Vitiligo is a disease that causes the skin color to fade. Besides being able to attack any area of the skin on the body, this fading color can also occur on the inside of the mouth, eyes, and hair.
Vitiligo is a non-communicable skin disease that lasts long term (chronic), and is estimated to affect 1 in 100 people. Although it can affect anyone, vitiligo generally occurs before the age of 20, and is more pronounced in black people.
Vitiligo Causes and Risk Factors
The color of the skin, hair, and eyes is produced by the body's pigment cells. In people with vitiligo, these cells stop producing body color or pigment. As a result, white patches appear on the skin and gray hair.
It is not known why pigment cells stop producing pigment in the body, but the condition is thought to be related to a number of factors:
- Inherited genetic disorders.
- Autoimmune disease, which is a condition when the body's immune system attacks and destroys healthy body cells, including the body's pigment cells.
- Stress, sunburn, or exposure to chemicals are also thought to trigger vitiligo.
Symptoms of Vitiligo
The symptom of vitiligo is the appearance of hypopigmented patches on the body. At first, the patches that appear are lighter in color than the skin, then they will gradually whiten. The appearance of patches begins on body parts that are often exposed to sunlight, such as the face, lips, hands and feet, then spreads to other parts of the body.
Other symptoms of vitiligo include:
- Loss of color pigment in hair, beard, eyelashes, and eyebrows, making them look like gray hair.
- Loss of color pigment in the black part of the eyes, the inside of the mouth and nose, and in the genital area.
- In some cases, the center of the spot is white, while the edges are brown or reddish.
- Some sufferers feel pain and itching in the area of the skin affected by vitiligo.
- A rash appears on the skin area affected by vitiligo, after exposure to the sun.
Vitiligo patches generally appear symmetrically on both sides of the body, and develop and stop repeatedly. When and how quickly the patches stopped spreading, cannot be determined. In rare cases, the patches only appear on one side of the body, then spread for 1-2 years and then stop.
See a doctor immediately if the color of your hair, skin, or eyes fades. Proper treatment at an early stage can slow the progression of this disease.
Diagnosis of Vitiligo
Doctors can suspect a patient has vitiligo, if there are symptoms that have been described previously. But to be sure, the doctor will ask the patient a number of things, such as:
- Family history of vitiligo or autoimmune disease.
- History of trauma to areas of skin affected by vitiligo, such as sunburn (sunburn), or a severe skin rash in the area.
- History of treatment ever done.
- Are there certain areas of the skin that are more sensitive to sunlight and more prone to sunburn?
- Are there certain areas of the skin that improve without needing therapy, or are they getting worse?
To confirm the diagnosis, the doctor will run a more detailed examination. One of them is skin examination using an ultraviolet lamp. In this test, the patient will be asked to enter a dark room. Then, the ultraviolet lamp will be placed at a distance of 10-13 cm from the skin. Ultraviolet light will make it easier for doctors to see patches of vitiligo, and rule out other skin diseases such as tinea versicolor.
The doctor will also run blood tests, to check for other conditions such as diabetes, Addison's disease, or hyperthyroidism. Blood tests are done, because in some cases, vitiligo can be associated with autoimmune diseases.
Treatment Vitiligo
Vitiligo treatment aims to restore skin color to its original state. Some treatment methods can cause side effects. Therefore, the doctor will advise the patient to first use tanning lotion or darkening lotion. Doctors will also advise patients to wear sunscreen with an SPF of 30 or more to prevent further skin damage from sun exposure.
If the above methods don't work, your dermatologist will suggest other methods, including:
Drugs
Although there is no drug that can stop the development of vitiligo, the following drugs can restore the patient's skin tone:
- topical corticosteroid. Corticosteroid creams or ointments can help prevent patches from spreading and restore the patient's skin tone, especially in the early stages of vitiligo. Corticosteroids are used in vitiligo that has not spread. Prescription topical corticosteroids, including betamethasone, fluticasone, and hydrocortisone. Corticosteroids should not be used in pregnant women, or patients with vitiligo on the face.
- Tacrolimus. In vitiligo that only occurs in small areas, such as the face and neck, the doctor will prescribe an ointment containing tacrolimus. This ointment can be used in conjunction with ultraviolet B (UVB) light therapy.
- Hydroquinone. In patients with vitiligo that is very widespread almost all over the body, the doctor will prescribe a lotion with ingredients hydroquinone. The lotion will be applied to normal skin, so that the color becomes similar to the vitiligo patches.
UV light therapy
UV light therapy or phototherapy is chosen when the vitiligo has spread widely, and cannot be treated by topical medications. Phototherapy is done by exposing ultraviolet A (UVA) or B (UVB) rays to the skin area affected by vitiligo. Before phototherapy, patients will be given psoralen which is applied to the skin, so that the skin becomes more sensitive to UV rays. Patients require therapy 3 times a week, for 6 to 12 months.
Phototherapy can also be combined with laser therapy, medication prednisolone, type of vitamin D calcipotriol, and drugs that affect the immune system such as azathioprine.
Surgical procedure
Surgical procedures are performed when phototherapy is not effective in the patient. The goal of surgery is to restore the normal color of the skin affected by vitiligo. A number of surgical methods to treat vitiligo are:
Cskin graft Blister graftingJust like skin grafts, blister grafting done by taking healthy skin to coat the skin affected by vitiligo. The difference is, the skin taken will be blistered first, then the top of the blister will be removed before grafting. Micropigmentation Please note, it can take months for treatment to be effective. However, the results will vary greatly in each patient. Talk to your doctor about the right type of treatment. Untreated vitiligo can continue to develop, and lead to the following complications:Complications of Vitiligo