Living With Vitiligo

What is vitiligo?

Autoimmune diseases are caused by an alteration in our immune system, which attacks our own tissues and organs as if they were not our own. This reaction can cause damage to a variety of cells and depending on how intense the attack is of our own immune system to a certain organ, it can cause from mild to severe consequences.

Vitiligo is an autoimmune disease that affects the skin of patients by promoting the discoloration of certain regions of the body.

Giving color to our skin

Vitiligo affects melanocytes, special cells that have the function of producing melanin, the pigment that gives color to our skin, eyes and hair. Melanin production differs from person to person and is mainly determined by our genes. This is why there are differences in skin color all around the world.

Melanin protects us from UV light, since it absorbs most of it and prevents damage to skin cells.

Contrary to what you may think, the intensity of skin color does not depend on the number of melanocytes that we have, but on how active they are. Certain situations can over activate the activity of melanocytes. For example, exposure to UV rays increases their activity and therefore, melanin production, giving as a result a darker skin.

What happens in patients with vitiligo?

Known also as leucodema, vitiligo is considered to be a disease caused by an autoimmune reaction. The immune system of the patient no longer recognizes his or her melanocytes and attacks them, causing melanocyte’s death.

Why does the immune system go mad? This is not known. The reason could be related to both genetic and environmental factors, such as trauma to the skin, hormonal changes and stress, but scientists have not been able to establish why the immune system looses tolerance to melanocytes, specifically in this case.

Because melanocytes get damaged and die, melanin production decreases in the areas were the number of melanocytes is reduced, giving as a result the patchy appearance that is visible in patients suffering from vitiligo.

Vitiligo is not specific of any age, since it can affect from children to old adults. Although, research has detected that vitiligo tends to appear before the age of 20.

Symptoms and diagnosis of vitiligo

Vitiligo does not cause any type of pain and its main symptom comprises the formation of flat areas of skin without pigmentation.

These areas have normal skin, except for the lack of color they show, and they appear mainly on the face, hands and feet, elbows and knees and on the genital area.

Because there is no melanin present in those areas, they are more prone to suffer sunburns, as they lack of the natural protection against UV light.

Vitiligo rarely affects hair and eyes, even though there are melanocytes present in those regions also.

Depending on the type of vitiligo, colorless skin patches can be symmetrical and can be found in both the front and back parts of the body, or segmental when light skin patches localize in just one side and do not spread to other areas.

More Facts About Vitiligo, An Autoimmune Disease Of The Skin

Vitiligo is detected by just examining the skin of the patient, but a skin biopsy may be required to confirm the diagnosis. A biopsy is a tiny piece of tissue, in this case of skin that is surgically removed and sent to a specialist for its analysis.

Diseases related to vitiligo

Vitiligo is also related to other diseases, which include hyperthyroidism, Addison’s disease and pernicious anemia.

In hyperthyroidism, the thyroid gland produces more thyroid hormone than normal, affecting several body functions, including the activity of melanocytes.

Addison’s disease is also related to hormonal imbalances but they are caused by an alteration in the adrenal glands, which are located on the top of our kidneys. These glands control the function of the immune system; when they are affected, so is the immune system, leading to the development of autoimmune diseases such as vitiligo.

Finally, pernicious anemia is caused by a deficiency in vitamin B12. This vitamin is important in the production of red blood cells and when there is a lack of it, the number of red blood cells is decreased. The deficiency in B12 is due to a bad intestinal absorption, which can be related to a problem of autoimmunity, where the immune system attacks the lining of the intestine and destroys it. This condition, as you can read, is similar to vitiligo, which is why they tend to be related.

When vitiligo is diagnosed, the specialist also runs tests to determine if one of these three vitiligo diseases is also present. A blood sample is what the doctor requires to make the diagnosis of any of these related illnesses.

Can vitiligo be treated?

Vitiligo has no cure and is a very difficult disease to treat, since there is no effective treatment that can stop the loss of melanocytes and the formation of colorless skin regions. There are several options for patients though, to slow down the progression of the disease.

Phototherapy, for example, is a widely used treatment for vitiligo.

The skin of the patient is carefully exposed to UV light (or other type of light) to induce an increase in the production of melanin, in the melanocytes that are still functional.

Other treatments include the use of creams containing medication to reduce the immune response, which are applied directly on to the body areas affected by vitiligo.

Micropigmentation is also used to color the light skin patches and even surgical implantation of grafts of normal colored skin on to the areas affected by the disease can be performed.

Patients can experience an intense anxiety due to the development of vitiligo, which makes the disease to develop faster. Vitiligo is more visible in people with darker skin, a situation that can be difficult for patients to cope with. People with vitiligo can even experience discrimination as a result of the lack of knowledge and understanding of the disease.

Psychological treatment is therefore also very important for people with vitiligo.

It can help them in dealing with the disease and reduce their stress levels, helping at the same time in delaying the formation of colorless skin patches.

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