The most common form of depigmentation, this auto-immune disorder leaves smooth, white patches of skin that may be treated with laser or other derma-therapies.
Vitiligo is a skin condition characterized by hypopigmentation or pigmentation loss. It is the most common depigmenting disorder, affecting 0.5 percent of the world population. Vitiligo is an auto-immune disorder that damages melanin or pigment-producing cells, causing of smooth, white patches of skin to appear on the body. The disorder occurs among all racial groups and sexes equally
Physicians distinguish between three types of vitiligo:
- General pattern or non-segmental vitiligo: the most common form, characterized by white patches that are often symmetrical appearing on both sides of the body. White patches may increase in size over a period of time.
- Segmental vitiligo: often characterized by a white patches appearing on only on one side of the body.
- Focal vitiligo: characterized by a single white patch or small number of white patches appearing on a localized area of the body.
Vitiligo is a depigmenting disorder caused by the loss of melanocytes, the cells that make pigment. Several studies suggest that the disease is genetic, but it is probably caused by several different genes.
About 30% of patients who suffer from vitiligo have relatives with the disorder. The exact cause is not well understood, but sun exposure and occupational factors may exacerbate vitiligo and cause depigmentation.
Although there is no cure for vitiligo, a variety of laser treatments, topical and oral drugs, skin grafting, and ultraviolet light therapies may be used to treat vitiligo. Narrow-band ultra violet light treatment has been the standard treatment advocated by physicians; the goal being to achieve re-pigmentation. Topical coricosteroids and calcineurin inhibitors (Protopic or Elidel) have also been prescribed for sensitive areas.
Targeted light therapy is another effective option for treating vitiligo. The Excimer laser targets the affected skin with a high-intensity light but avoids exposure to normal skin. Rapid therapeutic responses are seen and cumulative UV exposure is limited. It is best to use this therapy with one of the previously described topical treatments. IPL using the UVB device works similarly and some say it is just as effective, but far cheaper. This is important since most insurance companies do not cover this treatment.
Finally, there have been advances in the surgical treatment of vitiligo. For a stable disease or disease that has not responded to the above measures, procedures may include suction blister grafts (suctions pull the top layer of skin off and this is grafted onto the vitiligo areas), melanocyte transfer, punch grafts, and sheet grafts. In another technique, melanocytes are taken from the patient, cultured out and then transplanted onto the vitiligo site.
Camouflage makeup and cosmetic tattooing may also be utilized to hide the appearance of skin affected by vitiligo.