Vitiligo & White Patches On Skin

Vitiligo causes white patches in your skin that could be unsightly and annoy. Vitiligo is a health condition caused by the loss of pigmentation in skin cells that can affect all races equally, but it can happen to anyone at any age. Vitiligo is not contagious, meaning you won’t catch it from somebody else if there are Vitiligo white patches on their skin. However, Vitiligo does tend to run in families, so if you have a parent or sibling who has Vitiligo, there’s a higher chance you will too.

What are the causes for Vitiligo?

Everyone’s Vitiligo causes are different, but Vitiligo tends to be associated with an autoimmune condition (the body attacks itself). Vitiligo affects the melanocytes in your skin cells. These cells are the ones that produce melanin, which is responsible for Vitiligo pigmentation in your skin. Vitiligo does not cause any permanent damage to your health, and there are Vitiligo treatments that can help you live with Vitiligo more comfortably.

What are the signs/symptoms of Vitiligo?

There are no other Vitiligo symptoms beyond the Vitiligo white patches that appear on your skin. Vitiligo white patches can appear anywhere on your body. Vitiligo usually begins with one or two small Vitiligo white patches and then spreads over time.

All Depigmented spots are not vitiligo. Many skin diseases depict vitiligo these are:

Idiopathic guttate hypomelanosis (IGH): It is always asymmetrical Vitiligo in adults. Vitiligo spots appear as well defined, sharply circumscribed Vitiligo patches with round or oval shapes. White macules on the dorsal surface of hands and feet, often associated with Vitiligo of nails. It does not affect mucous membranes.

Nevus depigmentosus: These are Vitiligo-like macules. Vitiligo is present at birth or appears during the first few weeks of life. Vitiligo spots appear as well-defined Vitiligo patches with round or oval shapes.

Pityriasis alba: generally, occurs in children but may occur at any age. Vitiligo skin areas appear as ill-defined depigmented lesions without scale; sometimes, a hyperpigmented halo surrounds Vitiligo lesions.

Albinism: It also mimics vitiligo clinically. Albinism is a genetic disorder of pigmentation of the skin, hair, and eyes due to a defect in the tyrosinase enzyme (present in melanocytes). Albinos lack melanin in the skin, hair, and eyes. It is an autosomal recessive disorder occurring with equal frequency in males and females. At the same time, vitiligo is an acquired pigmentary disorder that causes loss of color (pigment) from portions of the skin resulting in irregular-shaped white patches or spots.

Piebaldism: It is a rare autosomal dominant disorder of pigmentation. A white forelock runs from the eyebrows, along the hairline to the back and sides of the head. The white patch may enlarge posteriorly to involve most of the scalp, including central baldness, producing a “skullcap” appearance. Other body hair and eyelashes are normal. Piebaldism results from an absence of melanocytes (pigment cells) in patches on the skin.

Tinea versicolor: It is due to an infestation of the superficial layers of the skin by a form of yeast usually present on the surface of the human body. It affects areas with more sebaceous glands (i.e., face, chest, and back). The antifungal drug fluconazole can treat this condition if it is severe or resistant to topical antifungals.

Progressive macular hypomelanosis is a rare acquired, localized form of hypopigmentation that begins in childhood and progresses slowly. Effects are usually light brown or tan macules with significant friction (from prolonged pressure).

Congenital diffuse hypomelanosis is an autosomal recessive disorder characterized by a nearly complete lack of cutaneous pigmentation at birth—diffuse areas of generalized hypotrichosis involving the trunk and extremities without hair follicles. The depigmented patches may enlarge over time; however, they do not undergo malignant transformation to melanoma.

Discoid Lupus: It is a chronic inflammatory skin disease common in women, particularly of African descent. It usually begins as a scaly red rash on the face and scalp, although any skin area can be affected. The areas most commonly affected are sun-exposed body areas such as the face, neck, ears, chest, upper back, and arms. These patches may be itchy and painful.

