VITILIGO

 Basic information

description

Vitiligo is a loss of skin pigment (color) that results in white patches. It often affects the skin on the hands, face and lips, arms, armpits, legs, and, sometimes, the genitals. It is more common in late childhood (9 to 12 years) to mid-adulthood. This condition can affect persons of any race or ethnic group. Most people who get the disorder are in good general health.

FREQUENT SIGNS & SYMPTOMS

• White patches on the skin.
• They are flat and can't be felt with the fingers. Skin texture does not change.
• They don't hurt or itch.
• They spread to form very large, irregularly shaped areas without pigment.
• The amount of skin affected differs in each person. Some may have small areas, while others may gradually lose pigment over their entire body.
• Hair color may turn gray prematurely.

causes

Exact cause is unknown. An autoimmune problem is likely involved. The immune system by mistake attacks the body itself. With vitiligo, it attacks the pigment-producing cells (melanocytes), and they become weak or die, resulting in a lack of pigment production. Genetic factors may also play a role.

risk increases with

• Family history of vitiligo.
• Autoimmune disorders (e.g., thyroid disease).

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

• Treatment can be prolonged and often unsatisfactory. Complete and permanent repigmentation rarely occurs. It is impossible to predict how much improvement will occur with treatment. Younger individuals (under 30) and those who obtain treatment early usually respond best. Allow 1 year to evaluate results.
• Research is ongoing to look for the causes and find new, effective forms of treatment.

possible complications

• Disorder may never disappear completely, causing permanent white skin areas.
• Emotional problems may occur.
• Eye problems.
• Increased risk for autoimmune disorders.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam of the affected areas of the skin. Medical tests may be done to check for disorders such as a thyroid problem.
• Treatment is sometimes not needed. The disorder is benign and often more of a cosmetic concern.
• Some patients with limited disease may choose to use a makeup product. Cover the affected skin with opaque makeup, self-tanning products, or dyes to help make it less noticeable. Use hair dye if hair affected.
• Counseling may be helpful for patients if the disorder is causing emotional problems.
• If treatment is desired, your health care provider will discuss several options. Treatment can be done to repigment the affected skin or depigment the non-affected skin.
• Treatment measures may include drugs, phototherapy (use of light), PUVA (light therapy combined with drugs), lasers, or surgery.
• To learn more: National Vitiligo Foundation, PO Box 23226, Cincinnati, OH 45223; (513) 541-3903 (not toll free); website: www.nvfi.org.

medications

• Drugs to apply to the skin for repigmenting (e.g., corticosteroids, immunomodulators, or repigmenting agents) may be prescribed.
• Drugs to apply to the skin for depigmenting (e.g., monobenzylether of hydroquinone) may be prescribed.
• Oral drugs (e.g., corticosteroids) may be prescribed.
• Use a sunscreen with SPF of 30 or higher.

activity

No limits.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of vitiligo.
• Skin appearance does not improve with treatment.

Special Notes: