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Vitiligo

Vitiligo is a chronic disease that causes skin depigmentation. The disease promotes the development of unsightly white patches, and can severely alter ones appearance. The body's white blood cells attack the skin's pigment cells due to a genetic mutation. There is no cure for vitiligo, but there are treatments available to lessen the appearance. The disease doesn't affect one's overall health, but can be very a difficult thing to deal with psychologically and emotionally looking different from everyone else.

What is Vitiligo?

Vitiligo, or Leucoderma, is a chronic disease that causes depigmentation of the skin, and affects 1-2 percent of the U.S. population.
Vitiligo causes the skin to develop patchy,discoloured areas, and is usually more noticeable in individuals with darker skin color. This occurs because, for what reason, the body’s white blood cells, as they are foreign invader. Vitiligo is therefore classified as n autoimmune disorder. There is no cure for the condition, but there are numerous treatments options, which can improve symptoms.
Aside from certain factors, vitiligo poses no threat to general physical health; however, it can certainly be emotionally painful dealing with the social issues surrounding the disease.

Signs and Symptoms

Vitiligo is usually first noticed as white patches appearing on the skin. They are more noticeable in more sun-exposed areas such as hands, arms and feet.
These white spots are usually round and occur simultaneously on both sides of the body, producing a mirror- image effect.
Symptoms can appear at any age, but the onset is most common between the ages of 10 and 30.

Melanin and Melanocyte

Melanin is a dark brown pigment that occurs in most mammals and is responsible for pigmentation of skin and hair. A Melanocyte is a specialized skin cell, which stores melanin. Darker skin individuals have cells that can store more melanin than those of lighter skin. In the animation to the left you can see the Melanocyte is a dark brown color because of the melanin it holds. The cell uses its tender like extensions to distribute the pigments evenly throughout the skin. When a white blood cell attacks on melanocyte in an individual with vitiligo the white blood cell treats pigments out as a foreign invader and damages it. Thus the melanocyte can no longer store or produce melanin causing the surrounding skin cells to lose pigmentation.

Development

Here, are more about vitiligo development patterns

Generalized

This is the most common type of depigmentation type of pattern .In generalized vitiligo; the patchy white areas often flat with definite borders, and may spread to any part of the body in a bilateral or symmetrical pattern.

Segmental

In segmental vitiligo, the white patches are usually exclusive to only one side of the body, and do not usually spread or worsen after the first six months of appearance.

Focal

In this type, the depigmentation is limited to one or only few areas of the body. Pigmentation may even reappear, and the problem may fix itself for some time.

Spreading

In many cases, white patches slowly progress and spread over time. However, there are certainly some individuals whose condition never worsens, and others have even reported spontaneously repigmentation without any treatment.

There is no definite way to determine if the patches will spread.

Is it contagious?

Vitiligo is certainly NOT contagious. It cannot be spread from one individual to another, because you must be genetically susceptible to contract it.

Causes

Causes of vitiligo are not fully known. However, most medics will agree the disease is hereditary, and only occurs in those individuals who are genetically susceptible, meaning if exposed to certain elements with the right genes, you will most likely develop symptoms.
As mentioned previously, vitiligo appears more prominently in individuals with darker skin color. Light skinned individuals can have the disease, but have little or no signs because the contrast of skin and depigmentation is not as prominent.

What are the Causes?

Autoimmunity

Vitiligo is a type of autoimmune disorder. The body’s immune system sees the skin pigment cells as foreign bodies and attacks them. The basis for this autoimmune disorder is believed by most to be genetic.
Stress, traumatic events, injury, or severe sunburn, may trigger or worsen vitiligo only in those who are genetically susceptible.

 Oxidative Stress

Oxidative stress is a theory that the skin over accumulates hydrogen peroxide, which triggers the onset of symptoms. Everybody’s skin produces hydrogen peroxide as a byproduct of many natural biological processes.

An enzyme called”catalase” normally breaks down the hydrogen peroxide in the skin into its basic water and oxygen molecules. However, some individuals with vitiligo may have a problem manufacturing, utilizing or delivering catalase to the skin.

