Vitiligo is a skin disease that causes loss of pigment, resulting in the appearance of white patches on different parts of the body. This condition affects millions of people around the world, regardless of gender, age or race, although it tends to be more visible in people with darker skin tones. Despite its chronic nature, vitiligo is not a contagious disease nor dangerous to physical health, but it can have a significant impact on the emotional health and quality of life of those who suffer from it.
What is vitiligo?
Vitiligo occurs when melanocytes, the cells responsible for producing melanin (the pigment that gives skin its color), die or stop working. Melanin is the substance that protects the skin from ultraviolet rays and determines the color of the skin, eyes, and hair. When these cells do not produce enough melanin, the skin becomes discolored, creating white or depigmented patches that can vary in size and distribution.
Vitiligo can appear anywhere on the body, although it is most common on sun-exposed areas such as the face, hands, and feet. It can also affect the mucous membranes inside the mouth, eyes, and scalp.
Types of vitiligo
Vitiligo comes in several types, depending on how and where the spots appear. The main types are:
Generalized vitiligo: This is the most common type, where the depigmented spots are distributed symmetrically in various parts of the body.
Segmental vitiligo: In this type, the spots appear only on one part of the body, usually in a smaller area, and usually progress over a limited time.
Localized vitiligo: Affects only a few areas of the body and usually does not progress to other areas.
Vitiligo universalis: This type is rare and is characterized by almost complete loss of pigment throughout the body.
Each case of vitiligo is unique, and the severity of the condition can vary considerably from person to person. Some people may develop only a few spots, while others may experience pigment loss over large areas of the body.
Causes of vitiligo
Although the exact causes of vitiligo are not fully understood, a combination of genetic, autoimmune, and environmental factors are thought to contribute to its onset. Possible causes include:
Autoimmune theory: One of the most widely accepted theories suggests that vitiligo is an autoimmune disease, meaning that the immune system mistakenly attacks melanocytes, destroying them or inhibiting their function. People with other autoimmune diseases, such as Hashimoto's thyroiditis or rheumatoid arthritis, may be at higher risk of developing vitiligo.
Genetic factors: There is evidence that vitiligo may be hereditary. About 20% of people with vitiligo have at least one close relative with the disease. Certain genes have been identified that may increase susceptibility to vitiligo, but not all carriers of these genes develop the disease.
Oxidative stress: It has been hypothesized that an imbalance between free radicals and antioxidants in skin cells may play a role in the development of vitiligo. Oxidative stress can damage melanocytes, which may explain why some people develop vitiligo after experiencing emotional or physical stress.
Environmental factors: Skin injuries, exposure to chemicals, or severe sunburn can trigger or worsen vitiligo in genetically predisposed individuals.
Vitiligo symptoms
The main symptom of vitiligo is the appearance of white or depigmented patches on the skin. These patches may be small at first, but they often grow and spread over time. Other characteristics include:
Loss of skin pigment: The spots are usually most noticeable on sun-exposed areas, such as the face, hands, arms and feet, although they can also appear on other parts of the body.
Loss of hair color: People with vitiligo may notice that the hair on their scalp, eyebrows, eyelashes, or beard turns white prematurely.
Discoloration of mucous membranes: Internal areas such as the lips, mouth, or genitals may also be affected.
Eye color change: Although less common, vitiligo can affect the melanocytes in the eyes, which can cause a slight loss of pigment in the iris.
Diagnosis of vitiligo
Vitiligo is usually diagnosed by a dermatologist based on a physical exam and a review of the patient's medical history. In some cases, a Wood's lamp, which emits ultraviolet light, may be used to better view the affected areas of the skin.
If there is a suspicion that vitiligo may be related to other autoimmune diseases, your doctor may recommend blood tests to check thyroid function or detect the presence of abnormal antibodies.
Treatments for vitiligo
Although there is no definitive cure for vitiligo, there are several treatments that can help improve the appearance of the skin and stop the progression of the disease. Treatments vary depending on the extent of vitiligo, the location of the patches, and the patient's preferences. Some of the most common treatments include:
Topical medications: Corticosteroids and calcineurin inhibitors are creams that are applied directly to the affected areas. These medications may help restore skin color in mild to moderate cases, especially if used early in the disease.
Phototherapy: Narrowband ultraviolet B (UVB) light therapy is one of the most effective treatments for vitiligo. This therapy is performed in a dermatology clinic and involves exposing the affected skin to UVB rays, which can stimulate the production of melanocytes.
Skin grafts: In more extensive cases of vitiligo, skin grafts may be performed. This procedure involves transplanting small areas of pigmented skin to the depigmented areas.
Depigmentation: In cases of very extensive vitiligo where treatments have not been successful, some patients choose to depigment the remaining areas of pigmented skin, achieving a more uniform skin tone.
Makeup and self-tanners: Some people opt for cosmetic products, such as makeup or self-tanners, to hide white spots and achieve a more even appearance.
Although vitiligo is not a dangerous disease for physical health, its impact on the emotional and psychological well-being of patients can be profound. Visible patches on the skin can generate feelings of insecurity, anxiety or depression, especially in societies where physical appearance plays an important role.
It is essential that people with vitiligo receive emotional support. Support groups, psychological therapy and counselling can be useful tools for coping with the emotional challenges that this condition brings.
Vitiligo is a disease that, although not life-threatening, can have a significant impact on the quality of life of those who suffer from it. While there is no definitive cure, advances in medicine have allowed the development of treatments that improve the appearance of the skin and stop its progression. In addition, emotional support and education about the disease are essential to help people with vitiligo lead full and healthy lives.