WHAT IS VITILIGO?
Patients with vitiligo develop white spots on the skin that vary in size and location. The spots occur when pigment cells, or melanocytes, are destroyed and the pigment melanin can no longer be produced. Melanocytes normally occur throughout the skin, as well as in the hair follicles, mouth, and eyes. In vitiligo, pigment cells can be lost in any of these areas. Common sites of pigment loss are:
• Exposed areas: hands, face, upper part of the chest
• Around body openings: eyes, nostrils, mouth, nipples, belly button, genitalia
• Body folds: arm pits, groin
• Sites of injury: cuts, scrapes, burns
• Hair: early graying of hair of the scalp, beard or other areas
• Area immediately surrounding pigmented moles
• Back of the eye
Vitiligo (vit-uh-lie-go) causes the skin to lose color. Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.
Vitiligo usually affects the skin, but it can develop anywhere we have pigment. Patches of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color.
People of all races and ethnicities get vitiligo.
Vitiligo is not contagious. It is not life-threatening. But, vitiligo can be life-altering. Some people develop low self-esteem, no longer want to hang out with friends or develop serious depression. Most people have vitiligo for life, so it’s important to develop coping strategies.
A coping strategy that helps many people is to learn about vitiligo. Another helpful strategy is to connect with others who have vitiligo.
WHO GETS VITILIGO?
Vitiligo affects approximately 1% of the population worldwide. About 5 million people in the U.S. live with vitiligo. About half of the people who develop this skin disorder experience some pigment loss before the age of 20, and about one third of all vitiligo patients say that other family members also have this condition. Though its more noticeable on darker skin tones, vitiligo does not discriminate based on race, gender, socioeconomics or any other basis. Patients are usually not born with vitiligo. Though the average age for onset is in the mid 20's, onset can occur at any age. Even though most people with vitiligo are in good general health, they face a greater risk of having hyperthyroidism or hypothyroidism (increased or decreased thyroid function), pernicious anemia (vitamin B12 deficiency), Addison's disease (decreased adrenal function), alopecia areata (round patches of hair loss), and/or uveitis (inflammation of the eyes).
WHAT DETERMINES SKIN COLOR?
Melanin is the substance that normally determines the color of skin, hair, and eyes. This pigment is produced in cells called melanocytes. If melanocytes cannot form melanin or if their number decreases, skin color will become lighter or completely white as in vitiligo.
Leukoderma is a general term that means white skin. Severe trauma, like a burn, can destroy pigment cells resulting in leukoderma. Vitiligo is just one of the forms of leukoderma.
WHAT IS THE CAUSE OF VITILIGO?
The precise cause of vitiligo is not known. A combination of genetic, immunologic and environmental factors is involved in most cases. This means that certain people are predisposed (have a greater tendency) to develop vitiligo upon exposure to the right trigger. Many people report pigment loss shortly after a severe sunburn, while others have related their onset of vitiligo to emotional trauma associated with an accident, death in the family, or divorce.
HOW DOES VITILIGO DEVELOP?
The beginning of vitiligo and the severity of pigment loss differs with each individual. Light skinned people usually notice the pigment loss during the summer as the contrast between depigmented skin and suntanned skin becomes distinct. People with dark skin may observe the onset of vitiligo at any time. Individuals who have severe cases may lose pigment over their entire body surface. There is no way to predict how much pigment an individual will lose. Illness and stress can result in more pigment loss. The degree of pigment loss can also vary within each vitiligo patch, and a border of abnormally dark skin may encircle a patch of depigmented skin.
Vitiligo frequently begins with a rapid loss of pigment, which may be followed by a lengthy period when the skin color does not change. Later, pigment loss may resume, perhaps after the individual has suffered physical trauma or stress. The loss of color may continue until, for unknown reasons, the process stops. Cycles of pigment loss followed by periods of stability may continue indefinitely. It is rare (but possible) for a patient with vitiligo to repigment or regain skin color spontaneously. Most patients who say that they no longer have vitiligo may actually have become depigmented and are no longer bothered by contrasting skin color. While such patients appear to be "cured", they really are not. People who have vitiligo all over their bodies do not look like albinos because the color of their hair may not change (or it can be dyed) and eye color does not change.
DOES VITILIGO HAVE AN EMOTIONAL IMPACT?
Many individuals with vitiligo are distressed because of their uneven skin color. It is difficult for people who do not have vitiligo to appreciate the significance of this problem. Individuals with vitiligo benefit from talking to, and sharing experiences with, other people with the disease.