Introduction

Have you ever noticed someone with patches of lighter skin scattered across their face, arms, or elsewhere on their body?

This could be a result of vitiligo, which is a relatively common skin condition affecting millions of people worldwide.

Unlike other skin conditions, vitiligo does not cause any physical discomfort or illness.

However, the appearance of vitiligo can raise questions and sometimes lead to self-consciousness among those who have it.

World Vitiligo Day is observed on June 25th each year, a tradition that began in 2011. This day is dedicated to recognizing the more than 100 million people worldwide who have vitiligo, increasing awareness about the condition, and supporting the search for a cure.

Living with Vitiligo can be a rollercoaster ride.

The milky-white patches on your skin can serve as a constant reminder that your body is doing something different. But you don't have to face it alone!

In this blog, we will explore the highs and lows of living with vitiligo, providing you with practical tips to manage the condition, boost your confidence, and connect with others who understand what you're going through.

We will celebrate the beauty of unique skin and empower you to live your life to the fullest, vitiligo and all.

What is Vitiligo?

Vitiligo is a chronic autoimmune condition that affects the skin, causing certain patches to lose color or pigment.

The condition occurs when the immune system mistakenly attacks melanocytes - the cells responsible for producing melanin, which gives the skin its colour.

This attack destroys melanocytes, leading to the development of white patches on the skin.

Although these patches can show up anywhere on the body, they are typically found on the face, hands, feet, and around orifices such as the mouth and genitals.

It is common for the white patches to appear symmetrically on both sides of the body, such as on both hands or both knees.

Sometimes, the loss of colour can be sudden, and it may even cover a large area. 

There are Two Main Types of Vitiligo 

Generalized (non-segmental) vitiligo: Generalized vitiligo is the most common type, affecting around 90% of people with vitiligo.

It causes white patches to appear on both sides of the body in a symmetrical pattern.

For example, you may notice patches on both hands, elbows, knees, or cheeks. 

Segmental vitiligo: Segmental vitiligo is less common and affects around 10% of people with vitiligo.

It causes white patches to appear on one side of the body or in a limited area such as the face, arm, or leg.

Segmental vitiligo usually develops more quickly than generalized vitiligo and tends to affect children more often. 

Causes of Vitiligo

The exact reason for this is unknown, but research suggests there are several possible causes. 

Autoimmune Disorder: When the immune system mistakenly attacks healthy cells (melanocytes) as if they were harmful invaders like bacteria, it can cause an overreaction in the immune system, leading to the destruction of melanocytes.

Genetic Changes: Genetic changes, such as a mutation or alteration in DNA affect how melanocytes function. There are more than 30 genes that can increase the risk of developing vitiligo.

Stress: Stress may also play a role in the development of vitiligo. Emotional or physical stress can affect the amount of pigment produced by melanocyte cells, especially after an injury.

Environmental Triggers: Environmental triggers like exposure to ultraviolet radiation or toxic chemicals can impact how melanocyte cells function and contribute to the development of vitiligo.

Symptoms of Vitiligo

The most obvious symptom of vitiligo is having pale or white patches of skin.

The white areas of skin usually have clear borders, and there is no inflammation.

Some other common symptoms of vitiligo are:

• Vitiligo can occur in areas where the skin has been damaged, such as from a cut or burn. It may appear in places where the skin rubs together, such as under the arms, in the groin, or between the buttocks. It can also develop in areas that are exposed, like the face or hands.
• People with vitiligo may also have white hairs in the affected area, and their head or facial hair may start to turn grey earlier than normal. The patches of skin affected by vitiligo may be itchy or more sensitive.
• Vitiligo can spread to other parts of the body, especially during times of stress, illness, or pregnancy. In some cases, the condition remains stable, and the white patches do not spread. However, in other cases, the patches can suddenly regain their pigment.
• Some people may also experience hearing loss, loss of eye pigmentation, and other autoimmune diseases, such as thyroid disease.

Diagnosis of Vitiligo

The diagnosis of vitiligo is usually done by a dermatologist and involves several steps:

Your doctor will ask about your medical history and perform a physical exam to assess the location, size, and symmetry of the white patches.

A Wood's lamp examination may also be conducted to help differentiate vitiligo from other skin conditions. This handheld device emits ultraviolet (UV) light that can make vitiligo patches appear a bright white or blue-white colour, while other conditions may appear in different colours.

A skin biopsy may be necessary to confirm the diagnosis of vitiligo. During this minor procedure, a small sample of skin is removed from an affected area and examined under a microscope.

While blood tests are not typically required to diagnose vitiligo, they may be done to check for other autoimmune diseases that can sometimes occur with vitiligo, such as thyroid disease or pernicious anaemia.

