By Charles E. Crutchfield III, MD
Vitiligo is a condition where white patches occur on the skin. This was a condition that Michael Jackson had. It can be particularly troubling when patients have tan, brown or dark brown skin, as the spots are much more obvious. Socially and psychologically, vitiligo can be devastating and have profound quality-of-life effects.
What causes vitiligo?
Vitiligo is a condition where the cells in the skin that produce color (melanocytes) either die early, or are inappropriately destroyed by the patient’s immune system. It can also be induced by environmental toxins and exacerbated by stress. Researchers have identified several genes that may be involved in vitiligo and continue to look for other involved genes.
How common is vitiligo?
About one in 100 people will develop vitiligo in their lifetime. Unfortunately, when you are a person of color, vitiligo is much more obvious. As a result, some insurance companies have claimed that the condition is only a cosmetic concern, because in patients with lighter skin, it’s very difficult to see.
How is vitiligo diagnosed?
Vitiligo is most easily diagnosed by a board-certified dermatologist. This can be done by a special light examination called a “wood’s lamp” or by a skin biopsy.
Can vitiligo be prevented?
Vitiligo cannot be prevented; however, once it occurs, aggressive treatment can keep it from spreading.
How is vitiligo treated?
Vitiligo is treated by using topical prescription medications, meticulous sun protection, and special phototherapy light treatments. In extreme cases, when only a small patch of dark skin remains, the area can be lightened (depigmented). Sometimes small grafts of skin from normal areas can be transplanted into areas of vitiligo. Also, camouflaging skin (with make-up) can work well.
Emerging research indicates that medicines called prostaglandins may also be beneficial in treating vitiligo. Once all of the genes causing vitiligo have been identified, researchers may develop better treatments. The ultimate goal is to find a treatment that will permanently stop the skin from losing color.
Action steps for anyone with unwanted vitiligo
Be sure to get under the care of a board-certified dermatologist and learn about vitiligo (www.AAD.org). Also, join the National Vitiligo Foundation and participate in their local support groups (www.mynvfi.org/). In patients where vitiligo causes psychological and social problems, I would insist that the insurance company cover treatments as medically necessary. Your doctor can help you with this.
It is important to realize that vitiligo is a common condition, and you are not alone. There are many good treatments for vitiligo.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.