Vitiligo is an autoimmune condition that affects over 70 million people around the world.
It occurs in all races and ethnic groups and most commonly starts before the age of 30. It causes white patches of skin to develop and can occurs on the face, hands and body. It can even affect the lips and hair. But not all white spots are vitiligo. Post-inflammatory hypopigmentation, Pityriasis alba (a type of eczema on the face or upper arms) and Pityriasis versicolour (overgrowth of yeast on the skin) are some of the conditions that may be mistaken for vitiligo.
The founder of Chroma Dermatology, Dr. Michelle Rodrigues, is a globally renowned expert and key opinion leader in vitiligo.
She has published several research papers and textbook chapters on the subject and has been invited to speak nationally and internationally about the diagnosis and treatment of vitiligo. This expertise, combined with the best laser and light technologies available at Chroma gives patients the best possible chance of regaining pigment.
More about Vitiligo
Vitiligo is an autoimmune skin condition affecting approximately 1% of the population. Men and women are equally affected and it usually presents before the age of 30. Vitiligo results in white/light “spots” on the skin, which are caused by the absence of pigment cells (melanocytes) in the skin and/or mucous membranes (lips, genitals)
Vitiligo is an “autoimmune” process. This means that the person's own immune system accidently attacks the skin’s “pigment cells” (called melanocytes). This causes these cells to die, which causes the skin to turn white (called depigmentation). Vitiligo is not due to a poor immune system; in fact it is related to a small part of the immune system being “over active.”
Only about 20-30% of patients have an effected family member, meaning that in it is not inherited in the majority of cases. Some people report a single triggering event, such as sunburn/other skin trauma or severe emotional distress but these are just triggers for the underlying condition
Vitiligo looks like white, flat, non scaly spots. It may be seen on any part of the skin, lips and genitals and white hairs (scalp, eyelashes etc) may also be seen. Sometimes the white spots can be seen in areas of trauma (eg. hips – where pants sit, armpits – where shaving or friction occurs and at sites of surgery).
Not all white spots are vitiligo. Many other conditions can appear similar to this. A consultation with a dermatologist who specialises in pigmentation is recommended to establish the diagnosis.
Vitiligo is not contagious, is not an infection and is not diet-related. Some people with vitiligo also have other “auto-immune” conditions such as thyroid disease (about 15%), diabetes or anemia (less than 1%). During the consultation, we will determine what tests, if any, are necessary for your unique situation.
Other skin problems that can occur with vitiligo are small patches of hair loss (called alopecia areata) or moles with white halo around them (called halo neavi).
Vitiligo can be cosmetically devastating and can cause psychologically traumatic.
A dermatologist will usually be able to diagnose the condition based on an examination of the skin. Sometimes a Woods lamp/light can help to diagnose the condition. In some instances, a biopsy is necessary to differentiate vitiligo from other conditions that cause white spots on the skin.
Treatment should be started as early as possible to give the best chance of regaining pigment. While not all patients with vitiligo will want to or need to treat their spots, others do. It is important to treat all aspects of vitiligo, including the psychological impact of the condition. Safe and medically proven treatments exist but require a long-term commitment to therapy
Treatment has to be undertaken over many months or years. There is no quick fix for vitiligo but the treatment aims to stop progression and induce repigmentation rather than permanently curing it. The return of colour may take many months to years and may be ‘partial’ rather than ‘complete.’ Every person is different so different treatments are needed in different patients.
The best treatment regimen will be planned during your consultation. At CHROMA, only state-of-the art light and laser therapies in addition to specially mixed creams that have been scientifically proven to help vitiligo are used. CHROMA will also soon offer a specialized skin grafting technique called non-cultured epidermal cell grafting that can put pigment back into stable patches of vitiligo. Areas with high numbers of hair follicles (especially if these are dark rather than white hairs) are likely to re-pigment more easily and more rapidly. So areas like the face, chest, back and limbs respond better than non-hairy areas like hands, feet, ankles and wrists.
In some cases, the vast majority of the body surface area is affected and the condition proves to be severe and progressive. In this instance, a patient may wish to depigment the remaining skin with bleaching cream (called monobenzyl ether of hydroquinone). This is only suitable in a small proportion of patients and should be closely supervised by a dermatologist.
Exciting new advances have been made in recent times in vitiligo. Some new treatments for vitiligo have been trialed in with good results but further trials are required before they become available in Australia. Alpha-MSH analogue, Afamelanotide is one such example and is used in conjunction with light therapy to enhance repigmentation. The most exciting, targeted treatment however, is emerging biologic therapies such as tofacitinib and ruxolitinib which target the specific part of the immune system that is misbehaving in vitiligo. It is indeed exciting times for those who are passionate about finding a cure for vitiligo and, most importantly, for those that live with vitiligo.
Let’s face it, not everything we read on the internet is actually true. Here are some trusted sources of information on vitiligo
- Plastic Surgery Practice News
- News release distributed
- Step Up for Vitiligo: more to know about vitiligo, Examiner.com
- Not just cosmetic: For afflicted, vitiligo is a serious matter, Worcester Telegram
- World Vitiligo Day national news release
The news release reached a potential total audience of 92,000,000+ viewers with pickups by 213+ media outlets nationally on high-traffic sites such as: Yahoo!, Bloomberg, Boston Globe, Foreign Press Association, dozens of regional business journals and numerous local NBC/CBS/ABC television affiliates around the USA.
- Solving the Vitiligo Puzzle, Practical Dermatology
- What it is really like living with vitiligo, Yahoo Beauty
- Area woman raises awareness for vitiligo, Lonsdale News Review
- Awareness Campaign Aims to Bring Attention to Vitiligo, Plastic Surgery Practice News
- Doctor Radio program with Dr. Nada Elbuluk and Dr. Marie Leger (podcast not available)
- Dermatologists campaign to raise awareness, Derm City
- New Discoveries Regulating Pigmentation, Dermatology Times
- Step Up for Vitiligo: The Dermatologist magazine
- Vitiligo: No-nonsense Beauty blog
This information has been written to provide an overview of the condition only. While authoritative information about skin diseases, conditions and treatment for patients and their health professionals is provided, information should not be regarded as medical advice for individuals. This information for personal use only and should not be reprinted or distributed. © Dr. Michelle Rodrigues 2017