Vitiligo is generally classified as an autoimmune disorder, a disorder in which the body’s immune system attacks its own cells or organs.
Researchers suspect that, in cases of vitiligo, the immune system is attacking the melanin-producing cells, resulting in a loss of pigmentation.
Vitiligo is a disease that causes skin color loss that appears as white or light-colored patterns or ‘blotches’ on various parts of the body. This happens when melanocytes, which are pigment (or color) producing skin cells, are attacked and die or stop functioning properly. This causes the loss of skin color that can affect any part of the body, including the mouth, scalp, and hair, causing the skin and areas of the hair to turn a milky-white color.
The most obvious sign or symptom of vitiligo is loss of pigment on the skin, resulting in milky-white, irregularly-shaped patches on the skin. Vitiligo typically occurs first on sun-exposed areas (face, hands, feet, arms, legs) or areas where clothing or shoes consistently rub on the skin.
Less common signs include pigment loss or graying of hair on scalp, eyebrows, eyelashes, or other affected areas. Some may also experience loss of pigment on the tissues that line the inside of the mouth (mucous membranes) and the retina of the eye.
Some of those affected by vitiligo experience intense itching at the site of depigmentation during active stages.
The doctor usually begins by asking the person about his or her medical history. Important factors are a family history of vitiligo or other autoimmune diseases; a rash, sunburn, or other skin trauma at the site of vitiligo 2 to 3 months before depigmentation started; stress or physical illness.
The doctor may take a small sample (biopsy) of the affected skin, and/or a blood sample to do lab work that checks for thyroid antibodies/disease, vitamin D levels, and other conditions that may affect general health or autoimmune status.
The doctor may also use a Woods light (specialized black light) to confirm vitiligo, as even when undetectable by the eye alone, the depigmented areas will glow under this light.
What causes the disease is unknown, and currently, there is no cure. It affects men and women equally and currently there are more than 70 million people worldwide affected by this disorder, half of which are children. Many people are born with it or develop the condition in early childhood.
It is believed that others develop it over their lifetimes due to a multifactorial process involving the interplay of genetic, autoimmune, environmental, and neurogenic factors.
Vitilago is NOT contagious!
Currently, there is no cure for Vitiligo. While researchers are looking for a cure, treatment cannot currently cure this disease.
Doctors can prescribe treatments that might help even out skin tone, and these treatments can help restore lost skin color, but the color (repigmentation) may fade over time. To keep their results, many patients have maintenance treatments.
There are also a variety of 'natural' tanning products and 'skin makeup' that may provide a more even appearance.
Generalized vitiligo is a progressive disease resulting in somewhat unpredictable cycles of spreading and cycles of stability throughout life. For some, it begins slowly with only a few areas of the body affected; for others, it begins rapidly, with many areas affected by both large and small patches of pigment loss.
Many people report going many years without new patches developing, then experience pigment loss years later. Others report spontaneous repigmentation, with no treatment at all.
Vitiligo is ‘generally’ separated into two main types – generalized vitiligo and segmental vitiligo with a couple of notable subsets in each. In both types of vitiligo, the cells that create skin pigmentation are destroyed, creating patches of lighter skin. However, generalized and segmental vitiligo present differently on the body.
Generalized Vitiligo
Generalized vitiligo is characterized by symmetrical patches of depigmentation on both sides of the body. Often, generalized vitiligo starts with patches of skin discoloration on the hands, feet, elbows, armpits, or face. Generalized vitiligo can also be referred to as non-segmental vitiligo, bilateral vitiligo, or vitiligo vulgaris as noted in the diagram.
About nine in 10 people with the condition have generalized vitiligo. A person can develop generalized vitiligo at any age, and it frequently progresses throughout life.
Generalized vitiligo may cause non-skin symptoms and is associated with autoimmune and thyroid conditions.4 Learn more about health conditions related to vitiligo.
Generalized vitiligo can be divided into several subtypes:
Segmental Vitiligo
In contrast to generalized vitiligo, segmental vitiligo usually affects just one side of the body. Segmental vitiligo can also be referred to as unilateral vitiligo.
