- Mouth
- Eyes
- Genitals
Some people with vitiligo also report itchy or painful skin where the patches are. Other symptoms include low self-esteem and depression because of how it affects a person's physical appearance.
Causes of vitiligo
Doctors are still trying to understand the root cause of vitiligo, but different theories have been connected to it:
- Autoimmune disorders where the body's immune system attacks a healthy part of the body may cause or contribute to vitiligo. White blood cells may attack melanocytes directly.
- Neurogenetic factors may cause the nervous system to go awry in some types of vitiligo.
- Genetics may play a part in vitiligo. If a close blood relative has had it, your chances may increase.
- An acute event, such as severe sunburn, stressful life event, or chemical contact, may cause vitiligo.
Diagnosing vitiligo
If you suspect that you have vitiligo, it's best to see a dermatologist for a confirmed diagnosis. They'll also tell you what specific type of vitiligo you have. Your doctor will ask about your medical history and your family history to find out if any relatives have vitiligo. They'll also perform a physical exam to look at the affected areas.
In addition to analyzing your skin, a dermatologist may also perform a blood test to check on your thyroid gland's health. Many people with vitiligo also have thyroid disease.
It is important to accurately diagnose and treat vitiligo, as it can put you more at risk for:
- Severe or painful sunburn
- Vision and tear duct problems
- Hearing loss
- Autoimmune diseases
- Anxiety and depression
Treatments for vitiligo
There are many different treatment options for vitiligo, and you should consult with your dermatologist to choose the right one. With all treatment options, though, the goal is to restore the loss of pigmentation. The type of treatment option they'll recommend will depend on your age, overall health, and the location of where vitiligo has appeared on your body.
Treatment options include:
Topical medication
Your dermatologist may suggest using multiple topical medicines to bring color back to the affected areas. The most common medications given are potent corticosteroids. Sometimes these are combined with other medications for maximum results. Topical treatments work best in people with darkly pigmented skin. About 45% of patients will see pigmentation coming back after four to six months.
Light treatment
Light treatment can restore the pigmentation in the skin. This type of treatment is more time-consuming and requires sessions two to three times per week. There are two methods used with light therapy: sitting in a lightbox or receiving excimer laser treatments. About 70% of patients regain color.
However, the results can disappear within a year if treatment is stopped. Your dermatologist may recommend doing light therapy in addition to using corticosteroids.
PUVA light therapy
This treatment option uses a combination of UVA light, and a prescribed medication called psoralen. The medication is either used topically or taken orally. PUVA therapy is useful in treating widespread vitiligo and can effectively restore color in your face, upper arms, upper legs, and trunk.
One thing to consider before committing to this therapy is time. It requires twice-weekly visits to a hospital or PUVA center for about a year, which will be closely monitored to avoid any serious side effects.
Surgery
Surgery for vitiligo is only recommended for adults and people who are not prone to scarring. There are different types of surgical options available, but all treatments involve removing skin with your natural color and placing it in depigmented areas. It's effective in about 90–95% of patients, but possible risks include infection and cobblestone-like skin.
Depigmentation
Depigmentation involves removing the pigment from all your skin. Few people with vitiligo choose this option because it will leave them with completely colorless skin. However, it may be a good option for adults with minimal color left in their skin. This treatment can take anywhere from one to four years to complete and involves using a cream twice a day to remove pigmentation.
Alternative therapies
Sometimes vitamins, minerals, amino acids, and enzymes are used to restore pigmentation. The herb ginkgo biloba has also been used to treat vitiligo. These interventions have been studied minimally or not at all, so more testing is needed to prove their effectiveness.
No treatment
Some people with vitiligo choose not to use any treatment options. This is also recommended for children to avoid any negative side effects caused by medication. Some people decide to use cosmetic options like makeup and self-tanners to even out skin tone. While it helps make it less noticeable, it can be time-consuming because you have to reapply the makeup consistently.
Vitiligo is usually treated with a combination of these interventions. Talk to your doctor about the best approach for your condition.