Vitiligo

Vitiligo (the word derives from the Latin word for defect or blemish - 'vitium') is a chronic skin condition where skin pigment cells - melanocytes - stop functioning or die. This causes white spots or patches to appear on the skin. It is most noticeable on darker skin and is not linked with melanoma (skin cancer) as it is the very absence of the melanocytes, which is where melanoma forms, which gives rise to the lack of pigment.

Vitiligo affects less than 1% of the population, although rates are higher amongst darker skinned people. One in two people affected develops the condition before the age of 20 and most sufferers have the condition appear before they are 40 years old. The condition is first mentioned in an ancient Egypt text from 1500BC and Roman physician Celsus was the first person to use the term 'vitiligo'. Well known sufferers of vitiligo include Michael Jackson and Jon Hamm (of TV show Mad Men).

There are two types of vitiligo, 'common vitiligo' where only a few pale or white spots appear, and 'segmental vitiligo' which usually affects children and is often just one patch of white or pale skin which grows quickly and then stops, with generally no further patches developing.

Causes of Vitiligo

Medical science has not yet been able to determine exactly what causes the condition, however many studies point towards it being connected to the immune system and being caused by an immune response which destroys the melanocytes.

The condition cannot be cured, but it can be controlled.

Treatments

Phototherapy/Excimer Laser

Treatment with Ultraviolet (UV) Light - generally a form called 'Narrowband UVB' - otherwise known as 'phototherapy' - which is quite different from the light used in solarium machines - is used to treat affected areas. It reduces the growth of patches and does achieve some repigmentation of affected skin. An excimer laser is a similar device which is used to treat smaller spots and patches with a targeted pulse of laser light.

Epidermal Cellular Grafting (non-cultured)

This technique involves the removal of a piece of skin from another part of the body and adding skin cells from this area to an area affected by vitiligo in a liquid suspension - these cells then attach themselves and repigment the skin. This technique is only suitable for smaller patches , but the new skin does match the persons healthy skin.

Steroid (cortisone creams)/Immune suppressive tablets

These can be effective in stopping the growth of the depigmented patch of skin, but they do not return any pigment to skin already affected. Immune suppressive tablets are stronger than topical creams and act to slow down or stop the growth of depigmented skin patches, but they do not repigment skin.

Cosmetic camouflage/Micro-tattooing

The careful application of accurately coloured cosmetics can improve the overall appearance of the skin but of course takes time and regular (daily) application. An alternative is a semi-permanent 'micro-tattoo' which matches the healthy skin and generally lasts much longer (months to years).

Depigmentation

Where vitiligo has affected substantial areas of skin (over 50%), depigmentation, or skin bleaching is another option. Using a bleaching agent such as monobenzyl ether of hydroquinone applied to the skin, a daily treatment program achieves results over a 3-6 month period.

Often a combination of two or more of the techniques described above results in the best outcomes for sufferers of vitiligo.