Segmental vitiligo impacts about one in 10 people with vitiligo and is more prominent in children – three in 10 children with vitiligo have segmental vitiligo.
Individuals with segmental vitiligo typically develop the condition as children or young adults. Unlike generalized vitiligo, which can advance throughout a person’s life, segmental vitiligo usually progresses for a year or two and then stays constant.
Segmental vitiligo can manifest in specific patterns that are consistent from person to person. Many people with segmental vitiligo also lose some amount of hair color on the head, eyelashes, or eyebrows.
Segmental vitiligo is less strongly associated with autoimmune conditions.
Vitiligo, while primarily a physical condition, can have a profound emotional and psychological impact.
If you have vitiligo and are experiencing any of these psychological symptoms, you aren’t alone. Recognizing and acknowledging the mental and emotional impact of vitiligo in your life can be a first step to identifying avenues for coping.
Here’s how vitiligo can influence your everyday life.
1. Low Self-Esteem:
Self-esteem is intricately linked to one’s self-image. For those with vitiligo, the visible nature of the condition can lead to feelings of self-consciousness and inadequacy. Society’s emphasis on appearance and the desire to “fit in” can exacerbate these feelings, leading to a negative self-image. Stares, comments, or even well-meaning but intrusive questions from others can further undermine confidence, making social situations challenging.
2. Anxiety:
Anxiety is a common response among those living with vitiligo. The unpredictability of the condition, which can cause new patches of depigmentation to appear at any time, often leads to feelings of uncertainty and fear. Social interactions can become particularly stressful, as individuals may worry about how others perceive them. This heightened state of anxiety can manifest in various ways, including nervousness, restlessness, rapid heart rate, and even panic attacks.
3. Depression:
Depression is another significant concern for individuals with vitiligo. The chronic and visible nature of the condition can lead to persistent sadness and a sense of hopelessness. The struggle to accept one’s appearance, coupled with the societal pressure to conform to certain beauty standards, can result in a profound sense of isolation. Depression can manifest in various ways, including fatigue, changes in appetite, sleep disturbances, and difficulty concentrating.
Embracing Your Identity:
Acceptance is a powerful tool in managing the psychological impact of vitiligo. Embracing one’s unique appearance and recognizing that beauty comes in all forms can lead to a more positive self-image. Many individuals with vitiligo have found empowerment in celebrating their uniqueness and advocating for broader definitions of beauty.
Global studies have consistently reported the negative impact of vitiligo on patients' self-esteem and quality of life. In addition, vitiligo causes isolation, stigmatization, loss of self-esteem, depression, and self-consciousness.
Often it starts with just processing the diagnosis and then allowing yourself to grieve. You are going through a tangible loss, and that is OK.
The Global Vitiligo Foundation may be a great resource for many people,
www.globalvitiligofoundation.org.
This organization is often focused on treatment, and with a small success rate, many Vitilagans have shifted to private support groups on social media that don't allow the promotion of any treatments and instead focus on embracing the condition and seeking to honor what Vitiligo is and find the beauty in the vastly differing skin colors and patterns that are prevalent throughout the vitiligo community .
I have vitiligo, now what?
Seeking Professional Help:
Professional counseling or therapy can be highly beneficial for individuals struggling with the emotional impact of vitiligo. Mental health professionals can provide a safe space to express feelings, work through self-esteem issues, and develop coping strategies. Cognitive-behavioral therapy (CBT), in particular, has been shown to be effective in managing anxiety and depression.
Practicing Self-Care:
Self-care is essential for maintaining mental wellness. This includes physical self-care, such as maintaining a healthy diet and exercise routine, as well as emotional self-care, such as engaging in hobbies and activities that bring joy and relaxation. Mindfulness practices, such as meditation and yoga, can also help manage stress and improve overall well-being.
Building a Support Network:
Connecting with others who have vitiligo can provide a sense of community and understanding. Support groups, both in-person and online, offer a platform to share experiences, exchange advice, and receive encouragement. Knowing that others are facing similar challenges can be incredibly reassuring and empowering.
By fostering a supportive community and raising awareness, we can help those with vitiligo navigate their journey with confidence and resilience.
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