Vitiligo is a disease that causes loss of color pigment in the skin. As a result, the skin condition is like striped. This disease makes the original skin colors will disappear in certain areas and most often occurs on the back of the hands, face, and underarms. Moreover, this skin disease can also attack the hair and inside of the mouth.
Vitiligo is actually a non-lethal and non-communicable disease. However, it cannot be cured. This disease is related to other diseases such as thyroid and is estimated to affect 1 in 100 people.
How common is vitiligo?
Vitiligo can occur in people of all racial and ethnic groups. However, this disease will be more clearly seen in people with dark skin. This skin disease can also occur at any age. However, half of the cases occur in people less than 20 years.
The main symptom is the loss of skin color evenly in several parts of the body. Usually, the color change is first seen in areas exposed to sunlight such as hands, feet, arms, face, and lips. In general, the following are various vitiligo symptoms:
- Loss of skin color evenly in certain areas of the body
- An early appearance of gray hair in whole-body hair, eyebrows or beard
- Color loss in the tissue lining which lines the mucous membranes (in the mouth and nose)
- Loss or discoloration of the eyeball or retina
- Some sufferers feel pain and itching in the area of the skin affected by vitiligo
- A rash appears on the area affected by vitiligo, after exposure to the sun
As already mentioned before, this symptom can appear at any age. But generally, it more often appears before someone turns to 20 years old.
Reporting from the American Academy of Dermatology, vitiligo consists of 2 different types:
1. Segmental Type
The following is segmental type characteristics:
- Only appear in 1 part of the body such as legs, face, or arms
- Most of them have lost the color of hair, eyelashes or eyebrows
- Usually appears at an early age or very young
- It often lasts for about a year and then stops expanding
2. Non-Segmental Type
Non-segmental type is the type that most often attacks. The following is non-segmental symptoms that usually appear:
- Appears on both sides of the body, such as both hands or knees
- The first white patches are symmetrical
- Color loss starts from the tip of the finger, wrist, until the hand
- Appears on skin exposed to sunlight such as the face, neck, and hands
- Skin color disappears quickly then stops for a while and can start again
- Missing colors tend to develop and expand
Besides these two major types, there are several subtypes in vitiligo. Subtypes show the grouping spots that appear on the body. They are:
- Locally, the appearance of one or several spots on several areas of the body.
- General, the most common condition that causes spots to spread throughout the body.
- Universally, most of the skin pigment is gone.
So far, there is no way that can be done to predict how widespread the disease progresses. Some people can continue to experience expansion, while others cannot. There may be signs and symptoms not mentioned above. If you have a concern about a particular symptom, consult your doctor.
When should I see a doctor?
You should contact a doctor if your skin, hair or eyes change color. This skin disease cannot be cured, but therapy can prevent or slow down the process and can restore skin color.
If you have some signs or symptoms above or have other questions, consult your doctor. This is because each person’s body is different and can cause different symptoms. Always consult a doctor to get accurate information and proper treatment.
Vitiligo is a skin disease due to the loss of dye cells called melanocytes. Melanocytes are the parts of the body that produce melanin, the pigment that determines hair color. This disease is suspected to be autoimmune. Autoimmune diseases develop when cells in the immune system are mistaken.
T cells or cells that fight infection actually attack healthy cells as if they were killing germs that cause disease. In this case, the body may recognize melanocytes as a foreign substance. As a result, melanocytes are attacked and destroyed. So, they no longer work as they should.
There are many risk factors for vitiligo. They are:
- Family history, children who have parents with this skin disease are at risk of developing the same problem.
- Autoimmune diseases, especially Hashimoto’s disease (thyroid disease) or alopecia areata (causing hair loss).
- Triggering things such as sunlight, stress, or exposure to industrial chemicals.
People who do not even have these factors are not always free of vitiligo. Some of these factors are only the most common and frequent. You need to consult a doctor for more detailed information.
The information provided is not a substitute for medical advice. ALWAYS consult your doctor.
The following are various tests that can be done to diagnose vitiligo:
1. Medical History and Examination
When you check yourself, the doctor will usually examine the body by looking at symptoms that appear. The doctor will use a lamp with a special ultraviolet light to see the condition of the skin more clearly.
After that, the doctor will ask you and your family’s medical history. The reason is, vitiligo is a hereditary disease in the family. Through physical examination and medical history, doctors can begin to determine whether you have this disease or not.
2. Skin Biopsy and Blood Collection
Besides doing a physical examination and seeing your medical history, the doctor will take further steps. Biopsy or taking the sampling of skin affected by vitiligo is one of the methods to be performed. In addition, the doctor will also do a blood test to see if there are other diseases that trigger the emergence of this disease.
The treatment for vitiligo depends on health conditions, age, location of the disease, and its severity. Various treatments for vitiligo indeed cannot restore the skin color permanently. However, it is very useful to prevent the wider spread and even the skin tone. There are various treatment options for vitiligo:
1. Corticosteroid Cream
Corticosteroid cream is a topical medication used to treat vitiligo in a small area. This cream helps prevent the spread of pigment loss. So, it is not getting wider. In fact, applying corticosteroid creams to the affected skin helps restore color, especially if used early. About 45% of patients get almost normal skin color after 4 to 6 months.
