Table of contents:
- Definition of vitiligo
- How common is vitiligo?
- Vitiligo signs and symptoms
- Segmental type vitiligo
- Vitiligo non-segmental type
- When to see a doctor?
- Causes and risk factors for vitiligo
- What are the risk factors for vitiligo?
- Diagnosis and treatment
- What are the usual tests to diagnose vitiligo?
- Medical history and examination
- Skin biopsy and blood draw
- What are the treatment options for this disease?
- Corticosteroid cream
- Medicines that affect the immune system
- Light therapy and psoralen (PUVA)
- Depigmentation
- Blister grafting
- Tattoo (micropigmentation)
- Home remedies
- Protect skin from UV rays
- Using cosmetics
- Don't get tattooed
Definition of vitiligo
Vitiligo is a disease that causes the loss of color pigment in the skin. This disease causes the original skin color to disappear in certain areas.
This condition most commonly occurs on the backs of the hands, face, and armpits. However, this skin disease can also attack the hair and the inside of the mouth.
This type of skin disease is not deadly and is not contagious. However, vitiligo cannot be cured. Sometimes this disease is associated with other diseases, such as thyroid.
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.
Vitiligo can also occur at any age. However, half of the cases occur in people less than 20 years of age.
Vitiligo signs and symptoms
Reporting from the American Association of Dermatology, vitiligo itself is divided into two types, namely segmental and non-segmental. The two types actually have different symptoms.
However, regardless of the type, the main characteristic of vitiligo remains the same, namely the appearance of patches that are lighter in color than the surrounding skin due to the loss of pigment. Over time, these patches can turn white.
Following are the symptoms according to the type of disease.
Segmental type vitiligo
For the segmental type, here are the characteristics.
- Only appears on 1 part of the body such as legs, face, or arms.
- Experiencing premature gray hair, eyelashes, or eyebrows.
- It usually appears at an early or very young age.
- Often it lasts for about a year then stops expanding.
Vitiligo non-segmental type
The non-segmental type is the most common type of vitiligo. Below are the various signs and symptoms that usually appear.
- Appears on both sides of the body, such as the hands or both knees.
- The first white patches are symmetrical.
- The loss of color starts from the fingertips, wrists, and hands.
- Appears on sun-exposed skin such as the face, neck, and hands.
- Skin color fades quickly then stops for a while and can start again.
- Missing colors tend to expand and expand.
Apart from the above symptoms, pigment loss also occurs in the tissues that line the mucous membranes such as the mouth and nose, accompanied by discoloration of the lining of the eyeball or retina.
As already mentioned, this symptom can appear at any age. However, it generally occurs more often before a person turns 20 years of age.
So far, there is no way that can be done to predict how much area of skin will be affected by vitiligo. There are some people whose spots continue to expand, some do not.
There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.
When to see a doctor?
You should contact a dermatologist if your skin, hair or eyes change color. Vitiligo cannot be cured, but therapy can prevent or slow down the change process and restore color.
If you have any signs or symptoms above or any other questions, please consult your doctor. This is because each person's body is different and can cause different symptoms.
Causes and risk factors for vitiligo
Broadly speaking, vitiligo occurs when melanocytes, the melanin-producing cells that determine hair color, cannot work or die.
It is not yet known specifically how the mechanism of this disease arises. However, it is strongly suspected that this disease is triggered by autoimmune problems.
Autoimmune diseases develop when cells in the immune system mistake healthy cells for harmful germs.
In this case, it could be that the body mistakenly recognizes melanocytes as foreign substances. As a result, T cells, which function to fight infection, attack and destroy melanocytes so that they can no longer work properly.
What are the risk factors for vitiligo?
There are many risk factors for vitiligo, which are as follows.
- Family history, children whose parents with vitiligo are at risk of developing the same problem.
- Have an autoimmune disease, especially Hashimoto's disease (thyroid disease) or alopecia areata (causing hair loss).
- Trigger stuff, 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 will need to consult a doctor for more detailed information.
Diagnosis and treatment
What are the usual tests to diagnose vitiligo?
The following are various tests that can be done to diagnose vitiligo.
Medical history and examination
When you get checked out, the doctor will usually examine the body by looking for visible symptoms. The doctor will use a lamp with a special ultraviolet light to see the skin condition more clearly.
After that, the doctor will ask you and your family's medical history. The reason is, vitiligo is a disease that runs in families.
Through a physical examination and medical history, your doctor can begin to determine whether you have vitiligo or not.
Skin biopsy and blood draw
In addition to doing a physical examination and seeing your medical history and your family, the doctor will take further steps.
