Vitiligo is a relatively common, acquired loss of pigmentation of the skin, affecting 1% to 2% of the population. Destruction of melanocytes, or pigment cells, occurs and the skin becomes white. The most common sites of pigment loss are body folds (like the groin or armpits), around body openings, and exposed areas like the face or hands. It can also develop at sites of injury: cuts, scrapes, and burns.
Vitiligo can begin at any age, but in half of all affected patients, its onset is noted before the age of 20. It can be associated with a number of autoimmune conditions, such as thyroid disease and diabetes. Most people with vitiligo are in good health and have no symptoms other than areas of pigment loss. Although the precise cause is unknown, genetic factors, autoimmune factors, trauma to the skin and anxiety or stress can be associated. Vitiligo is not infectious and cannot be spread to other people. People with melanoma can occasionally develop vitiligo. Research on the cause continues.
The diagnosis is based on clinical examination where asymptomatic white areas are present with well defined edges. Lesions can be either local or general and the distribution is usually symmetrical. White hairs can occur within an area of vitiligo and early graying or whitening of scalp hair, eyelashes, eyebrows and beard hair can also occur, as well also occur around the eye.
Vitiligo can remain localized and stable indefinitely, or it may progress slowly or rapidly. There is no way to predict this. Factors that have been suggested may include emotional distress, physical illness, severe sunburn, and pregnancy. De-pigmented areas may sometimes spontaneously re-pigment.
The cosmetic disfigurement, particularly in darker-skinned people, can have profound psychological effects. Low self esteem, depression and job discrimination have been reported, and vitiligo can therefore ultimately alter lifestyles, create social barriers and limit employment opportunities. It is therefore important to find treatment for these individuals.
There seems to be a hereditary component to vitiligo – 10% have a family history. Many people do not realize that anyone in their family has even had vitiligo. Children of people with vitiligo have a higher probability of developing vitiligo than children from families with no history of the condition. This, however, does not mean that these children will definitely inherit vitiligo. In most cases of vitiligo, there is no family history.
The answer at this time is no. Vitiligo is probably caused by a variety of factors interacting in specific ways. Research has advanced the understanding of the physical and psychosocial aspects of vitiligo, but the cause and cure are unknown. A specialist or dermatologist is the best person to assess and manage vitiligo. Unfortunately, the treatment of vitiligo is prolonged and progress is slow.
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