Vitiligo Definition, Reason, Symptoms, Treatment & Prevention
Definition
Vitiligo is a condition that causes loss of color on the skin. This causes white patches to form on the skin in various areas of the body.
White patches can also affect the hair, inside the mouth and even the eyes.
Normally, hair, skin and eye color is determined by melanin. However, in vitiligo, the cells that produce melanin die or stop functioning.
Vitiligo can affect people with all skin types but may be more pronounced in people with darker skin.
Although not dangerous or contagious, sufferers can also experience stress or lack of confidence because of this condition.
There are two main types of vitiligo:
1. Vitiligo Segmental
In this type, areas of the skin that lose their original color are only found on certain parts of the body.
Segmental vitiligo is less common and more common in children.
2. Vitiligo Non-Segmental
In this type, the skin symptoms are found on both sides of the body and are generally symmetrical. About 90 percent of people with vitiligo belong to the non-segmental type.
In addition to the two main types above, there are also subtypes that depend on the extent of the body affected by vitiligo.
These subtypes are local (only in one area), general (splotches spread over the body), or universal (almost the whole body is affected, very rarely).
Vitiligo Symptoms
The symptoms of vitiligo are as follows:
- White patches on the skin
- Loss of color in the tissues lining the inside of the mouth and nose
- Loss of color in the genitals
- Loss or discoloration of the inner layers of the retina
- Gray or gray hair on the scalp, eyelashes, eyebrows and beard (usually before age 35)
- Itching or pain in patches of vitiligo (rare)
Vitiligo can occur at any age. However, most are experienced before the sufferer is 20 years old.
Vitiligo Reason
Vitiligo is caused by stopping or dying of cells that produce skin dye. The substance is supposed to function to give color to the skin, hair, and eyes.
The cause of these cell death is not known with certainty. However, it is suspected to be related to the following:
- genetic factor
- Other triggers, such as stress, sun exposure, or industrial chemical exposure
- Autoimmune disease, which is when the body’s immune system attacks melanocytes in the skin
There is a suspicion that non-segmental vitiligo is associated with an autoimmune condition.
Meanwhile, segmental vitiligo is related to problems in the body’s nervous system.
Risk Factors
Here are some risk factors for vitiligo:
- Having a close relative with vitiligo
- Have an autoimmune disease, especially Hashimoto’s disease or alopecia areata
- History of autoimmune disease in the family
- Have malignant melanoma or non-Hodgkin’s lymphoma
- Genetic disorders associated with non-segmental vitiligo
Diagnosis
Diagnosis of vitiligo is done by:
1. Medical interview
The doctor will ask about the history of vitiligo in the family, is there a history of autoimmune disease, are there wounds on the affected area, etc.
2. Physical Examination
Physical examination can use ultraviolet light (Wood’s lamp). You need to be in a dark room and the lamp is placed 10-13 cm from the skin.
The use of UV light will make it easier for the doctor to see patches of skin that have changed color due to a lack of dye.
3. Tissue Sampling
If necessary, the doctor may also suggest taking patient tissue samples.
4. Laboratory Tests (If Necessary)
Laboratory tests, particularly blood, may be advised to check for other autoimmune conditions.
The doctor may recommend that you see an ophthalmologist, to see if there is inflammation in the eye.
In addition, the doctor will evaluate hearing function, because people with vitiligo are at a higher risk of hearing loss.
Vitiligo Treatment
Treatment of vitiligo consists of drugs, surgery, and other additional therapies. Treatment is generally carried out by skin and genital specialists.
In addition, the type of therapy will depend on the number of white spots on the body, their location, size, and how widely they have spread.
Each individual also has a different response to the treatment.
Some of the treatment options for vitiligo are:
1. Not Doing Medication
Patients are not given drugs to treat vitiligo but are encouraged to use cosmetics to disguise skin differences.
This method is often recommended for children to avoid side effects of drugs.
2. Drugs that are applied to the skin
One of the drugs that are often prescribed are strong corticosteroids. About 45 percent of patients experience improvement within 4-6 months.
Drug response is often better in dark-skinned patients. The use of this topical drug is mandatory under the supervision of a doctor because there is a risk of side effects such as thinning of the skin (skin atrophy).
3. Light Therapy (Phototherapy)
The use of light therapy is done to restore skin color (laser or light box).
Treatment is effective for many patients, although complaints may recur.
4. PUVA therapies
PUVA therapy uses ultraviolet A (UVA) light combined with the drug psoralen.
This method could be an option for the treatment of extensive vitiligo. However, side effects may occur in the eye so patients will be closely monitored.
5. Surgery
The doctor will take an area of healthy skin and place it over the area where the skin has lost its natural color.
This method is often used as a last resort if the response to other treatments is not good.
Fortunately, the effectiveness of surgery is very good, that is, it is effective for 90-95 percent of patients.
6. Depigmentation
In the depigmentation method, the doctor uses a cream that is applied topically to completely remove the patient’s original skin color. The skin color becomes even.
The depigmentation process can take 1-4 years. However, this is an option that is rarely used.
So, can vitiligo be cured? Some of the methods above can indeed overcome vitiligo skin discoloration.
However, do not rule out the spots appearing again in the future. The doctor can suggest daily treatments to slow it down.
You can apply the following two things:
7. Protect the skin from exposure to sunlight
If you have vitiligo, using sunscreen is mandatory. Choose a product with a minimum SPF of 30, protects from UVA and UVB (or broad spectrum ) exposure, and is water resistant.
Apply regularly every two hours or so, especially if you’re swimming or outside, and sweat a lot.
Also, use clothes that can protect the skin from sun exposure.
8. Avoid getting tattoos
If the skin is damaged by the tattoo, new patches can appear within two weeks. So people with vitiligo are not advised to get a tattoo.
Some of the commonly used vitiligo drug ingredients are:
- Krim steroid
- Calcineurin inhibitor
- Psoralen
- Methotrexate
- ciclosporin
- Hydroquinone
Prevention
Vitiligo cannot be prevented. If diagnosed with vitiligo, treatment can be carried out with the main goal of preventing this condition from spreading.
Complications
Some of the complications of vitiligo that can arise:
- Sunburn easily, due to loss of skin color
- Inflammation of the eye: inflammation of the iris, uveitis
- Hearing problems (hypoacusis)
- Lack of confidence due to skin appearance
- Stress due to social stigma
- Side effects of therapy, such as dry and itchy skin
- Skin cancer