Morphea: It is a localized induration of the skin due to dermal fibrosis. The condition may be idiopathic or as part of an autoimmune disorder such as systemic lupus erythematosus, dermatomyositis, or morphea.

Tinea versicolor: It is due to an infestation of the superficial layers of the skin by a form of yeast usually present on the surface of the human body. It affects areas with more sebaceous glands (i.e., face, chest, and back). The antifungal drug fluconazole can treat this condition if it is severe or resistant to topical antifungals.

Sarcoidosis is a rare multisystem disorder when the body’s immune system makes an abnormal response to specific proteins called antigens. It can cause lesions like vitiligo on the skin, lungs, and other organs.

Leprosy: It is caused by the bacteria Mycobacterium lepre. Leprosy causes patchy loss in standard skin color and pigment-producing areas of flat whiteness thickened and dry appearance. Sometimes it may also cause missing or distorted eyebrows or eyelashes, eye inflammation, scarring and ulcers on the soles of the feet (also known as beriberi), slowed growth, and nerve damage.

Masked Melasma: Is caused by exposure to the sun. When dark-skinned people become very fair on some parts of their bodies, such as the forearm, they get a blotchy pigmentation called Morphea (localized induration of skin).

Post-inflammatory hyperpigmentation refers mainly to discoloration involving the face and is a common sequela of dermatitis, especially chronic irritant contact dermatitis.

A white patch on the skin may also be caused by other medical conditions affecting pigmentation. For example, seborrheic bleaching increases serine protease activity that causes melanocytes to lose their pigment.

This is a list of some other diseases and skin conditions that can cause Vitiligo or white patches on the skin:

1)Actinic keratoses,

2)Addison’s disease,

3)Amelanotic melanoma,

4)Anaemia, including iron deficiency anemia and hemolyticanemia,

5)Angiofibroma of tuberous sclerosis,

6)Bowenoid papulosis,

7)Chemical leukoderma; mercury toxicity [Occupational],

8)Chloroquine pigmentation (due to chloroquine therapy

9)Cicatricial pemphigoid,

10)Collie-Nair syndrome (localized dermal hypoplasia),

11)Cutaneous metastases from internal neoplasms,

12)Dimorphic fungi of the genera “Sporothrix” and “Phaeoacremonium.”

How skin doctors or dermatologists diagnose vitiligo:

Usually, your skin doctor or dermatologist will diagnose vitiligo by looking at your skin.

Wood Lamp Test: Your skin doctor may also use a special ultraviolet light called a Woods Lamp. White patches on the skin will show up as lighter areas when compared with surrounding normal-colored skin. The presence of the pale regions – even if there are only small spots or freckles where pigment should generally be present – can indicate that vitiligo has begun. It is important to note that not everyone with vitiligo will show patchy areas of depigmentation when exposed to the Woods Lamp.

Skin Biopsy: In some instances, a skin biopsy may be used to make the diagnosis. A small piece of skin is removed and sent to the laboratory for examination by a pathologist – a doctor who specializes in tissue diseases. The pathologist will look at the sample of skin under a microscope. In some cases, this test is recommended to rule out other conditions such as leprosy or fungal infections that cause patches on the skin.

Treatment of Vitiligo:

There is no permanent cure for vitiligo. However, various treatment options are available to restore a standard color (pigmentation) of the skin:

