SKIN WHITENING DISEASE – VITILIGO

A disease in which skin loses its color in the form of patches is called Vitiligo. This condition can affect any part of the skin, including your hair and inside of the mouth. The discolored patches usually get more significant with time. The pigment on the skin and hair is determined by melanin, already present inside the human body. Vitiligo occurs when cells responsible for the production of melanin die or are impaired, failing to produce the pigment.

Vitiligo can occur in all skin types but is more visible in people with dark skin. It can make anyone feel bad about themselves, which can be stressful. The condition is not contagious or life-threatening. Vitiligo can’t wholly go, but the white patches can reduce its appearance on treatment with certain drugs. The pale areas are sensitive to sun damage; sunscreen with high SPF is necessary to prevent any discoloration.

WHY DOES IT OCCUR?

It occurs when the pigment-producing cells known as melanocytes become impaired due to the individual’s immune response. It’s an auto-immune disorder where a person’s body attacks its cells instead of attacking the invading germs. The immune response results in the loss of characteristic pigment- Melanin.

Vitiligo is also a hereditary disease. It can occur due to family history. If someone in your family has an altered gene, it can be transferred. Skin trauma, severe sunburn, stress, or contact with certain chemicals can also trigger Vitiligo.

PROGRESSION

The white patches are small initially at a few locations in the body. It gradually spreads to the whole body in several months. Vitiligo generally begins on the hands, feet, forearms, and face but can show up at any body part. It can also appear on the mucous linings of the mouth, nose, rectal and genital areas.

The white patches may continue to spread and become wide over time. Some patients show more minor patches.

WHAT ARE THE SYMPTOMS?

Vitiligo begins to appear as pale patches on hands, feet, or face, which gradually become white. They may remain unchanged in size, but from time to time, they might get bigger. You may have cycles of pigment loss and immobility. It also appears on eyelids and hair.

THE DIAGNOSIS

Primarily, the white patches on the skin are visible, and health care providers can examine them quickly. Doctors, at times, use a Wood’s lamp, which throws Ultra Violet light onto the skin that helps differentiate white patches from other skin conditions like Chemical Leucoderma, Tinea Versicolor, Albinism, and Pityriasis alba.

The diagnosis can include a biopsy and a few blood tests.

HOW TO MANAGE AND TREAT IT?

There’s no permanent treatment for Vitiligo. The treatment regimens include substances that can even out the skin tone by restoring the pigment or driving out the remaining color. Treatment of Vitiligo depends upon the age, how much skin is involved and where, how quickly the disease progresses, and how it affects a patient’s life.

Some medications have serious side effects, so your doctor might first recommend using a self-tanning product to change how the skin looks. If you’re being treated with medicines or surgery, the result comes in a few months, and there’s no certainty of progress.

– THERAPY WITH DRUGS

Anti-Inflammatory Drugs: The use of corticosteroid creams will help you to regain the pigment. It is most effective in the early stages, but it has side effects like thinning and the appearance of wrinkles and fine lines on your skin.

Medicines can’t correct or reverse Vitiligo. They can prevent further depigmentation and provide an even skin tone.

Immunosuppressants: Small areas of pigmentation can be treated by Calcineurin inhibitor ointments like Tacrolimus, Pimecrolimus. FDA has warned of skin cancer and lymphoma with the use of these drugs.

– THERAPIES

Phototherapy: Light therapy with ultraviolet (UV) B narrow-band has been proven to discontinue and slow down the spread of Vitiligo. It shows better results when used with corticosteroids or calcineurin inhibitors. The treatment requires three to four months to show results. You’ll have to get the phototherapy thrice a week.

Excimer lasers are also an option that emits a wavelength of ultraviolet light close to narrow-band UVB. This treatment option is approved for patients who do not have widespread or significant lesions since it is expressed in small, targeted areas.

Some side effects of UV B include burning, redness, and itching, which generally wears away after some time.

Combined Therapy: This treatment combines a plant-derived substance called psoralen with light therapy (photochemotherapy) to restore the lost color on the light patches. After taking psoralen by mouth or applying it to the affected skin, you’re exposed to ultraviolet A (UVA) light. This isn’t easy to perform and is replaced by UV B therapy.

Depigmentation: Depigmentation is considered when no other treatment option has worked for the patients, and Vitiligo has widely spread all over. A depigmenting agent is applied to the unaffected parts of the skin. It progressively lightens the darker areas, blends with the discolored skin, and achieves an even skin tone.

– SURGERY

When light therapies or drugs don’t work, surgeries are suggested to restore the lost color.

Skin Grafting: The surgeon transfers healthy small sections of your skin to the light patches; this treatment is usually for patients with more little patches. This treatment has some associated risks like infection, scarring, a cobblestone appearance, spotty color, and failure of the area to recolor.

Blister Grafting: The doctor creates blisters on your pigmented skin, commonly with suction, and then transplants the apex of the blisters to discolored skin.

Cellular Transplant: In this procedure, the doctor takes a part of tissue on your pigmented skin, puts the cells into a solution, and then transplants them onto the prepared affected area. The results of this repigmentation procedure start showing up within four weeks.

While you are waiting to see your doctor, limit your exposure to the sun in the meantime. Use a broad-spectrum sunscreen of above SPF  30 every time you step out in the day. If you feel conscious about how you look, apply makeup to even your skin tone.