Vitiligo
Published on Nov 22, 2015
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PRESENTATION OUTLINE
VITILIGO
Vitiligo is a long term skin condition that causes depigmentation of the skin in blotches. It can affect skin on any part of the body. It can also affect hair, the inside of the mouth and even the eyes. It affects people of all ethnicities but is more noticeable in people with darker skin. It is not life threatening or contagious.
CHANTELLE YOUNG-BROWN
FORMER CONTESTANT ON AMERICAS NEXT TOP MODEL
What causes it?
Vitiligo occurs when melanin producing cells called melanocytes die or stop producing melanin. Melanin is the pigment that gives skin, hair and eyes their color. Doctors still do not know exactly why this happens but some theorize it could be because of an autoimmune disorder, where the body attacks and destroys its own melanocytes. It could also be hereditary, or even be triggered by a traumatic event such as sunburn, exposure to chemicals and even stress.
SYMPTOMS OF VITILIGO
- Skin discoloration (the skin will become pale or white)
- Premature (before age 35) whitening or graying of the hair on the scalp, eyelashes, eyebrows, or beard
- Loss of or change in the color of the retina
- Vitiligo can start at any age but usually appears by 20
TYPES
- Generalized: Many parts of the body are covered with patches, it often progresses symmetrically on corresponding body parts.
- Segmental:Only affects one side of the body or one part of the body. This type usually occurs at a young age, progresses for a few years and then stops.
- Localized:One part or only a small area of the body is affected
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COMPLICATIONS
- Social or psychological distress
- More susceptible to sunburn and skin cancer
- Eye problems such as iritis
- Hearing loss (the correlation between hearing loss and vitiligo is evidence that vitiligo is a systemic disorder influencing the whole pigmentary system, including melanocytes in the inner ear. Cochlear melanocytes and also melanin-containing cellular elements of the auditory system may be affected in vitiligo and interfere with the conduction of action potentials.
HOW IS IT DIAGNOSED?
- If your physician suspects you have Vitiligo they will first ask about your medical history and will examine you to rule out dermatitis or psoriasis
- They may also take a blood sample and do a skin biopsy
- Your physician may suggest that you see an eye specialist and a hearing specialist because of the correlation between inflammation of the eye and increased risk of hearing loss in people with vitiligo.
AVAILABLE TREATMENTS
- Creams that control inflammation: topical corticosteroid, they are easy to use and usually effective.
- Medications that affect the immune system: Ointments are effective for treating small areas on the neck or face.
- Vitamin D: Topical cream that can be used with light therapy
- Medication and light therapy: This treatment uses a drug called psoralen with light therapy (photochemotherapy) to return color to light patches.
Creams contain corticosteroids may cause skin thinning or the appearance of lines or streaks on the skin.
Ointments contain an pimecrolimus or tacrolimus which the FDA has warned about a possible link between them and lymphoma and skin cancer
Vitamin D cream side effects include dry skin, itching, and rash.
After taking the psoralen by mouth or applying it to the skin you are exposed to ultraviolet A or UVB light. The drug makes your skin more sensitive to light so it turns pink. After it heals a more normal skin color will appear. This treatment may take repeated treatments lasting from 6 weeks to 12 months. Side effects include severe sunburn, blistering, itching, over darkening of the skin, an increased risk or cataracts and skin cancer. This treatment is not recommended for children under 12.
Other treatments include laser therapy, which brings color back to the skin by using a specified wave length of UVB light. side effects include redness and blistering.
Removing the remaining color is also an option when no other treatments have worked and the vitiligo is widespread. A medication containing monobenzone is applied to unaffected skin. This gradually lightens the skin so it blends with the affected areas.
Surgery is also an option if light therapy and medications don't work. Possible treatments include skin grafting (small sections of normal skin are attached to areas that have lost pigment) side effects include infection, scarring, a cobblestone appearance and failure.
Another option is blister grafting which involves the physician creating blisters on pigmented skin, usually with suction. He then removes the top of the blisters and transplants them to affected skin. Possible risks include scarring, a cobblestone like appearance, and failure of t he area to recover.
Tattooing also called micropigmentation is another option. The physician uses a special tool to implant pigmentation under the skin. It is most effective around the eyes but can be done on other small patches of skin. The only draw backs are fading, difficulty matching the skin, and inability for the skin to tan. The damage done from tattooing could potentially trigger another patch of vitiligo to appear.
Makeup and self tanners can also be used to improve the look of skin but isn't really a long term solution.
Ointments contain an pimecrolimus or tacrolimus which the FDA has warned about a possible link between them and lymphoma and skin cancer
Vitamin D cream side effects include dry skin, itching, and rash.
After taking the psoralen by mouth or applying it to the skin you are exposed to ultraviolet A or UVB light. The drug makes your skin more sensitive to light so it turns pink. After it heals a more normal skin color will appear. This treatment may take repeated treatments lasting from 6 weeks to 12 months. Side effects include severe sunburn, blistering, itching, over darkening of the skin, an increased risk or cataracts and skin cancer. This treatment is not recommended for children under 12.
Other treatments include laser therapy, which brings color back to the skin by using a specified wave length of UVB light. side effects include redness and blistering.
Removing the remaining color is also an option when no other treatments have worked and the vitiligo is widespread. A medication containing monobenzone is applied to unaffected skin. This gradually lightens the skin so it blends with the affected areas.
Surgery is also an option if light therapy and medications don't work. Possible treatments include skin grafting (small sections of normal skin are attached to areas that have lost pigment) side effects include infection, scarring, a cobblestone appearance and failure.
Another option is blister grafting which involves the physician creating blisters on pigmented skin, usually with suction. He then removes the top of the blisters and transplants them to affected skin. Possible risks include scarring, a cobblestone like appearance, and failure of t he area to recover.
Tattooing also called micropigmentation is another option. The physician uses a special tool to implant pigmentation under the skin. It is most effective around the eyes but can be done on other small patches of skin. The only draw backs are fading, difficulty matching the skin, and inability for the skin to tan. The damage done from tattooing could potentially trigger another patch of vitiligo to appear.
Makeup and self tanners can also be used to improve the look of skin but isn't really a long term solution.
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WHO IS AT RISK?
- Vitiligo usually appears in people by the age of 20. It occurs equally in all races and is equally divided between males and females.
- You are more likely to get it if you have a close blood relative with it or have an autoimmune disease like Hashimoto's disease (a thyroid condition) or alopecia areata
MANAGING VITILIGO
- If you have vitiligo it is very important to protect your skin from the sun. The use of sunscreen is essential as skin that has lost its pigment is more sensitive to sunburn and a lot of the medication given to treat vitiligo causes increased sensitivity to the sun.
- Wear clothing that protects and covers your skin from sun exposure.
- Do not get tattooed, it can cause something called Koehler phenomenon to occur. When the skin is wounded a new patch of vitiligo can appear 10-14 days later.