A biopsy or sampling of skin affected by vitiligo is one method that will be done. In addition, the doctor will also do a blood test to see if there are other diseases that trigger the appearance of vitiligo.
What are the treatment options for this disease?
The type of treatment for vitiligo depends on your health condition, age, location of the vitiligo and its severity. Indeed, treatment cannot restore skin color permanently.
However, medication is very useful to prevent wider spread and even out the color. There are various treatment options and vitiligo drugs below.
Corticosteroid cream
Corticosteroid creams are one of the topical medications used to treat vitiligo in a small area. This cream helps prevent the spread of pigment loss from expanding and helps restore skin tone.
Medicines will be more effective when used at the onset of symptoms. Compared to the hands and feet, the face is the area of the skin that feels the most effect after being treated with corticosteroid creams.
This topical cream is quite easy to use. However, like any medicine, creams can cause side effects. One of them is skin thinning.
Medicines that affect the immune system
Medicines of this class, such as tacrolimus or pimecrolimus (calcineurin inhibitors), are quite effective for areas of vitiligo that are not too large. This medication is especially good if you lose skin pigment on the face and neck.
In addition, this treatment also has fewer side effects compared to corticosteroid creams. However, the US Food and Drug Administration found a link between the use of this drug and lymphoma and skin cancer.
Light therapy and psoralen (PUVA)
This therapy is carried out by combining the drug psoralen with light therapy. The goal is to bring the skin back closer to its original color. Usually used for conditions that have spread widely.
In this therapy the doctor will give psoralen to drink or topically to be used directly on the affected area. After that, light therapy such as UVA, UVB, or excimer rays will be given.
Therapy is quite effective in restoring pigment in the face, body, upper arms and upper legs by about 50 to 75 percent. Unfortunately, this procedure is not very effective on the hands and feet.
To get maximum results, you will need to repeat the treatment up to 3 times a week for 6 to 12 months.
Depigmentation
Depigmentation is a therapy for vitiligo that is usually used if the area of the rash is widespread. In addition, this therapy is also recommended if other treatments have not worked.
Depigmentation aims to reduce skin tone on the unaffected area to match other, whiter areas.
Therapy is carried out using a strong topical lotion or ointment such as monobenzone, mequinol, or hydroquinone. Therapy will be carried out once or twice a day for nine months or more.
This treatment can provide quite lasting results. But unfortunately it makes the skin more fragile and very sensitive to the sun. In addition, the side effects that are quite disturbing are redness, swelling, itching, and dry skin.
Skin grafts
This procedure is performed by removing small, pigmented sections of normal skin. Then, this part will be affixed to the areas that have lost the pigment.
Generally, this surgical procedure is performed if you have small patches.
Also, this procedure is only recommended for adults whose spotting hasn't changed after six months of treatment. Children are not encouraged to undergo this process.
Blister grafting
In this procedure, the doctor will make a small incision in the pigmented skin by way of an aspiration. Then the top of the skin is removed and transplanted in the discolored area.
However, the risks are the same as in previous surgical procedures, namely scarring to the skin that cannot fuse. In addition, the skin damage caused by the suction can also lead to the appearance of other patches.
Tattoo (micropigmentation)
This is done by doctors using special surgical instruments to implant pigment into your skin. Usually this method is effective on the inside and around the lips of people with darker skin.
The drawback is that it is difficult to match the right skin tone. In addition, tattoos also have the potential to trigger the appearance of other vitiligo patches.
Home remedies
The following are lifestyle and home remedies that can help you deal with vitiligo.
Protect skin from UV rays
When you have vitiligo, try to keep your skin away from overexposure to natural and artificial UV rays. Use sunscreen with a high SPF if you are going to be outdoor activities.
At the very least, choose a sunscreen that has SPF 30 and is water resistant. Apply it every two hours or any time you feel the sunscreen wear off due to sweat.
In addition, protect your skin from the hot sun by wearing closed clothes. Wear long sleeves with trousers plus a hat if necessary.
Protecting the skin from sun exposure helps prevent sunburn. This is because sunlight can greatly worsen your vitiligo condition.
Using cosmetics
To increase your confidence, cover the vitiligo area with the help of cosmetics. This method can be done if the area of the skin that is losing pigment is not too large.
Choose a color that matches your real skin so that the stripes on the skin are well hidden.
Don't get tattooed
Covering the spot with a tattoo is not a wise choice. It's not that the skin is covered properly, it can actually get damaged even more. In fact, tattoos can trigger new patches within two weeks of the procedure.
Remember that no treatment method can provide permanent and complete cure for vitiligo.
If you have any questions, consult your doctor for the best solution to your problem.