New treatments for vitiligo offer new hope

The bad news is that vitiligo is a common condition that affects self-esteem. 

The good news is that vitiligo can be treated.

Vitiligo (vit-uh-lie-go) is a common skin condition that affects millions of people worldwide. People with skin of color are especially prone to the negative effects of the disease. 

Vitiligo appears as white spots and patches on the skin. Michael Jackson had vitiligo. The condition can be particularly troubling when patients have tan, olive, brown or dark brown skin, as the white spots and patches are much more apparent. 

Vitiligo is not contagious, and it is not life-threatening. But, vitiligo can be life-altering. Socially and psychologically, vitiligo can be devastating and have profound quality-of-life effects. Vitiligo can affect self-esteem and interfere with friendships. Some people with vitiligo develop depression. 

The good news is that there are many suitable treatments for vitiligo.

What causes vitiligo? 

The exact cause of vitiligo is not fully understood. Vitiligo is a condition where the cells in the skin that produce color (melanocytes) either die early or are inappropriately destroyed by the body’s immune system. It can also be induced by environmental toxins, steroid injections, and some new anti-cancer medications. 

Interestingly, the development of vitiligo on the hands after receiving some of the newer cancer (monoclonal antibody) medications indicates a better outcome in fighting that cancer. Vitiligo is exacerbated by stress. Researchers have identified several genes that may be involved in vitiligo and continue to look for additional involved genes.

How common is vitiligo?

About one in 100 people will develop vitiligo in their lifetime. Unfortunately, vitiligo is much more apparent when you are a person of color. Vitiligo is a medical disease and not just a cosmetic concern. 

Vitiligo occurs equally in people of all skin colors. Men and women develop vitiligo in approximately equal numbers. It can occur anywhere on the body, in small areas or large patches. It can also cause the hair to turn grey/white. Vitiligo can occur at any age, but commonly it occurs before age 20.  

The risk of getting vitiligo increases if a person has a close blood relative who has vitiligo; or an autoimmune disease, especially thyroid disease, anemia, or alopecia areata (hair loss).

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, aggressive treatment can keep it from spreading and even reverse its course.

How is vitiligo treated?

Vitiligo is treated using topical prescription medications (including anti-inflammatory agents and vitamin D creams), meticulous sun protection, and narrow-band UVB phototherapy treatments. In extreme cases, when only a small patch of dark skin remains, that area can be lightened (depigmented) with special chemicals. 

Sometimes tiny grafts of skin from uninvolved areas can be transplanted into areas of vitiligo. Also, camouflaging skin (with makeup) can work well. 

People with vitiligo should protect their skin using exceptional sunscreens and sun-protective clothing. They should also avoid tanning and trauma to the skin (like getting tattoos), which can cause the disease to spread via a process called the Koebner effect. 

People with vitiligo should live a healthy lifestyle free from tobacco, minimize alcohol consumption, eat a healthy diet, exercise regularly, and minimize stress. For people with vitiligo, it’s important to develop coping strategies such as learning about the disease or connecting with other people with vitiligo through support groups and social gatherings, like Camp Discovery for kids. 

Into the mainstream

Camp Discovery offers children living with chronic skin conditions, such as vitiligo, eczema, psoriasis, alopecia, epidermolysis bullosa, and ichthyosis, a one-of-a-kind week-long camp experience. Camp Discovery is provided at no cost to the campers.

Fortunately, many companies are creating products that embrace vitiligo, like the new “Fashionista” Barbie Collection, featuring a Barbie Doll with vitiligo. Additionally, many high-profile models like Chantelle Brown-Young and Winnie Harlow are embracing their vitiligo, bringing it into the mainstream. Their efforts are applauded.   

Emerging research indicates that medicines called JAK inhibitors may also be beneficial in treating vitiligo. Researchers may develop better treatments once all of the genes causing vitiligo have been identified. The ultimate goal is to find a treatment that will permanently stop the skin from losing color. 

Currently, a combination of treatments, including topical medications, JAK inhibitors, and narrow-band UVB light treatments, can have dramatic and satisfying results, as shown in the accompanying photographs. 

Action steps for anyone with unwanted vitiligo

Be sure to get under the care of a board-certified dermatologist and learn about vitiligo. Also, join the National Vitiligo Foundation and participate in their local support groups. In patients where vitiligo causes psychological and social problems, insist that the insurance company covers treatments as medically necessary. Your dermatologist can help with this.

Patients with vitiligo can also experience hearing and vision changes. This is because melanocytes in the eyes and ears can be affected. If you have vitiligo, check your hearing and eyesight regularly. 

It is essential to realize that vitiligo is a common condition, and you are not alone. There are many new, effective and promising treatments for vitiligo. If you have vitiligo, see a board-certified dermatologist.