What is vitiligo?

Vitiligo (vit-il-EYE-go) is a skin disorder that causes the skin to lose its color. Smooth lighter or white areas (called macules or patches) appear on a person’s skin. If vitiligo occurs in a hair-bearing area, the hair in those areas also may turn white.

The condition occurs when melanocytes (the skin cells that produce melanin, the chemical that gives skin its color, or pigmentation) are destroyed by the body’s immune system.

How does vitiligo progress?

Vitiligo usually begins with a few small white patches that may gradually spread over the body over the course of several months. Vitiligo can develop on any part of the body, including the mucous membranes (moist lining of the mouth, nose, genital, and rectal areas), the eyes, and inner ears, but typically begins on the hands, forearms, feet, and face.

Sometimes the patches continue to widen and spread, but usually they stay in the same place for years. The location of the macules shifts and changes over time, as certain areas of skin lose and regain their pigments. Vitiligo varies in the amount of skin affected. If you have the more generalized form of the disease it may appear with only few spots, or may result in widespread loss of skin color.

What are the types of vitiligo?

Vitiligo can be segmental, which is restricted to one side of the body or one area, such as the hands or face. Vitiligo can also be generalized, which is the most common type, when macules appear in various places on the body. Other subtypes of vitiligo include focal, mucosal, trichrome, and universal vitiligo.

How common is vitiligo?

Vitiligo occurs in about 1% of the United States’ and the world’s population. Vitiligo affects all races and genders equally; however, it is more visible in people with darker skin. Although vitiligo can develop in anyone at any age, it most commonly appears in people ages 10 to 30 years. Vitiligo rarely appears in the very young or very old.

What causes vitiligo?

Although the causes of vitiligo aren’t completely understood, there are a number of different theories:

  • Autoimmune disorder: The affected person’s immune system may develop antibodies that destroy melanocytes.
  • Genetic factors: Certain factors that may increase the chance of getting vitiligo can be inherited. About 30% of vitiligo cases run in families.
  • Neurogenic factors: A substance that is toxic to melanocytes may be released at nerve endings in the skin.
  • Self-destruction: A defect in the melanocytes causes them to destroy themselves.

Vitiligo may also be triggered by certain events, such as physical or emotional stress. Because none of the explanations seem to completely account for the condition, it’s possible that a combination of these factors is responsible for vitiligo.

What problems are associated with vitiligo?

Although vitiligo is mainly a cosmetic condition, people with vitiligo may experience a variety of problems:

  • Because they lack melanocytes, macules are more sensitive to sunlight than the rest of the skin, so they will burn rather than tan.
  • People with vitiligo may have some abnormalities in their retinas (the inner layer of the eye that contains light-sensitive cells) and some variation of color in their irises (the colored part of the eye). In some cases, there is some inflammation of the retina or iris, but vision is usually not affected.
  • People with vitiligo may be more likely to get other autoimmune diseases (in which the body’s immune system causes it to attack itself), such as hypothyroidism, diabetes, pernicious anemia, Addison’s disease, and alopecia areata.

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