Treatments

There are several treatment options available for vitiligo:

Phototherapy: Phototherapy involves exposing the skin to controlled doses of ultraviolet B (UVB) light, which helps to stimulate the production of melanin. Narrowband UVB (NB-UVB) is the most common type of phototherapy used for vitiligo. Another type of light therapy is excimer laser therapy, which is used for small areas of vitiligo.

Medications: Medications are prescribed to reduce inflammation and stimulate the production of melanin.

Depigmentation therapy: Depigmentation therapy is an option for people with widespread vitiligo. This treatment involves lightening the pigment in unaffected areas of skin to match the colour of the vitiligo patches.

Surgery: Surgery such as skin grafting and melanocyte transplantation may be used to treat vitiligo, but these procedures are typically only considered for people who have yet to respond to other treatments.

Camouflage makeup: Makeup can camouflage vitiligo patches and even out skin tone.

Embracing Life with Vitiligo: Psychological Strategies for Well-Being

Living with vitiligo can be challenging, but there are several psychological strategies that can enhance acceptance, resilience, and overall well-being.

Here’s a personal guide to help you navigate your journey:

Acceptance

First and foremost, embracing vitiligo as a part of who you are is crucial. Focus on managing your condition through healthy habits rather than constantly seeking a cure. Acceptance can pave the way for a more peaceful and content life.

Self-Compassion

Treat yourself with kindness and patience. Speak to yourself with the same understanding and empathy you would offer a close friend. Remember, self-compassion is a powerful tool for emotional healing.

Mindfulness

Practicing mindfulness can help you stay focused on the present moment, reducing stress and anxiety about your condition. Techniques such as deep breathing and meditation can be very effective.

Positive Self-Talk

Incorporate positive affirmations into your daily routine. Remind yourself, "I am me, and there’s nothing better," and "There is room for all types of beauty in the world, including mine." These affirmations can boost your self-esteem and outlook on life.

Coping Strategies

Learning effective coping strategies is essential for managing stress and anxiety related to living with vitiligo. Here are some techniques:

• Relaxation Exercises: Focus on your breath and the present moment, letting tension melt away with each exhale. Repeat to yourself, "I am here, at this moment, finding peace within."
• Cognitive Reframing: Challenge negative assumptions with self-acceptance and realistic perspectives. For instance, instead of thinking, "People will stare at me and judge me because of my vitiligo," reframe it as "My vitiligo is a part of me, and those who matter will accept me for who I am."

Self-Care

Engage in activities that bring you joy and relaxation, such as yoga, meditation, or hobbies. Taking care of your overall well-being can make a significant difference.

Skin Protection

Protecting your skin is vital:

• Sunscreen: Use sunscreen with an SPF of at least 30 daily, reapplying every two hours.
• Avoid Intense Sun Exposure: Seek shade and avoid artificial UV light sources like tanning beds.
• Wear Protective Clothing: Opt for long-sleeved shirts, broad-brimmed hats, and long pants. Look for clothing with a UPF (Ultraviolet Protection Factor) label to reduce UV radiation exposure.
• Cosmetic Cover-Ups: Use skin-friendly cosmetics like self-tanning products, concealers, and makeup to even out your skin tone safely.
• Avoid Tattoos: Steer clear of permanent tattoos, as they can damage your skin and trigger new patches of vitiligo. Consider temporary tattoos instead.

Express Yourself

Embrace your individuality through art, fashion, or other creative outlets. Celebrate your unique appearance and use your style as a form of self-expression.

Reframe Identity

Understand that your identity is multifaceted, encompassing much more than just your appearance. Practice writing positive affirmations, journaling about your journey, and reminding yourself daily that you are beautiful just the way you are.

Social Support

Connecting with others who have vitiligo can foster a sense of community. Join online forums, local support groups, or social media communities to share experiences and offer mutual support.

Cognitive-Behavioral Therapy (CBT)

Consider working with a therapist trained in CBT to help identify and challenge negative thoughts. Developing healthier thinking patterns and coping mechanisms can significantly improve your mental health.

Dealing with Social Stigma when Living with Vitiligo

Living with vitiligo can also involve dealing with social stigma. Here are some strategies to help manage this aspect:

Education and Awareness

Increase public knowledge and understanding of vitiligo through educational campaigns, workshops, and media outreach. Providing accurate information about the causes, symptoms, and treatment options for vitiligo can dispel myths and misconceptions.

Celebrate Diversity

Celebrate the diversity of human appearance and challenge stereotypes around beauty and perfection. Emphasize that individuality and uniqueness make us special and valuable.

