Vitiligo is characterized by patches of skin pigment loss, turning areas of skin whiter in color. The rapid spreading usually begins before the age of 20, but can occur at any age. It is usually followed by long periods of no change. Patches of pigment loss usually occur on face, elbows, knees, hands, feet and genitals. The condition often accompanies prematurely graying hair. The suspected cause is auto-immune: when cells attack and destroy melanocytes—the cells that produce brown pigment. It is not contagious.
Diagnosis usually begins with a visual examination. Doctors will begin the process with a medical history, physical and an eye exam. Blood tests will rule out other auto immune diseases such as Addison’s disease, hyperthyroidism and pernicious anemia. A skin biopsy may also be performed.
There is no known way to prevent vitiligo and standard treatments do not exist. Dyes, stains, and self-tanners are often used but do wear off. Limited success has been had with phototherapy, corticosteroids, Excimer lasers, and narrow band UVB (nbUVB).
nbUVB requires psoralen; either as a cream or in oral form. The area is then exposed to natural or artificial sunlight. Nausea may occur with this medicine. Corticosteroids can slow the loss of color and help color return to small areas but may also cause thinning of the skin. Patience is required as these treatments take months to work. Nevertheless, it is important to begin treatment early because older patches are harder to repigment. In extreme cases, some people choose skin grafting or depigmentation.
Areas without pigment are at greater risk for skin cancer and therefore require regular sunscreen usage. Sunscreens also prevent tanning of the skin surrounding the depigmented areas which would make the vitiligo patches more noticeable.
Unfortunately, there is no known cure for vitiligo.