What Is Vitiligo—and Why Does It Cause White Patches of Skin?
Experts don't entirely understand this life-changing skin condition. Here's what to know.
Vitiligo is a skin condition that causes people to lose pigment in patches of skin. These patches typically become more and more pale, eventually appearing white with clearly visible borders.
There are two kinds of vitiligo: segmental and non-segmental. The former typically affects just one side or area of your body. The latter is the most common form of vitiligo, and the white, pigmentless patches affect both sides of the body symmetrically.
Experts don’t entirely understand why a person develops vitiligo—nor do they know what determines which type they get, Christel Malinski, MD, board-certified dermatologist at Benson Dermatology, tells Health. “Vitiligo is a multifactorial disease that can have both genetic and environmental causes, and we don't really know why some people get one form over another.”
Here’s what to know about this life-changing skin condition.
Patches of skin without color are the main sign a person has vitiligo. But the condition can also cause hair to turn gray or white in the affected areas.
Vitiligo can show up anywhere on the body, but patches are most typically seen on the face, hands, underarms, and genitals.
Vitiligo patches vary widely in size and number from person to person. There's usually no way to tell when the vitiligo will stop or how fast it’ll progress.
Vitiligo develops when melanocytes (cells that produce pigment) die or simply stop making melanin. The medical community doesn't yet know exactly why this happens, just that there are genetic and environmental factors at play.
Often, vitiligo is considered an autoimmune disease. “Particularly in non-segmental vitiligo, the melanocytes are attacked by the body,” Dr. Malinksi explains. “It's also associated with other autoimmune conditions in some patients, so a lot of times, we'll screen vitiligo patients for other autoimmune diseases. If you have one autoimmune disease, you're more likely to have another.”
In addition to having other autoimmune diseases or a family history of autoimmune conditions, you’re also more likely to develop vitiligo if other family members have it, if you've been exposed to certain industrial chemicals, or if you have melanoma, a dangerous type of skin cancer.
How is vitiligo diagnosed?
Doctors can sometimes diagnose vitiligo just by looking at your skin (and hearing about your family history). But in other cases, it’s not as straightforward.
Sometimes a biopsy is needed, Dr. Malinski explains. “If the patient is very fair-skinned and the discoloration is not that obvious, a special light called a Wood’s lamp is used. The light basically helps to better see the color difference caused by the absence of melanocytes,” she says.
Vitiligo is a long-term condition, but it’s not life-threatening and does not necessarily need to be treated. Most treatments try to restore skin color or even skin tone, but they may not always work and could come with side effects.
If you do decide to pursue treatment, it might involve topical steroids, light therapy, or medication, Dr. Malinski says. There are also surgical procedures for vitiligo, including punch grafting, she says, “where you can take pigmented skin from one area of the body and transfer it to the area of vitiligo, and sometimes that skin will cause the vitiligo-effected skin to re-pigment.”
Coping with vitiligo
Many people who opt out of vitiligo treatment turn to cosmetics—foundations, concealers, etc.—to help cover up vitiligo if they’re really bothered by it. Others embrace their vitiligo and don’t cover it up—like model Winnie Harlow.
There’s one important step for anyone with vitiligo to take, however: sunscreen. The areas of skin that are affected by vitiligo are particularly susceptible to sunburns and sun damage because there’s no melanin to protect it. (There’s even a chance that sun damage may make vitiligo spread.) Sunscreen will also prevent tanning, and tanning can make affected areas more obvious.
In the end, there is no wrong or right way to cope with vitiligo. Only you can decide whether covering it up or celebrating it makes you feel the most confident and comfortable.
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