Vitiligo

The pigment that gives your skin its normal colour is called melanin and is made by cells known as melanocytes. In patches of vitiligo the melanocytes are inactive but still may be present. The reason for this is not fully understood. However, vitiligo is considered to be an ‘autoimmune’ condition in which the body’s immune system rejects some of its own cells (melanocytes in the case of vitiligo). Thyroid disease and other autoimmune conditions are more common in individuals with vitiligo.

Repeated trauma such as burns, cuts, repeated pressure, rubbing or scratching the skin may trigger new areas of vitiligo in some patients. This is called the “Koebner Phenomenon”.

Vitiligo affects men and women of all races equally but is more noticeable in people with skin of colour. It is not infectious. There is no medical evidence of any link between diet or smoking and vitiligo.

Is vitiligo hereditary?

Yes, vitiligo has a genetic basis, although less than half of those with vitiligo know of someone in their family who also has it. If you have vitiligo, it does not necessarily follow that your children will develop it.

Vitiligo is not usually itchy or sore, but some people experience some itching sensation on the skin before a new vitiligo patch appears.

Sunlight may cause sunburn to exposed areas because there is no longer protective melanin in the vitiligo patches. In addition, some people may feel embarrassed by their vitiligo as it may stand out more obviously when the surrounding skin is tanned or richly pigmented.

Having vitiligo may affect you psychologically and you may experience anxiety, depression and low self-esteem. Please inform your doctor if this is the case, who will be able to recommend sources of self-help or referral to psychological services if needed.

Vitiligo consists of irregularly shaped patches of skin that lack the normal melanin pigmentation and are very pale, pink or white. It is often symmetrical, affecting both sides of the body. The skin otherwise feels entirely normal. The most common sites for vitiligo are the hands and face, around body openings (the eyes, nostrils, mouth, belly button and genital regions), and within body folds such as the underarms and groin. When hair-bearing skin is involved, the hair may lose its pigment and appear white.

Re-pigmentation (return of colour) often commences around hair follicles (roots), initially giving the skin a speckled appearance.

Images DermNetNZ.

The diagnosis is usually easily made by either your GP (including GP with Enhanced Role) or dermatologist. Occasionally, examination under an ultraviolet lamp is helpful to confirm affected areas, especially in light-skinned people. Once the diagnosis of vitiligo has been made, your doctor will usually take a blood sample to check for thyroid disease and may also test for other autoimmune conditions.

If you are avoiding all sun exposure because of your vitiligo you should discuss with your doctor about Vitamin D replacement and whether you may need your serum Vitamin D levels to be checked.

Clinical photographs may sometimes be taken by your doctor to monitor your vitiligo and the effect of any treatment you receive.

Can vitiligo be cured?

There is no cure for vitiligo. Although treatment may be helpful in restoring your skin colour, it cannot prevent its spread or recurrence and re-pigmentation may not be permanent.

There are treatment options that can be discussed with your healthcare professional.

You may decide not to treat your vitiligo, after talking to your healthcare professional. You may choose to protect your skin with sunscreens and find a good cover-up product for when you choose to use it.

If you do decide to seek treatment for your vitiligo patches, the following options are available.