Vitiligo: Types, Symptoms, Causes, Treatment & Recovery
1. Types of Vitiligo
Mucosal vitiligo: This type of NSV is seen by defined depigmentation of one or more mucous membranes, predominantly the oral and/or genital areas. It can occur in up to 50% of patients with NSV. Usually, patients with mucosal vitiligo will also have acrofacial vitiligo.
Acrofacial vitiligo: This is also a common type of NSV, which will occur in up to 45% of patients. It causes fewer depigmented patches than generalized vitiligo and will affect the face and extensor aspects of the distal extremities much more than other areas. For example, someone with acrofacial vitiligo may only have a few lesions on their face and hands. The pattern of depigmentation may never progress, or may eventually spread to become NSV. It is rarely seen in patients younger than 10 years of age.
Generalized vitiligo: This is the most common pattern of NSV and, as the name suggests, can affect any part of the body. Often it will start on the hands, fingers, wrists, face and neck or in the axillae or groin. It will generally start as symmetrical macules, which may progress to complete depigmentation. Generalized NSV is also the type which is most likened to other autoimmune diseases of the skin and can cause other autoimmune diseases within the patient or their family.
Nonsegmental vitiligo is the most common type of vitiligo, accounting for up to 85% of cases. There are three subtypes of NSV.
There are two main types of vitiligo: segmental vitiligo (SV) and nonsegmental vitiligo (NSV). These are two very different types of vitiligo and are a useful distinction to aid and direct patient treatment options.
2. Symptoms of Vitiligo
The pronounced contrast between the old and new skin colour will become more visible on individuals with darker skin. Among other common signs include: Premature Graying or Whitening of the Hair on Your Scalp, Eyelashes, or Eyebrows; Loss of Color in the Tissues That Line the Inside of Your Mouth and Nose (mucous membranes); Loss of or Change in Colour of the Retina.
Depigmentation is the most common symptom of vitiligo. It has an effect on the exposed parts of the body, such as the hands, feet, arms, face, and lips. Hair in the affected areas may also turn white. In addition to the white patches, the skin may become itchy, and some individuals experience sunburns in the affected areas.
Vitiligo causes a loss of colour in the affected areas of the skin. Although the total extent and rate of colour loss is unpredictable, the abnormal white patches of skin are quite typical visitors, usually doing so in the following ways.
3. Causes of Vitiligo
Vitiligo is observed worldwide, with 1-2% of the population affected, irrespective of skin color. Many researchers have come to the conclusion that vitiligo is not caused by a single factor but by several factors together, including genetic factors. It is said that 30% of vitiligo patients have an affected relative. Children who have a family with vitiligo are at high risk of getting infected with the skin disease through the inheritance factor.
Basically, it is hard to determine the cause of vitiligo. This is an concerning part about vitiligo. This is mainly because the causes of vitiligo are quite complex, as it involves genetic factors as well as damage to the skin. Besides these causes, autoimmune diseases and severe skin rashes are also causes of such disease. It is also prominent that the disease is caused by weather conditions and exposure to chemicals. A large number of sufferers disagree with the statement that the cause of their vitiligo. A recent survey proposed that up to 20% of sufferers know what caused their vitiligo. For individuals who understand the cause of their vitiligo, they would have noticed that a particular area of their skin has changed in color, and within a few weeks or months, the spot becomes larger. This pattern rather suggests that vitiligo is due to a single event happening to the cell with a triggering factor at a specific part of the skin.
4. Treatment for Vitiligo
The decision to treat should take into account the impact of the disease on the individual. Factors such as sex, age, ethnicity, and location of the vitiligo should be carefully considered. The risks, benefits, and costs of treatments should be discussed with the patient. Care should be taken to avoid exposing patients to treatments with no or little evidence of effectiveness. In all cases, treatment of vitiligo is an attempt to intervene in the natural course of the disease, which is unpredictable. Patients need to be carefully monitored and re-evaluated in order to make modifications to the treatment plan.
Camouflage with make-up is often used as it is an effective and safe treatment in the long term for most patients. There is some evidence to support the effectiveness of surgical treatments which are reserved for stable depigmented patches. Options include autologous melanocyte transplants, blister grafting, and tattooing. However, these treatments are more unpredictable and are expensive and carry significant risks.
There is presently no cure for vitiligo, but there are a number of effective treatment options available. The best evidence is for applied steroids and the use of ultraviolet light in combination with an oral or topical medicine psoralen. However, it is expensive and regular treatment may increase the long-term risk of skin cancer. Other treatments with good evidence include the use of calcineurin inhibitors, such as tacrolimus or pimecrolimus, though they are not recommended for use in children due to an increased risk of skin cancer and lymphoma. A 2009 Cochrane Systematic Review found evidence that narrow band ultraviolet B (NBUVB) could be helpful.
5. Recovery from Vitiligo
Dermablend and other cover-up make-ups and dyes may be effective in disguising vitiligo. They can be applied to the white patches of skin and will last for up to 12 hours. Although it is only a temporary solution, it is an inexpensive and safe alternative to medical treatments. Sunless tanning products have been an effective and popular cosmetic solution. Makeup or dyes are recommended if the patient has 50% or less of the skin surface affected. Permanent skin bleaching may be effective and option if the vitiligo is widespread and the natural skin color is not being restored at all. This is essentially to depigment the unaffected skin so as to match the color of the vitiligo patches. This option provides a consistent skin color but is difficult to reverse and continuous sun protection is required.
Re-pigmentation is easier to achieve for those who have fair skin because the difference between the color of the skin and the white patches is less. For people with darker skin, treatment can be slow and they are less likely to have good results. The choice of therapy depends on the number of white patches; their location, sizes, and how widespread they are; and the person's age, sex, and general state of health. A treatment that works for one person may not work for another. Current treatment options for vitiligo include medical, surgical, and other treatments. Most treatments are aimed at restoring color to the white patches of skin.