Vitiligo

Vitiligo is an autoimmune condition. This means the body’s defence system attacks its own cells by mistake. In vitiligo, the immune system is attacking melanocytes, the cells that make melanin (the pigment that gives skin its colour and protects it from the sun). When these cells are damaged, loss of colour can happen, causing pale or white patches to appear. 

Vitiligo may be linked to other autoimmune conditions, including thyroid disease and type 1 diabetes. Individuals with vitiligo may also have an increased risk of other autoimmune conditions. 

In some people, skin injury such as burns, cuts, scratches or rubbing can trigger new patches of vitiligo. 

Vitiligo is not contagious; this means it cannot be passed onto another person. There is no proven link between vitiligo and diet or smoking. 

Is vitiligo hereditary?

Vitiligo can run in families, but having vitiligo does not mean your children will definitely get it. 

 Vitiligo looks like pale, pink or white patches of skin with defined edges. The skin feels normal to touch. It may appear on one side of the body or both. Commonly affected places include the hands, face, areas around the eyes, nose and mouth, genitals, and body folds like the underarms and groin. The patches can vary in size. Hair within vitiligo patches may turn white. 

When colour comes back, it often starts around hair roots, giving a speckled look. Vitiligo is not usually itchy or painful, but some people feel itching before a new patch appears. Because vitiligo patches have no melanin, they may burn more easily in the sun. Melanin acts as natural sunblock and it is missing in vitiligo patches.

Images DermNetNZ.

Vitiligo is usually diagnosed by the way it appears on the skin. Your healthcare professional may use a special ultraviolet lamp called a Wood’s lamp to help find the patches. You may also be asked to do blood tests to check for vitamin D levels, thyroid disease or other autoimmune conditions, if relevant. There are no specific blood tests which are needed to make the diagnosis of vitiligo. 

Your healthcare professional may also take photos of your skin to keep track of changes over time. Sometimes it might be tricky to diagnose vitiligo as patches are small and may look similar to other conditions causing white patches. In these cases, your GP may need to refer you to a dermatologist to confirm the diagnosis. 

What are the different types of vitiligo? 

There are two main types of vitiligo:  

• Non-segmental vitiligo – patches appear on both sides of the body. 
• Segmental vitiligo – patches (usually small) appear on just one side of the body.  

Non-segmental vitiligo is the most common type, and most likely to spread to other parts of body, limbs and/or face.  

It might be important to find out which type of vitiligo you have as this will help your healthcare professional decide on the most appropriate treatment. 

Can vitiligo be cured?

Although there is no cure for vitiligo, several treatment options are available and may help bring the skin’s natural colour back. Vitiligo is usually a lifelong condition, which means that you may need to treat new patches as they come back or appear in new places. 

How can vitiligo be treated?

You can talk to your healthcare professional about the following treatment options. You may also choose not to have treatment. Whatever you decide, it is important to protect your skin from the sun. 

The following treatments may only be available in a few specialist NHS centres that have an interest in treating vitiligo. 

People affected by vitiligo have different feelings about it. Some are not concerned, while for others it can cause anxiety and distress. Some may find it affects their confidence or mood. If vitiligo is affecting how you feel, speak to your healthcare professional. They may suggest support or talking therapy. You can also self-refer using this link: www.nhs.uk/nhs-services/mental-health-services/find-nhs-talking-therapies-for-anxiety-and-depression/. 

Top sun safety tips

Vitamin D Advice

People who stay out of the sun might not get enough vitamin D. They should think about checking their vitamin D levels. If the level is low, they may consider:  

• Taking vitamin D supplements (10-25 micrograms per day). Your GP can advise you.  
• Eating more foods rich in vitamin D, such as oily fish, eggs, meat, butter, fortified margarine and cereals.