What is vitiligo?
Vitiligo a pigment condition that causes white patches to appear and spread. These patches are white, or at least much lighter than the original colour of the skin. Vitiligo is also known as leucoderma, meaning "white skin" in greek. It affects around 1 in 200 people, and isn't a deadly condition. It rarely causes derived complications when the proper protective measures are taken. White patches of vitiligo don't hurt, itch or become damaged more easily than non-affected skin.
The main impact that vitiligo has in patients isn't medical, but psychosocial. Patients with vitiligo are usually subject to discrimination and bullying, especially if they are young. When kids or teenagers start to develop vitiligo, it usually affects their quality of life and their social development. The cases when vitiligo is difficult to hide, like when it affects the face or the hands, are the worst. This condition can deeply affect the self-esteem and confidence of people and become a cause of segregation and harassment.
However, vitiligo is a skin disorder, not a life changer. Recently, health campaigns and even fashion campaigns have started to spread the word that there is nothing wrong with this condition or with people who have it.
Why does it happen?
The causes of vitiligo are unknown to scientists. As thousands of people are diagnosed with vitiligo, the same skin disorder Michael Jackson had, scientists study this condition to try and figure out what triggers it. Even if some patients report to associate the appearance of vitiligo to stressful situations, no link has actually been discovered, and the mechanisms of its genesis are yet to be found.
However, medical doctors have quite a clear idea on how vitiligo works. It is the result of immune system activation. This system is meant to attack and destroy potential threaths to our health, but in some disorders it can target substances or cells that aren't dangerous. When our immune system attacks our own healthy cells, we have an autoimmune disease.
There are cells in our skin, usually located at its first layer - known as epidermis - called melanocytes, meaning "black cells". Melanocytes produce melanine, the dark pigment that gives our skin its natural colour. Dark-skinned people have more melanin than fair-skinned people, though they all have about the same amount of melanocytes.
Vitiligo happens when our immune system attack and destroy melanocytes. As they no longer produce melanin, our skin becomes white. These white patches can appear at any age, gender or place in our bodies. They usually start to grow from periorificial areas such as mouth or eyes, or on bony prominences like hips, elbows, hands and feet.
As vitiligo is an autoimmune disease, thyroid and other autommune disesases should be discarded in these patients.
Vitiligo itself is a harmless condition, but it increases the risk of having skin cancer. Melanine is the natural pigment that protects us from the effects of solar radiation. Ultraviolet radiation is known to increase the risk of melanoma, the most severe type of skin cancer. In other words, people with vitiligo lack of pigment and burn easily in the sunlight. For this reason, they must protect their skin from radiation more than other people should. They must cover themselves with clothes and hats when walking under natural light. Also, sunblock is great to help prevent skin cancer due to solar radiation.
Treatment for vitiligo
As the causes of this condition haven't been clarified, there is no definite treatment for vitiligo. Even if scientists are working to find a cure for his condition, so far all doctors can do is try to prevent or decrease the spreading of white patches on the skin. There is no definitive treatment for vitiligo patients, but some measures can be taken to weaken the symptoms.
Steroid creams are the most frequent prescription for vitiligo. As steroids reduce the immune activity, they can protect the melanocytes from the destructive action of immune cells. Phototherapy with ultraviolet radiation is also prescribed in some cases, as well as pills.
For those cases that highly affect the quality of life of patients, there are surgeries available. Skin injerts are the most common intervention. A patch of skin that isn't affected by vitiligo is placed instead of an affected section. There is, of course, risk of scarring and a painful recovery, but this surgery has proven to be effective in some cases.
There is an experimental treatment that consists in skin cell transplant that is showing to be effective in clinical trials. The surgery is performed under local anesthesia and consists in transferring melanocytes and other skin cells from healthy areas of skin to affected areas. The results so far have showed great effectiveness, and white patches reduced significantly. This could be the discovery of a new, effective way of treating vitiligo.