Vitiligo is a skin condition that affects about 1 to 2% of the population. It is characterized by white patches on parts of the body caused by a lack of pigment. This condition has unique features that differentiate it from other skin conditions known as co-existing dermatoses or disorders, including eczema, psoriasis, seborrheic dermatitis, and tinea versicolor. Vitiligo usually affects people between ten and thirty years old, but it can affect anyone regardless of age. Vitiligo does not have any direct obstacles in life, such as psychological difficulties and social problems such as discrimination and stigmatization. The only problem is that many times Vitiligo leads to depression due to negative comments made against those who have Vitiligo. Let’s know more about Vitiligo and how it is different from other skin diseases.
Vitiligo is an autoimmune condition in which the cells responsible for producing melanin known as melanocytes are attacked and destroyed. The body’s immune system attacks its tissues or organs that it incorrectly interprets as harmful. This damages the tissue and often causes loss of function. Vitiligo is not contagious, nor can it be transmitted from person to person through contact. Vitiligo is a non-communicable disease which means that it cannot be transferred from one person to another. Vitiligo may start with small white spots on any part of the body due to depigmentation. Over time these spots get more significant and more widespread.
Non-segmental:Â It is also known as generalized, is the most common form of Vitiligo which affects more than 50% of those who have Vitiligo. This type appears as white patches on different parts of your body such as your face, neck, chest, arms, hands, and feet, among some other areas.
Segmental:Â It is also known as unilateral Vitiligo. It involves only one side of your body like if it occurs on the left side, then only the left side will be affected, not both sides, unlike in non-segmental vitiligo. Both sides can be affected, or it can affect different parts on the same side, like having a spot on the right foot and the left leg.
Mucosal:Â This type is found in or around mucous membranes, which are areas that can be affected by sunlight; for example, your mouth, genitals, eyes, etc., it appears as white patches on these areas.
Symptoms may vary depending on their type, but here are some general symptoms.
Non-segmental (Generalized):Â It starts with one or more spots that change into larger patches over time – Patches show up in different parts of your body like face, neck, chest, arms, hands, feet, among other areas – Sometimes, if there is a small amount of Vitiligo you may not notice it at first because there isn’t much pigmentation loss, however, it can still be diagnosed – It may accompany depigmentation on your hair and eyelashes – Patches are larger in sunnier areas
Segmental:Â Â It appears as a patch of Vitiligo on only one side of the body. For example, suppose it occurs on the left side. In that case, only that side will be affected, not both sides, unlike generalized, where both sides can be affected or can affect different parts. This type affects other features on the same side, like having a spot on the right foot and the left leg – Some people have this type with non-segmental Vitiligo, so they have patches all over their body, including their face, neck, etc.
Mucosal –Â It appears as white patches on any mucous membranes, which are areas that can be affected by sunlight, such as your mouth, genitals, eyes, etc. – This type is found in or around mucous membranes.
Your doctor will ask you about your symptoms and medical history and do a physical exam to check for patches(lesions). A skin biopsy may be recommended if there isn’t clear evidence of Vitiligo, although it can still be diagnosed without a skin biopsy. Skin biopsies are only needed in some cases where the diagnosis is unclear.
 1- In terms of origin: Vitiligo occurs from inside the body, whereas seborrheic dermatitis, psoriasis, tinea versicolor, and eczema happen due to an outside factor that triggers a reaction by the body.
2- Spreading:Â The spreading pattern is different for each condition because they originate from other sources. For example, seborrheic dermatitis spreads via scalp oil, whereas Vitiligo doesn’t spread and is more stable.
3- Itch:Â Some of these conditions cause itchiness, such as psoriasis, tinea versicolor, and eczema but not vitiligo.
4- Color:Â The color of the patches is different for each condition because they originate from other factors that affect the body’s pigmentation system.
5- Seasonal pattern:Â Although all these conditions can change the skin’s color, their seasonal ways are different because they affect the ability to produce pigments which determines if it will be lighter or darker during the summer or winter months. For example, psoriasis’ color changes are more prominent in winter or cold weather, while tinea versicolor’s lighter patches are more visible in the summer.
6- Hair:Â This one is easy because Vitiligo doesn’t affect your hair, whereas these other conditions do, so you can quickly tell them apart.
7- Scaling:Â Vitiligo doesn’t show scaling on the skin; however, all of these conditions have some form of scaling. If it’s not Vitiligo, then it’s probably one of the others I’ve mentioned earlier.
8- Personal history: If you have a personal account of any autoimmune disease, then there is a high chance that you’re going to develop Vitiligo also people who have had radiation therapy and autoimmune disorders like thyroid disease, lupus (Systemic Lupus Erythematosus), Sjögren’s syndrome or rheumatoid arthritis are more likely to develop Vitiligo.
Lupus itself, but photosensitivity makes your skin sensitive to sunlight, so you become more likely to develop depigmentation in areas where it’s exposed to the sun.
Tinea versicolor, also known as pityriasis Versicolor, is a common skin infection caused by yeast-like fungi called Malassezia, which are normal flora (commensals) found on your skin. It causes the production of excess pigments that paint the skin’s surface in multiple colors, giving you lighter or darker patches.
Albinism is a genetic condition that results in the absence of pigmentation, so you develop patches all over your body. The color can vary depending on what type of albinism you have.
Dandruff affects your skin and scalp, which causes dry flakes to appear on the skin.
A skin condition that usually affects children and young adults under the age of 21 is caused by a fungal or yeast-like infection (Malassezia) that makes the skin’s surface appear lighter.
Sunscreens that contain titanium dioxide or zinc oxide should be applied to your skin daily to prevent the loss of healthy pigmentation and reduce melanocyte damage. These two ingredients also gradually re-pigment areas affected by Vitiligo so you can find natural sunscreens with these ingredients.
Your dermatologist usually prescribes these medications to slow down the loss of melanocytes; however, they can also cause damage. If you decide that this treatment is proper for you, it’s best to apply daily depigmented patches.
3- Skin camouflage:
Use makeup or fabric dyes that match your skin color to conceal lighter areas affected by Vitiligo.
4- Laser treatments:
Four different laser treatments can be applied to your skin to get rid of patches and delay further melanocytes loss.
5- Melanocyte transplant:
This treatment is a type of cell therapy, so it requires your melanocytes to be extracted from donor areas, and then they’re injected into depigmented ones.
6- Vitamin B12:
Vitamin B12 injections can help people with Vitiligo because this vitamin plays a vital role in producing melanin (pigment) in your body.
7- PUVA Therapy:
This is like the opposite of sunscreen because you apply psoralen medications, which makes your skin sensitive to UVA radiation or sunlight. You expose yourself to it for a specific period – It’s only recommended in cases where other treatments don’t work.
8- Surgery:
This treatment is only given to people who have small patches because it can worsen large areas. It’s a type of skin graft where healthy pigmented skin is cut out and used to cover affected areas; the downside is that the graft may not “take,” which means there’s no colour change.
9- Corticosteroid injections:
Corticosteroids are usually injected into affected areas to slow down the production of melanocytes that causes depigmentation.
10- Narrowband UVB Therapy:
Narrowband UVB Phototherapy is a type of light therapy where you apply psoralen, which makes your skin sensitive to UVA radiation or sunlight. You expose yourself to it for a specific period. It’s an effective type of treatment because studies have shown that NB-UVB can be used safely and effectively in treating Vitiligo.
11-Homeopathic treatment for vitiligo:
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