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Vitiligo, the skin pigment disorder made famous by Michael Jackson, isn't medically dangerous nor contagious, but it can certainly be life-changing. Have you noticed lighter patches on your skin and are you wondering whether you could be affected?

Do you think you could be suffering from vitiligo, a pigment disorder that causes the appearance of white patches on the skin? You will, no doubt, have many questions. What causes the disorder, how do you know it's not something else, how do you get diagnosed, and is there anything you can do to treat vitiligo or at least prevent its spread to other areas of the body?

What Is Vitiligo?

Vitiligo is the white-patch causing skin pigment disorder made famous by Michael Jackson — but did you know that Holly Marie Combs, the Charmed star, also has it, along with NBA player Rasheed Wallace? Together, they make it quite clear that vitiligo affects people in rather varying ways, and that skin tone in large part determines how visible it will be.

In people affected by vitiligo, melanocytes, the cells responsible for creating pigment, are destroyed in the areas where the white patches form.

Skin on any part of the body can be impacted, though the white patches commonly appear in areas where the skin has had plenty of sun exposure, such as the hands, feet, and face. Besides skin, mucus membranes, hair, and even the retina can also be impacted by depigmentation.

It's still not quite clear what causes vitiligo. There's certainly a genetic component; people with immediate relatives already suffering from the disorder are more likely to develop it themselves. As seen by the fact that sun-exposed areas are more commonly struck by depigmentation, it is clear that environmental factors also play a role. What's more, many medical professionals are quite convinced that vitiligo is, in fact, an autoimmune disorder.

Vitiligo is equally common in men and women, and though the disorder is bound to be more visible in people with darker skin tones, no ethnic group is more prone to developing vitiligo than others. The first signs of vitiligo typically appear when someone is in their twenties. 

Think You Might Have Vitiligo?

If you have noticed the appearance of white patches of skin or mucus membranes that do not improve with time, and you have not been exposed to skin lightening chemicals, you may have developed vitiligo, or you could be dealing with another disorder that causes depigmentation.

In order to obtain the correct diagnosis, it is important to seek medical help despite the fact that vitiligo isn't in any way medically dangerous.

(And no, it certainly isn't contagious either, despite the fact that some people you encounter will think this.)

Differential diagnoses include:

  • Pityriasis alba, a pigment disorder that is most commonly seen in children and related to eczema. This disorder can be treated with Hydrocortisone, though it typically resolves on its own by adulthood. In this case, the white patches gradually fade into the surrounding skin, and are round-ish or oval shaped.
  • Halo nevi are moles with white patches around them.
  • Tinea versicolor, the appearance of which is more striking, is in fact caused by a yeast infection and benefits from anti-fungal treatment.

Blood tests, a skin biopsy, and an eye exam can rule out other conditions before you are diagnosed with vitiligo.

I Have Vitiligo: What Now?

So, you are newly diagnosed with vitiligo or have noticed lightening of your skin in certain patches and suspect you are dealing with vitiligo? Your first two questions are bound to — will the vitiligo spread, and what are the treatment options? The answers to both questions are less than straightforward.

Will My Vitiligo Spread?

It is possible that you will, after first noticing signs of depigmentation, go on to develop further white patches in various parts of the body. This may happen slowly, over many years and even decades, or the vitiligo can spread more rapidly as well. There is, unfortunately, no way to tell whether you personally will develop further white patches or not, nor when.

What Are The Treatment Options For Vitiligo?

People whose vitiligo is limited to small areas of the skin in places not usually exposed to the sun may not need any treatment, nor do they need to make any lifestyle changes.

If your vitiligo is present on larger areas of the skin, and especially areas of skin that are routinely exposed to the sun, however, you will want to investigate some treatment and management options.

Limiting your exposure to sun is of prime concern, because the areas of skin where your pigment was destroyed are much more prone to sunburn. You'll need to be very diligent about the use of a sunscreen with a sun protection factor of 30 or above at all times, even when you're driving a car or sitting in an office with windows, for instance. Covering depigmented areas of skin with clothing will help prevent sunburn.

Note: The flip side of keeping your skin out of the sun to protect yourself from skin cancer is that you may develop a vitamin D deficiency. You will want to talk to your doctor about taking vitamin D supplements.

Topical corticosteroid creams, though unlicensed for the treatment of vitiligo, may help prevent the spread of white patches and can even restore some of your lost pigment to your white patches. They may be an option for you if less than 10 percent of your body is affected by vitiligo, you're not pregnant or trying to conceive, and you have no other contraindications. Note that topical corticosteroids cannot be used on the face for the treatment of vitiligo, as well as that they may not have the effect you are hoping for.

Camouflage makeup is another management option for people with vitiligo who would like to hide the white patches from others. By asking your doctor about this option, you will be able to find a makeup professional trained in exactly this. Such camouflage treatments aren't anything like normal makeup — some can remain on your body for days at a time very successfully.

People suffering from vitiligo that covers much of their body and that has not responded well to topical treatment may also benefit from phototherapy. Talk to your doctor about this option, though be sure to also ask them about the possible risks. There is some evidence that this light therapy increases the risk of skin cancer slightly.

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