The color of your skin (and eyes) is caused by melanin, which is produced by cells called melanocytes. In people with vitiligo, these cells are destroyed by the body for some reason. As a result, the skin loses its color and white spots appear on the body.
Why can this happen?
Doctors believe it is an autoimmune disease in which the body’s immune system destroys melanocytes, causing white spots to appear. Anyone can potentially develop vitiligo. It affects men and women of all races and ages, although in most cases the white patches associated with vitiligo begin to appear before the 20th birthday.
White patches on the skin are the hallmark of vitiligo
The most obvious sign of someone with vitiligo is the appearance of white patches on the skin. They are usually much lighter than the patient’s normal skin and more evident in patients with darker skin. This is simply because the contrast between normal skin and skin affected by vitiligo is more marked in dark-skinned people. Vitiligo spots can appear anywhere on the body. Usually, however, the spots appear on places that have been exposed to the sun, such as the hands, feet, arms, and face. They also tend to appear in the armpits, groin area, or belly button.
Some people, especially those with dark skin, may also have vitiligo on the inside of their mouth, which may then lose its color. It is also possible for vitiligo to affect the hair. These patients may present with early graying or whitening. It can affect not only the hair on the head, but also the eyebrows and eyelashes. The retina of the eye could also lose its color. These spots first appear as patches of paler than normal skin that gradually turn slightly pink (as the body’s immune system attacks healthy melanocytes) and then, in many cases, almost completely white. Some treatments may be more effective at first, when the skin begins to lose its pigment.
It should also be noted that the white spots associated with vitiligo differ depending on the type of disorder:
People who develop vitiligo at a young age usually only experience it on one side of the body, which is called segmental vitiligo. In these people, the disease usually extends for one or two years and then stops.
Localized or focal vitiligo
This is vitiligo that affects only a few parts of the body.
The most common type of vitiligo, it results in the appearance of white spots in the same area on each side of the body.
Sometimes vitiligo progresses and gets worse, and sometimes the color may come back
No two cases of vitiligo are exactly the same, and whether or not the spots spread depends on the type of vitiligo the person has. Segmental vitiligo stays in one part (or segment) of the body, whereas non-segmental vitiligo can spread to other places. This can happen quickly or over several years – it varies from person to person.
It is impossible to say how extensive a given case of vitiligo will be. Sometimes the skin can re-pigment spontaneously, but just as often the loss of skin color can spread. Treatment for vitiligo may help restore color to the affected area or make vitiligo less noticeable, but it will not prevent vitiligo from spreading or white spots from developing elsewhere. Currently, there is no treatment that can stop or reverse vitiligo. However, there are new treatments that can bring back pigmentation in some people safely and effectively.
Also, certain factors can aggravate the loss of pigmentation caused by vitiligo. Sun damage is one, so experts recommend that people with vitiligo apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Wearing sunscreen also helps prevent skin from tanning, which will minimize the difference in appearance between vitiligo-affected skin and normal skin.
Certain triggers can make vitiligo worse
It helps to understand a bit about the initial causes of vitiligo. Most cases of vitiligo are linked to a genetic predisposition, which means that you probably have some genetic background that puts you at risk of developing this condition. There are over 30 genes associated with it. Variations in two genes in particular – NLRP1 and PTPN22 – play a role in increasing risk, as they can lead to inflammation and cause the immune system to mistakenly attack body tissues.
Then there needs to be a triggering event that causes the immune system to attack the body’s melanocytes. Potential triggers include:
Ultraviolet radiation, which can come from the sun, tanning beds, mercury lamps, UV disinfection bulbs
Exposure to certain chemicals
Therefore, it is a combination of genetic and environmental factors (most of which have yet to be identified by researchers) that leads to vitiligo. And the same environmental triggers that can trigger vitiligo in the first place, like exposure to industrial chemicals, can also make vitiligo worse.
Vitiligo is linked to certain physical complications, as well as emotional distress.
Although vitiligo does not pose a serious threat to a person’s overall health, it is possible that it can cause other problems, including:
Eye problems: People with vitiligo may experience inflammation of the iris, called iritis.
Hearing problems: People with vitiligo may lose some of their hearing, which is called hypoacusis.
Sunburn: Melanin helps protect the skin against some of the sun’s dangerous ultraviolet rays. Because people with vitiligo have white patches on their skin that lack melanin, they may be more sensitive to the effects of the sun and are at risk of getting sunburn.
One of the most pronounced side effects of vitiligo is the emotional distress that usually accompanies the diagnosis. The intensity and troubling nature of the diagnosis may depend on the extent of the condition and where it appears on the body. The loss of pigmentation can be emotionally distressing, especially in people with darker pigmentation, as it is more noticeable in these patients.