Everything You Need To Know About Vitiligo

Vitiligo is a condition in which there is loss of normal skin colour leading to appearance of white patches on the skin and/ or mucous membranes. It occurs due to dysfunction of pigment-producing cells (melanocytes) in the skin. To mark the occasion of World Vitiligo Day on 25'h June, Mumbai-based dermatologist Dr Bindu Sthalekar tells us all about its causes, prevention and more.

Symptoms:

► Vitiligo can affect any part of the body but can be seen more commonly on sun exposed areas such as hands, arms, legs, face, lips etc.
► It can also affect the mucous membranes such as the oral cavity, genitals, rectal area etc. It can affect people of any skin type but is more noticeable in people with dark skin.
► Vitiligo can be accompanied by loss of colour in the hair of skin, can appear as small patches or can cover large areas of the body too.

Causes:

There are several factors that may be involved in the development of vitiligo. Genetic tendency, autoimmunity (body's own cells attacking the melanocyte), oxidative stress, environmental factors like ultraviolet exposure, and psychological stress can all have a role to play in the development of vitiligo in an predisposed individual.

At the risk of developing skin cancer:

It was initially thought that people with vitiligo are at an increased risk of developing non-melanoma skin cancer due to the lack of melanin which plays an important role in protecting the skin against UV mediated mutagenesis. But studies have shown that people suffering from vitiligo do not have the risk of developing both melanoma and non-melanoma skin cancer. Vitiligo related genes seem to lead to an enhanced immune activity against skin cancers.

Prevention:

There are no sure-fire methods to prevent the occurrence of vitiligo, but these tips can help treat the condition.

► Use a broad spectrum sunscreen with an SPF of 30 or more for all the sun exposed areas, 20 minutes before sun exposure.
► Repeat it after every three hours to prevent excessive sun damage to the skin.
► Improving diet and nutrition and consuming foods rich in antioxidants, vitamins and minerals like B12, copper and selenium is also important.
► Stay away from psychological stress by making lifestyle changes as stress is a trigger for the development of vitiligo. Protecting the skin from trauma is important too.

Treatment:

There are several treatment options available for vitiligo depending on the site, extent of involvement, rate of progression and stability of the disease. The aim of all these treatment modalities is to cause repigmentation in the white patches.

► The most commonly used treatment measures when small areas are involved is the application of topical creams like corticosteroids, calcineurin inhibitors, placental extract etc.
► For rapidly progressing extensive lesions, oral corticosteroid, immunosuppressants like cyclosporine and methotrexate are necessary to control the patches from spreading.
► In case of stable disease (no new white patches), light therapy with excimer light and/ or laser, UVB or PUVA therapy are excellent options for repigmentation.
► In stable disease not responding to medical treatment options, surgical options like punch grafting, slit skin grafting and melanocyte transfer can be explored.
► In addition to these, some vitamins, minerals, amino acids and enzymes have been reported to restore skin colour in people who have vitiligo.
► Last but not the least, cosmetic options like camoflauge creams and micropigmentation of the white patches are safe ways to make patches less noticeable.
► In case of extensive disease not responding to any treatment, depigmentation of the normal skin to match the vitiligo area is also an option.

Diet guide:

► People with vitiligo can consume foods rich in antioxidants, vitamins B12 and E, folic acid, alpha lipoic acid and Omega 3 fatty acids.
► Many people have noticed improvement in vitiligo by drinking water stored in copper containers. The copper ions that are absorbed in the water stored in a copper vessel for 8-10 hours are found to stimulate the production of melanin which is essential for the body, thus increasing your chances of not getting vitiligo patches on your skin. Apart from that, copper also aids in the production of new cells that help replenish the topmost layers of your skin.
► It is recommended to restrict the intake of citrus foods rich in ascorbic acid in vitiligo as it tends to reduce pigmentation. Mango, cashew, pistachio, cherry, red chilli, areca nut are other foods should be restricted as they can increase the oxidative stress in the body.