Vitiligo

What is Vitiligo?

Vitiligo is a chronic autoimmune condition that causes depigmentation of the skin due to the progressive loss of melanocytes (pigment-producing cells). It results in milky-white patches (leukoderma) that can occur anywhere on the body. Vitiligo is not contagious, but it can have significant cosmetic, social, and emotional impacts, particularly in people with darker skin, where the contrast between affected and unaffected areas is more noticeable.

Key Facts About Vitiligo

  • Prevalence: Affects 0.5–2% of the global population.

  • Cause: Likely a combination of genetic predisposition and autoimmune mechanisms, where the immune system mistakenly attacks melanocytes.

  • Associated Conditions: Vitiligo is often linked to other autoimmune diseases like thyroid disorders, diabetes, lupus, and rheumatoid arthritis.

  • Onset: Most cases develop before age 30, with peaks in childhood (<10 years) and early adulthood (20–24 years).

What Does Vitiligo Look Like?

  • Appearance: Patches of white, depigmented skin, often symmetrical and well-defined. The borders may appear inflamed, hyperpigmented, or normal.

  • Common Areas: Sun-exposed areas (face, hands), body folds (armpits, groin), areas prone to injury (knees, elbows), and around body openings (lips, nostrils).

  • Progression: Vitiligo spreads unpredictably, cycling through phases of spreading and stabilisation.

In darker skin tones, vitiligo is more visible and can lead to hyperpigmentation or hypopigmentation after repigmentation, adding to emotional challenges.

Who is at Risk?

  • Genetics: 20–30% of cases occur in individuals with a family history of vitiligo or other autoimmune diseases.

  • Autoimmune Connection: Conditions like thyroid disease, lupus, and diabetes are commonly associated.

  • Triggers: Emotional stress, skin injuries (cuts, burns, or friction), pregnancy, and certain medications may trigger or worsen vitiligo.

How is Vitiligo Treated?

Although there is no cure for vitiligo, treatments can stabilise the condition, promote repigmentation, and improve quality of life.

1. General Measures

  • Avoid skin injuries (cuts, burns, friction) to prevent new patches (Koebner phenomenon).

  • Use sunscreen to protect depigmented areas, prevent sunburn, and minimise the contrast between affected and unaffected skin.

  • Consider cosmetic camouflage: makeup, self-tanning products, or micropigmentation for visible areas.

2. Topical Treatments

  • Corticosteroids: Reduce inflammation and promote repigmentation in early-stage vitiligo.

  • Calcineurin Inhibitors (e.g., tacrolimus): Ideal for sensitive areas like the face and groin.

  • Vitamin D Analogues: May enhance repigmentation when combined with other treatments.

  • Ruxolitinib Cream: A newer treatment targeting immune pathways, effective for non-segmental vitiligo.

3. Phototherapy

  • Narrowband UVB (NB-UVB): The most effective light-based therapy for widespread vitiligo, promoting melanocyte activation.

  • Excimer Laser: Targets small, localised areas.

  • PUVA Therapy: Combines UVA light with a photosensitive medication.

4. Systemic Therapy

  • Oral Steroids: Used short-term to control rapid progression.

  • Immunosuppressants: Methotrexate or cyclosporine for severe or resistant cases.

  • Afamelanotide: A melanocyte-stimulating hormone analog combined with phototherapy for faster results.

5. Surgical Options

For stable vitiligo, surgical procedures like skin grafting, mini-punch grafts, or melanocyte transplantation can restore pigment.

Living with Vitiligo

Vitiligo often has a significant emotional and psychological impact. It can affect self-esteem, mental health, and social interactions. Support systems like counseling, family support, and cognitive behavioral therapy can help patients cope with the condition.

At our clinic, we provide comprehensive care that includes:

  • Diagnosis and personalised treatment plans.

  • Emotional support and psychological guidance.

  • Access to the latest medical advancements and therapies.

Book Your Consultation Today to start your journey toward healthier, even-toned skin!

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