Vitiligo is a skin condition characterised by loss of colour, typically in the skin and hair. It is thought to be autoimmune related, meaning the immune system is overactive. Rather than attacking infection, vitiligo primarily attacks the skin’s pigment cells. Pigment cells are responsible for colour, which is why the affected areas of skin turn from pale to losing complete loss of colour.
The cause of vitiligo is still unknown, but we do know that it is not triggered by any particular food choices, it is not cancerous, contagious, nor is it an infection. Many people report that it worsens during times of stress, and trauma to the skin may exacerbate the condition.
While it is not life-threatening, it certainly is life-altering. The psychological effects of the disease are far-reaching, impacting every sphere of life, especially self-esteem and confidence.
The vitiligo treatments and facts
Over 1% of the population suffer from this condition, and despite this, there is no cure. Furthermore, vitiligo treatments may or may not be effective.
Bringing more awareness to the condition may lessen the negative effects it has on the work life, relationships, and confidence of those who have this disease. A greater level of understanding from the general public would be particularly beneficial.
Vitiligo is a fairly asymptomatic condition, although some people may also experience itching or irritation around the affected area.
Around half of vitiligo cases are diagnosed before the age of 21, and the prognosis is generally uncertain. It’s difficult to say at the time of diagnosis whether the condition will worsen, remain stable, or improve over time. Each case tends to be unique, to a degree, even the amount of colour lost can vary among individuals. For that reason, we treat it as it arises.
This term relates to two medical conditions being present in the body at the same time. In the instance of vitiligo, other autoimmune diseases are commonly present. Around 20% of vitiligo patients had one other autoimmune conditions too. Thyroid disease and alopecia areata are two incredibly common diseases among those with vitiligo.Vitiligo treatment needs to be done with consideration of other possible conditions.
For people with vitiligo, it is important to remain vigilant of any possible bodily changes in order to identify a secondary autoimmune disease early on. Vitiligo sufferers may have other autoimmune disorders like Diabetes, pernicious anemia, inflammatory bowel disease, to name just a few.
How is vitiligo diagnosed?
Vitiligo is diagnosed by a dermatologist, like Dr. Khoza. In order to make an accurate diagnosis, Dr Khoza will ask you about your medical and family history.
As with most diseases, the earlier it is diagnosed, the better your response will be to treatment. Children generally respond well, as do most people’s facial regions. Hands and feet remain some of the more resistant areas. 4 – 6 months of therapy is necessary in order for vitiligo symptoms to improve. Here are some of the up to date therapies used to treat vitiligo:
There are a number of treatments available to control the symptoms of the condition, but there is no cure to completely eliminate it. Treatment options are chosen based on your health and the presence of other comorbid conditions. The severity, location, and other factors relating to the vitiligo itself also play an important role in choosing the correct form of treatment.
A number of topical steroids and topical creams can help to relax the autoimmune effect where they are applied, locally. Other more general steroids can also be used. It’s all about evaluating the condition, the patient, and the circumstances to choose a product and a treatment plan that will work best.
Phototherapy – narrowband UVB (or NB)
This vitiligo treatment stimulates pigment cells to produce melanocytes. NB vitiligo treatments entail exposing the body to light rays of the spectrum from 311-312 nm, the added benefit to this vitiligo treatment is that this light therapy is known for its ability to suppress the immune system. In the case of vitiligo, it can assist in controlling the overall condition.
There are different ways in which this therapy can be done, it can be done in a light cabinet at a dermatologist’s office. This is the most effective means of treating widespread vitiligo, and it is also necessary in order to achieve the immunosuppressant effects of light therapy. This form of NB therapy is safe for anyone who is old enough to lie still and keep goggles on in order to shield the eyes. NB vitiligo treatments can also be done at home with a prescription. These are more convenient and easier to use in selected areas, especially for young children.
This acronym stands for “Psoralen” and “UVA”. In this vitiligo treatments, you would first be given medications and then exposed to UVA phototherapy. The medications will then react to the light. You will also be required to wear sunglasses that offer UV400/UVB/UVA protection. They will need to be worn for 12 – 24 hours following vitiligo treatment, as there is the risk of causing damage to the eyes if they are exposed to UV rays after taking psoralens. This therapy is mostly outdated, as NB vitiligo treatments offer the same benefits with fewer side effects. Some of the side effects include an upset stomach, cataracts, liver issues, and burning. Because of these side effects, it’s not recommended for use on children. Learn more about protecting your skin from harmful UV rays and sun damage, here.
The 308 nm portion of the spectrum is used in this vitiligo treatment. It is very area specific, so it is only suited to small areas of stable vitiligo. It’s rather expensive and it carries the risk of further losing pigment once the vitiligo stabilises if the treatment is done on vitiligo that is not stable. There are side effects associated with this vitiligo treatment, most commonly burning. Results, however, are experienced earlier with laser than with other vitiligo treatments although areas like hands and feet are not generally treated with laser because it is not always effective.
Looking on the bright side
There is no vitiligo diet, as such, although a healthy lifestyle is always important. Caring for your skin is an important part of stabilising vitiligo, if you have dark skin, you can learn more about caring for your skin here.
While there are no cures currently, researchers are working hard at finding one and improving the current vitiligo treatments available. In the meantime, it is important to seek help with the psychological effects of vitiligo too. Joining support groups will foster a sense of community and acceptance while allowing you to express the challenges you face in a safe group of those who understand. Through these groups, greater awareness is brought to this condition, which will fuel research and hopefully provide a cure in the future.
A supportive doctor who will consider every element of your condition will also play an important role in stabilising and treating vitiligo. A doctor that offers understanding and vitiligo treatments options that are aligned with your needs will bring you both physical and emotional relief. Get yourself in a position to heal and live your best life. Book a consult with Dr Khoza today for care that promises a personal touch. Alternatively, you can learn more about Dr. Khoza and her prestigious medical background.