1. Skin camouflage or tattooing: This technique involves applying dyes to the skin to mask its appearance (discoloration). The dye is applied by an artist experienced in this technique and can last for several months before reapplication is required. It should be noted that there are risks associated with being exposed to some of the ingredients used in dyes employed for this purpose. Some individuals may develop allergic reactions or infections from these materials. Also, some pigmented products may not provide 100% cover over the affected areas as desired – especially on dark-skinned individuals who have a lower concentration of the pigment called melanin in their skin.
2. Topical Immunomodulators: These are medications that can benefit patients with vitiligo by re-pigmenting the skin. Two examples of these drugs are “Menticosteroids” and “Topical Corticosteroids.” This approach is usually not recommended for children or teenagers unless other treatments have failed to show satisfactory results. It should be noted that there may be a risk of side effects such as skin irritation, acne, allergic reactions, etc. when using this method.
3. Light Therapy (PUVA): If topical immunomodulators do not improve your condition sufficiently, then light therapy can be considered as an alternative treatment option that needs to be administered by a dermatologist. The treatment consists of taking a light-sensitive drug (called a psoralen) orally or applying it directly to the skin. This is followed by exposure to ultraviolet light (UVB) from a particular machine once or twice daily for several weeks. It should be noted that this treatment usually is not suitable for children and pregnant women as it may affect the unborn baby in the process.
4. Corticosteroids: These are medications injected into patches on your skin due to their depigmenting properties, hence reducing the size of affected areas over time. A typical example of these drugs includes fluocinonide.
5.  Surgery for vitiligo:

Skin Grafting: Skin grafting may be performed on more extensive vitiligo patches when repigmentation does not occur spontaneously or with topical treatments. Skin grafting works best for small patches with a moderate loss of pigment and would result in low-contrast, monochromatic skin color if depigmented. The skin graft is obtained from non-vitiligo areas of the body where there are no white patches.

Blister Grafting: Blister grafting is similar to skin grafting, but the blisters are made using a glass pipette or hypodermic needle heated over an alcohol flame. The blister fluid is then expressed, and the roof is peeled off to leave a thin split-thickness skin graft. These grafts are placed on areas of vitiligo after epithelializing with diluted triamcinolone acetonide ointment.
Isolated Cellular Grafts: Isolated cellular (non-meshed) grafts may be used as alternatives to skin grafting for small patches where the placement of a more extensive meshed skin autograft would result in a very poor cosmetic color.

Homeopathic Treatment for Vitiligo:

The homeopathic treatment is more popular among the patients because it has no side effects and proved to be effective in many cases. You can visit Dr Batras clinic for vitiligo treatment. Treatments with ‘homeopathy’ include:

1. Sulphur: It is considered the most essential medicine for the speedy recovery of vitiligo. In the case of leukoderma, sulphur should be taken immediately after consulting a homeopathic doctor. The best time to take this medicine is at night because it shows its effect better when taken before bedtime. The patient should take one tablet of sulphur 30c twice daily.
2. Sepia Officinalis: It is considered the most effective medicine for leukoderma and pigmentary disorders. This medication treats white patches, facial spots, and discolored areas due to vitiligo or leukoderma. The best time to take this medicine is at night. The patient should take one tablet of sepia officinalis 30c twice daily.
3. Psorinum: It is also an effective homeopathic medicine for treating vitiligo or leukoderma, which occurs due to hormonal imbalances in the body. This medicine is also helpful in treating the symptoms such as loss of appetite, burning sensation on the skin, and pain. The best time to take this medicine is at bedtime. The patient should take one tablet of psorinum 30c twice daily.
4. Natrum Muriaticum: This homeopathic medication is also effective for treating vitiligo or leukoderma. It should be taken at bedtime for effective results. The patient should take one tablet of natrum muriaticum 30c twice daily.
5. Medorrhinum: This medicine is also used to treat vitiligo or leukoderma, which occurs due to hormonal imbalances in the body. The best time to take this medicine is at bedtime. The patient should take one tablet of Medorrhinum 30c twice daily.
6. In addition to these medicines, other homeopathic remedies that help treat vitiligo or leukoderma include Lycopodium Clavatum, Carcinosin, and Sulphur 30c. Homeopathy doctors at Dr Batras clinic can help you to select best-suited vitiligo treatment.
7.  In some cases, other homeopathic remedies that help treat this skin condition are Carbo Vegetabilis, Arsenicum Album, and Lachesis Mutus. Homeopathic medicines prove beneficial for patients suffering from this skin disorders. You can book an appointment online through OHO Homeopathy in case if you are suffering from skin depigmentation.