This drug works most effectively in people with dark skin. Compared to the hands and feet, the face is the area that most feels the effect if treated with corticosteroid creams. This topical cream is quite effective and easy to use. However, like drugs in general, creams can cause side effects. One of them is skin thinning.
2. Medications that Affect the Immune System
These drugs are such as tacrolimus or pimecrolimus (calcineurin inhibitors). They are quite effective for areas of vitiligo that are not too broad. This drug is quite enough to give results if you lose skin pigment on the face and neck.
In addition, this treatment also has fewer side effects than corticosteroid creams. However, the Agency for Drug and Food Control in America found an association between the use of this drug lymphoma and skin cancer.
3. Light Therapy and Psoralen (PUVA)
This therapy is done by combining substances derived from plants (psoralen) with light therapy. The goal is to restore the original skin color. Usually, it is used for conditions that are widespread.
In this therapy, the doctor will give psoralen to drink or rub for immediate use in the affected area. After that, light therapy such as UVA, UVB, or excimer light will be given.
Therapy is quite effective in returning the pigment in the face, body, upper arms, and upper legs about 50 to 75 percent. Unfortunately, this procedure is not very effective for the hands and feet.
To get maximum results, you need to repeat the treatment up to 3 times a week for 6 to 12 months. This combined therapy tends to have better results compared to just medication or just light. Psoralen side effects can affect the eyes. Therefore, doctors usually advise you to do an eye examination before and after treatment.
Depigmentation is usually used if it has a widespread area. In addition, this therapy is also recommended if other treatments are not successful. This therapy aims to reduce the color of the skin in the unaffected area to match the other whiter areas.
Depigmentation is used by using lotions or ointments that are strong enough like monobenzone, mequinol, or hydroquinone. Therapy will be done once or twice a day for nine months or more.
This treatment can provide results that last long enough. Unfortunately, it makes the skin become more fragile and very sensitive to the sun. In addition, side effects that are quite disturbing are redness, swelling, itching, and dry skin.
Surgery is the last method to be performed if other therapies are not successful. The goal is to even out skin tone by returning the color to the original. There are several ways to do that:
The skin graft is done by removing small portions of normally pigmented skin. Then, this part will be attached to the area that loses pigment. Generally, this surgical procedure is done if you have small patches. Moreover, this procedure is only recommended for adults whose patches have not changed after six months of treatment.
Children are not recommended to undergo this process. People whose bodies are prone to keloids (protruding scars) are also not advised to do this procedure. Usually, this method is quite effective up to around 90 to 95 percent. The side effects that may arise are infection, scarring, to the failure of the skin to be fused.
In this procedure, the doctor will make a small incision on the pigmented skin by being vacuumed. Then, the upper part of the skin is removed and transplanted into the area that changes color.
However, the risk is the same as the previous surgical procedure which is scarring to the skin that cannot be fused. In addition, skin damage caused by suction can also trigger the appearance of other spots.
This method is done by doctors using special surgical tools to implant pigment into your skin. Usually, this method is effective for the inside and around the lips of people with darker skin. The disadvantage is the difficulty of matching the right skin color. In addition, tattoos also have the potential to trigger the appearance of other vitiligo spots.
6. Home Remedies
Here are the lifestyles and home remedies that can help you deal with vitiligo:
Protect Skin from UV Rays
When suffering vitiligo, try to keep the skin away from excessive exposure to natural and artificial UV rays. Use sunscreen with high SPF if going outdoors. At least, choose a sunscreen that has an SPF 30 and waterproof.
Apply for two hours or at any time when you feel the sunscreen faded due to sweat. In addition, protect the skin from the hot sun by wearing closed clothes. Use long sleeves with long pants and a hat if needed. Protecting the skin from sun exposure helps prevent sunburn. This is because sunlight can greatly aggravate your vitiligo conditions.
To increase your confidence, disguise the area of vitiligo with the help of cosmetics. This method can be done if the area of skin that loses pigment is not too broad. Choose colors that match your real leather. So the stripes on the skin can be well camouflaged.
Do not Get Tattooed
Covering the body that loses spots with a tattoo is not a wise choice. Instead of being covered properly, the skin can be more damaged. Moreover, tattoos can also trigger the appearance of new spots within two weeks after the procedure.
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Remember that there is no method of treatment that can provide a permanent and total cure for vitiligo. If you have questions, consult your doctor for the best solution for your problem.
Complications of Vitiligo
Untreated vitiligo can continue to develop, resulting in the following complications:
- Social or psychological stress, for example, lack of confidence
- Inflammation of the black part of the eye (iritis)
- Sunburn-prone skin
- Skin cancer
- Partial hearing loss
- Autoimmune diseases such as Addison’s disease, hyperthyroidism, or lupus disease