Vitiligo and Loss of Skin Pigmentation

Vitiligo is a disease caused due to the loss of skin colour. This discoloured area usually gets brighter than normal skin. Usually, vitiligo starts to develop from the sun-exposed area of the skin like the arm, face, feet. etc. It can also affect the hair and inside of the mouth. Vitiligo is also known as leukoderma. About 1% of the global population is affected by vitiligo disease. Vitiligo usually occurs before the age of 30 years. 

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The above image shows, vitiligo definition: Whitening of the skin due to lack of melanin pigments. 

Vitiligo Disease Reason

The colour of the hair and skin is mainly determined by the melanin pigments. Vitiligo is mainly caused due to the loss of melanin pigments in the skin. The substance called melanocytes is responsible for producing melanin in the skin. The loss of melanocytes or loss of ability to synthesize melanin by melanocytes is the main cause of Vitiligo. Still, the reason vitiligo skin disease is unclear, and researchers suggest that it may be due to environmental factors such as autoimmune diseases like hyperthyroidism, pernicious anemia, and alopecia areata. One among the five-person who became a victim of vitiligo skin disease has genetic susceptibility. 

How Does Vitiligo Disease Look? 

Vitiligo meaning milk-white irregular oval patches on the skin. This patches will be small during the initial days but it begins to enlarge gradually within a month. Vitiligo patches are roughly symmetrical. Vitiligo disease can mostly spot on the wrist, neck, face, wrists, and upper trunk. The hair growing in the depigmented affected area is also in white colour. A person with all skin types has the same probability to get affected. But, the person with darker skin has a high chance to be a victim of vitiligo. Meanwhile, Vitiligo skin disease is not a life-threatening or contagious disease. 

Types of Vitiligo 

The vitiligos are mainly classified into two types. They are listed below.

1. Non-segmental Vitiligo 

2. Segmental Vitiligo

Non-Segmental Vitiligo

The non-segmental vitiligo is mainly forming symmetry in the location of depigmentation. New patches also appear over time and can be generalized over large portions of the body or localized to a particular area. Non-segmental vitiligo is common among teenagers. 

Non-segmental vitiligo is classified based on its affected area. The types of it are listed below. 

1. Generalized

2. Segmental

3. Mucosal

4. Focal

5. Trichome

6. Universal

7. Acrofacial vitiligo

Generalized: Generalized vitiligo is a common type. The patches start to appear in various parts of the body 

Segmental: If the patches or spots restricted to one side of the body then it is termed segmental vitiligo. 

Mucosal: When the vitiligo occurs in the mucous membrane of the mouth, nose, inner ear, and genitals then it is termed mucosal vitiligo.

Focal: This is a rare type of vitiligo. The macules or spots occur in a small area and do not spread to other areas.  

Trichome: Here trichome vitiligo skin looks like, colourless white spot present at the center, and lightly pigmented skin and normal skin covered the white spot.  

Universal: This type of vitiligo is rare. The person who got affected by universal vitiligo has a lack of pigmentation in 80% of the body skin. 

Acrofacial Vitiligo: This vitiligo usually occur in fingers and periorificial areas

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This image defines vitiligo and Types of vitiligo. 

Segmental Vitiligo 

Segmental vitiligo looks different in appearance and frequency. This mainly occurs due to the illness. It affects the area of skin associate with the dorsal roots from the spinal cord. Segmental vitiligo does not show any improvements for UV light or topical therapies. This can be treated with cellular grafting techniques. 

Treatment for Vitiligo

Still, now there perfect no cure method for vitiligo. The main aim of medical treatment is to create a uniform skin tone either by restoring the colour of the skin or by eliminating the remaining colours. The common treatment for vitiligo is listed below. 

1. Camouflage therapy

2. Repigmentation therapy

3. Light Therapy

4. Surgery 

Camouflage Therapy:

Sunscreen with an SPF of more than 30 with suitable UV B light and UV A light protection can be used to minimize the skin tanning effect. This shows a contrast between the affected skin and normal skin. Can apply makeups for the depigmented areas. Can apply Hair dyes for affected hair.  Can use the drug monobenzone for treating depigmentation. 

Repigmentation Therapy:

The doctors will suggest corticosteroids as a pill or ointment to apply to the affected skin to regenerate the skin pigmentation. It may take 2 - 3 months for complete recovery. But long term use of this drug may cause side effects like skin thinning or stretch marks. 

Light Therapy:

Narrow band ultraviolet B light required to treat the affected area. This treatment should take several months and requires two to three sessions in a week. The patients with widespread or large patches can use excimer laser, which emits light with a wavelength of UV close to narrow-band UVB. Combining oral psoralen and UVA (PUVA) is showing effective results for people, who have large vitiligo in the head, neck, trunk, legs, and upper arms. 

Surgery:

A person with vitiligo can opt for micro-pigmentation. It is like tattooing on the affected area.  Autograft is a method to treat vitiligo. That is the skin from one part of the body is used to cover another part of the body. But it has some complications like infections, rashes, scares and sometimes it may fail to re-pigment in the grafted skin.