Community Support Groups

Join or establish community-based support groups for individuals with vitiligo and their families. These groups provide a safe space for sharing experiences, offering mutual support, and fostering a sense of belonging and solidarity.

Empowerment through Visibility

Embrace your condition and share your story openly. By doing so, you can raise awareness, challenge stigma, and inspire others to embrace their uniqueness.

Representation in Media and Advertising

Advocate for greater representation of individuals with vitiligo in mainstream media, advertising campaigns, and the entertainment industry. This can challenge narrow standards of attractiveness and promote acceptance of all skin types and appearances.

Empathy and Compassion

Foster empathy and compassion towards individuals with vitiligo by promoting understanding and acceptance of their experiences. Encourage open dialogue and active listening to create a culture of empathy and support.

Collaboration with Healthcare Providers

Work with healthcare providers, dermatologists, and mental health professionals to ensure comprehensive care and support. This may include psychosocial support, counseling services, and resources for coping with the emotional impact of vitiligo.

By implementing these strategies, you can build a positive self-image, manage your condition more effectively, and lead a fulfilling life despite the challenges of living with vitiligo.

Conclusion

Living with vitiligo can be challenging both physically and emotionally. However, individuals affected by this condition can lead fulfilling lives through understanding, acceptance, and support. 

Embracing one's unique appearance, seeking medical guidance when needed, and surrounding oneself with a supportive community can greatly enhance one's journey with vitiligo.

Remember that vitiligo does not define one's worth or beauty; it is simply a part of the diverse tapestry of human existence. 

With resilience and self-love, individuals can navigate the ups and downs of living with vitiligo and emerge stronger, more empowered, and truly beautiful in their skin.

FAQs

What are the major causes of vitiligo?

Vitiligo is a condition where the immune system attacks and destroys the cells responsible for producing brown pigment (melanocytes). This condition is believed to be caused by an autoimmune disorder.

How did your vitiligo start?

Perform a self-check skin exam to look for unusual signs or symptoms. No home tests can test for vitiligo, but you can check for depigmented areas.

Does vitiligo ever go away?

Although vitiligo currently has no cure, there are treatments available to restore some skin colour. However, it's important to note that the restored colour may fade over time, which means that repeat treatment may be necessary.

Can you stop vitiligo from spreading?

While there is no cure for vitiligo, certain medications and phototherapy can slow its progression but treatments like topical corticosteroids, phototherapy, and depigmentation can help to stop spreading it.

What happens if vitiligo is left untreated?

Living with untreated vitiligo can lead to several negative consequences. Besides increasing the risk of sunburn and developing mood disorders, it could also result in disease progression. In rare cases, untreated vitiligo can affect your eyes and ears, potentially leading to sight and hearing loss. Additionally, it can raise the chances of developing skin cancer.

References

• Advanced Dermatology & Skin Surgery (2023). Living with Vitiligo. Available at https://www.advancederm.net/living-with-vitiligo (Accessed 17/03/2024).
  
• Health Direct (2023). Vitiligo. Available at https://www.healthdirect.gov.au/vitiligo (Accessed 17/03/2024).
• Healthline (2023). What is Vitiligo and What Does It Look Like? Available at https://www.healthline.com/health/skin-disorders/vitiligo-pictures#takeaway (Accessed 17/03/2024).
• NHS (2023). Vitiligo. Available at https://www.nhs.uk/conditions/vitiligo/ (Accessed 17/03/2024).
• Medical News Today (2023). Understanding the symptoms of vitiligo. Available at https://www.medicalnewstoday.com/articles/245081#faq (Accessed 17/03/2024).
• Health (2023). How Is Vitiligo Diagnosed? Available at https://www.health.com/vitiligo-diagnosis (Accessed 17/03/2024).
• WebMD (2023). Living With Vitiligo Is Life Altering. Available at https://www.webmd.com/skin-problems-and-treatments/features/life-altering-vitiligo (Accessed 17/03/2024).
• Everyday Health (2023) Living and thriving with Vitiligo. Available at https://www.everydayhealth.com/vitiligo/living-thriving-vitiligo/ (Accessed 17/03/2024).
• Psychosocial Effects of Vitiligo: A Systematic Literature Review; Khaled Ezzedine, corresponding author1 Viktoria Eleftheriadou,2 Heather Jones,3 Kristen Bibeau,3 Fiona I. Kuo,3 Daniel Sturm,3 and Amit G. Pandya4,5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8566637/
• The psychosocial impact of vitiligo in Indian patients, Pahwa P, Mehta M, Khaitan BK, Sharma VK, Ramam M. T Indian J Dermatol Venereol Leprol 2013;79:679-685. https://ijdvl.com/the-psychosocial-impact-of-vitiligo-in-indian-patients/