Vitiligo

Vitiligo is depigmentation of the skin. It causes the skin to lose color, and patches of lighter skin appear. This happens when the melanocytes (skin pigmentation cells) die or cannot function. It is not contagious or dangerous.

The exact cause is unknown but may be triggered by genetics, a virus or an autoimmune response. An autoimmune response causes the immune system to attack some part of the body by mistake. Other possible, but unproven factors include sunburn, emotional distress and self-destruction of melanocytes.

Vitiligo usually affects people in their twenties, but the condition can occur at any age. The disorder affects all races and both sexes equally. However, it is more noticeable in people with darker skin.

People with certain autoimmune diseases (such as hyperthyroidism) or parents who have vitiligo are more likely to get vitiligo.

Symptoms

Small white patches of depigmentation can signify vitiligo. This usually occurs in areas where the skin is most exposed to the sun, such as around the face, feet, arms, hands, and lips. Sometimes it also appears in armpits, rectal areas and the genitalia.

First signs of vitiligo can be a loss of color inside the mouths or eyes and graying of the hair. The white patches may spread at vastly different rates on the body or not at all.

What can I do?

Vitiligo is not contagious or life-threatening, but it can have a significant emotional impact. Many people experience low self-esteem or distress, especially if the patches are visible. Talking to friends, family, or joining a support group like The Vitiligo Society can help.

You may also benefit from psychological support, such as cognitive behavioural therapy (CBT), which your GP can arrange. Skin camouflage creams, matched to your skin tone, are available and can help cover the white patches. These are often offered through services like Changing Faces and may be prescribed on the NHS.

Should I seek medical care?

If you have vitiligo, you should discuss treatment options with your dermatologist. There are many treatment options. The goal of most treatments is to restore lost skin color.

Treatment for Vitiligo

While vitiligo cannot be prevented or cured, treatment may help restore some pigment and improve appearance. Common options include narrowband UVB phototherapy, topical corticosteroids, and calcineurin inhibitors.

Additional approaches include topical treatments, short courses of oral corticosteroids for rapidly spreading cases, and depigmentation therapy in extensive vitiligo (more than 50% body coverage), using creams such as hydroquinone under specialist supervision.

Treatments such as corticosteroids or calcineurin inhibitors can have side effects, including skin thinning or sensitivity. Regular monitoring by a GP or dermatologist is recommended to ensure safe use.