Treatment of vitiligo depends upon the severity of the disease and varies from person to person
Vitiligo is a skin disorder that causes white patches on the skin and leads to loss of skin colour. The condition can affect people of all racial backgrounds. However, it is more visible on people with darker skin. The discoloured patches appear when the melanin pigment which adds colour to a person’s skin and hair, starts decreasing.
It is an autoimmune disorder where a person’s immune system attacks its own tissues and organs. Although the trigger is unknown, a combination of stress, genetic factors, skin damage and exposure to harsh chemicals are considered to be the contributing factors for vitiligo. While some people may have a few small spots, the disease could remain static or progress slowly and yet spread quickly and cover the entire body in a matter of months in some patients. A rare variant, universal or complete vitiligo, is said to affect the entire body.
There are two main types of vitiligo a person may have, segmental and non-segmental vitiligo. Segmental starts in childhood and is not associated with autoimmune conditions. It involves hair in the early stages, but is responsive to treatment. On the other hand, non-segmental can occur at any time, and is associated with autoimmune conditions. It affects the hair mostly in later stages and has poor response to treatment.
The loss of melanin is the only physical and visible symptom of vitiligo. It commonly appears on the hand, wrist, and face. These patches are painless and do not cause itching. But it can cause discomfort when exposed to the sun. Vitiligo is not contagious, but the disease has an impact on the patient’s life and they experience psychological distress and low self-esteem.
Treatment of vitiligo depends upon the severity of the disease and varies from person to person. General measures taken should include avoidance of trauma, wearing sun protective clothing and cosmetic camouflage. Depending upon the extent of body involvement, topical or systemic treatment consisting of steroids, calcineurin inhibitors, immunosuppressive therapies and phototherapy is considered. Surgical procedures are usually done in stable and cases not responding to oral or topical treatment, which includes procedures like punch grafting, melanocyte cell transfer, tattooing and skin grafting. With advanced treatment options vitiligo is now a more curable condition. It is best advised to avoid using home cures and consult a specialist dermatologist for better management and treatment options.
Further, person with vitiligo should always apply sunscreen of SPF higher than 15 to protect the skin from the sun and artificial sources of UV light. They should wear clothes that do not expose the skin to the sun; use a non-acidic soap while bathing. The skin should be kept moist and clean at all times. One should consume a balanced diet rich in C, B12, B6, and minerals like zinc and calcium.
Vitiligo is often poorly understood and people should know that this disorder is not lethal or infectious, and people with vitiligo should not be socially neglected. While many studies are underway, further studies are needed to improve the understanding of diseases and thereby lead to better treatment outcomes.
The author is a Consultant Dermatologist, Trichologist and Aesthetic Dermatologist, Kokilaben Dhirubhai Ambani Hospital. Views are personal.