Vitiligo appears as one or more milky-white patches with sharp borders against normal-colored skin. The patches are usually round or oval, but some may have an irregular shape. Occasionally, the patches may merge and create larger, continuous skin changes. The patches are at the same level as the surrounding skin and are neither dry nor scaly. Typically, there are no symptoms such as itch associated with the skin.
The distribution of patches often follows asymmetrical pattern (present on both sides of the body and in the same locations) and commonly affects the extensor surfaces of joints (e.g., backs of hands and front of knees). The armpits and groin are also frequently involved.
Vitiligo is usually diagnosed based on a thorough medical history and careful examination of the skin. Biopsy (tissue sample) is rarely necessary.
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Vitiligo is caused by the loss of pigment cells (melanocytes) in the skin. The exact cause is unknown, but it is believed to bean autoimmune disease, where the body's immune system attacks and destroys the pigment cells, resulting in their disappearance. Without pigment cells, the natural (brown) color of the skin fades. Vitiligo is considered an autoimmune condition.
In rare cases, vitiligo may result from skin trauma or injury. There have also been reported cases where medications triggered vitiligo. The condition cannot be prevented.
There is no cure for vitiligo, and current treatment options have limited to moderate effectiveness. Treatments may include immunosuppressive creams/ointments aimed at slowing disease progression. Phototherapy with specific wavelengths of light may also be attempted.
Ongoing research is being conducted to understand the cause of the disease and develop more effective treatment options. For example, the efficacy of JAK inhibitors, which target specific signaling molecules in the immune system, is being investigated.
In addition to medical treatment, it is important to protect the patches with sunscreen. This is crucial as vitiligo patches are prone to sunburn, and sunburn itself can trigger further disease progression. Applying sunscreen to the surrounding skin can also help reduce the contrast between the affected and unaffected areas.
Many individuals with vitiligo choose to use self-tanning creams and other cosmetic products to reduce the visibility of the white patches. These self-tanning creams do not bring back the pigment cells but cause a chemical reaction on the skin's surface that produces a darker color. As mentioned earlier, injury and friction to the skin can provoke or worsen vitiligo. Therefore, it is important to consider lifestyle modifications and skin protection.
There are several other conditions that can cause localized areas of lighter or whitish skin, including pityriasis versicolor, post-inflammatory hyperpigmentation, lichen sclerosus, and idiopathic guttate hypomelanosis.
