Vitiligo

What is vitiligo?

Vitiligo is a skin condition that causes you to slowly lose pigments in the skin called melanin. This means the colour of the skin is lost so you often see light patches of skin as a result. 

What are the symptoms of vitiligo?

The onset of vitiligo is gradual. It typically shows as pale patches on the skin, and the most common areas for this are:

• Mouth and lips

• Eyes

• Wrists

• Fingers

• Armpits

• Groin

Vitiligo patches are different on each person with the condition – mild vitiligo will show smaller areas on the skin compared to someone with a more severe form of the condition.

The patches often start off as pale before becoming entirely white. Sometimes they may appear red if the area has blood vessels under the skin. This means you could see either or both colours if you have the condition. 

Other symptoms include:

• Premature greying or whitening of the hair, scalp, eyelashes or beard

• Light patches of skin may be itchy when vitiligo is actively spreading, but otherwise it causes little to no discomfort

• Hearing loss, as cells inside the ear become affected

What are the types of vitiligo?

There are 2 main types of vitiligo:

• Non-segmental vitiligo – this is the most common type and it often appears symmetrically on each side of your body

• Segmental vitiligo – this type is more common in children and only affects one side of the body 

What causes vitiligo?

Vitiligo is caused by a reduction in the number of melanocytes. Melanocytes are cells that produce the pigment melanin, which is responsible for the colour of your skin.

It’s thought that vitiligo is caused by genetic and environmental factors. Scientists believe that non-segmental vitiligo is an autoimmune condition where the melanocytes are attacked by the immune system. 

Segmental vitiligo, on the other hand, is thought to be caused by neurochemicals (from nerves) which damage melanin producing cells.

How is vitiligo diagnosed?

A GP can diagnose vitiligo by asking a few questions. These questions may include:

• Does anyone in your family have vitiligo?

• Does anyone in your family have an autoimmune condition?

• Have you ever damaged the area of skin that’s affected?

• Have you tried any treatments?

At your appointment, you may also have procedures such as:

• Having your skin looked at under an ultraviolet light called a wood lamp – this enhances the white patches making them easier to see and helps the doctor exclude other skin conditions

• A dermoscopy which can tell the doctor whether the disease is active or stable. A dermoscopy is a procedure where your skin is looked at microscopically

• A skin biopsy, which is where an area of skin is looked at closely under a microscope.

You may have more tests to look for other autoimmune conditions – this is usually in the form of a blood test.

How to treat vitiligo

There is no cure for vitiligo but there are things you can do to treat the condition. These may include:

• Steroid cream which may restore pigment 

• Phototherapy, which is treatment using an ultraviolet light 

There are also some cosmetic ways of reducing the appearance of vitiligo for those that prefer it to be hidden. An example of this is using makeup products.

When living with vitiligo, it’s important to protect the light areas of skin from potential sunburn. Sunscreen should be applied more heavily to these areas.

Diagnosis

Vitiligo is relatively common, affecting 1% of the UK population. 

Vitiligo in children

In children, signs of vitiligo are similar to those in adults. The first sign is likely to be white patches on their hands, wrists, face or feet. You may also see lightening of their hair. It’s important that children with vitiligo are supported as their appearance may affect their confidence as they grow up.

How to prevent vitiligo

There’s no known prevention for vitiligo at the moment, but there are some steps you can take to prevent it worsening. These may include:

• Applying sunscreen

• Avoid injury to the skin

• Avoid tanning beds 

Who is at risk of vitiligo?

The likelihood of having vitiligo is often linked to whether anyone in your family suffers from vitiligo or any other autoimmune conditions.

When should I seek help?

If you’ve started to notice paler patches of skin that are persistent, speak to a doctor who can diagnose you or rule out other causes.