Genetic predisposition

Most experts believe genetics plays a major role in vitiligo susceptibility, based on a defect in one’s genetic structure. Though about 20 percent of patients report having a family member with the condition, the remaining 80 percent report no relatives that have it.
Just like all genes, people may carry the defect that causes vitiligo, and even pass it on to their children, without ever developing vitiligo themselves. Therefore, other environmental and personality factors may play a role in the development of vitiligo.

 Toxic Exposure

Some chemicals, especially photography chemicals such as Phenols, can prompt vitiligo in genetically susceptible individuals. Phenols can also be found in many types of hair coloring, household stains, and similar products. There are various other chemicals and substances, which may also trigger the onset of vitiligo.

Things to Avoid

People with vitiligo should also avoid the following things, as they may trigger or worsen symptoms
Prolonged, unprotected exposure to sunlight.
Skin products containing peroxide, often found in topical, over the counter acne treatment

Other conditions

Remember, you can still be a perfectly healthy individual if you have vitiligo. However, you should take extra precautions to avoid the preventable development of other conditions.

Other health issues

In and of itself, vitiligo does not appear to “lead” to any other condition. However, some other autoimmune related conditions may arise from the same genetic disorder that caused vitiligo. Thyroid disorders (especially hypothyroidism) are fairly common in those with vitiligo, and many doctors feel treating thyroid disorders is important when treating vitiligo.

Sunburn/skin cancer

Because of their lack of pigment, the white patches resulting from vitiligo will sunburn much more easily than the surrounding pigmented skin. Therefore, doctors always advise vitiligo patients to wear sunscreen at all times. Prolonged unprotected exposure to sunlight increases the risk of skin cancer, regardless of whether the individual has vitiligo or not.

Thyroid Function and Vitiligo

Thyroid is a small butterfly shaped gland located just below the Adam's Apple. This tiny gland is responsible for controlling the body’s metabolism or how fast to work and use energy. It does this by producing T3 and T4 chemicals most commonly known as Thyroid hormones. These chemicals travel through the blood streams to every part of the body. Hypothyroidism, the most common type of thyroid disorder causes the thyroid to slow down the metabolic process throwing off the delicate balance of many body functions. For this reason a properly functioning thyroid could be important in the treating of Vitiligo.

Doctors and Treatments

Before assuming you have vitiligo, it is imperative that you see a doctor about your condition. Proper diagnosis will ensure you are treated properly, and for the right condition.

Diagnosing Vitiligo

Diagnosing vitiligo can be tricky, as there are other conditions that can also cause skin depigmentation. Remember that only your doctor can decide if you have vitiligo or not. Your doctor will probably refer you to a dermatologist, or another skin specialist for a more accurate diagnosis.
Exploring various methods your doctor may use to diagnose vitiligo.

Biopsy

A biopsy is a type of medical examination, which involves removing a sample of tissue or cells from the affected area of skin. A biopsy is usually taken from a patient to rule out any other medical conditions unrelated to vitiligo.

Blood Sample

Your Doctor may also draw a blood sample to check your blood cell count, or to check for a malfunctioning thyroid. Remember that the thyroid controls a great deal of what goes on in your body, so determining this early on will ensure you are properly treated.

Wood Light

A Wood light is an ultraviolet lamp with a nickel oxide filter that only allows light with a maximal wavelength of about 3660 angstroms to be emitted, and is used to detect hair that are infected with fungi. Your doctor may inspect your skin with special tool to check for a possible skin infection.

Finding A Doctor

The best way to find a doctor for diagnosis and treatment is through a friend, family member, or trusted physician. Of course, this may be difficult if you don’t know anyone other than yourself who has vitiligo.

How Treatable Is Vitiligo?

Treating vitiligo is a very difficult and often lengthy process, but it does respond to treatment. In some cases, patients may not even being seeing until 8 months after starting therapy. Everyone’s body responds differently, and results vary extensively. The key to successful treatment is to use all medications as prescribed, and not give up, even if it seems not to be working.

Treatment Options

PUVA

PUVA is one of the oldest types of treatments. Oral PUVA is taken by patients with more developed vitiligo that covers more than 20 percent of the body. The patient orally ingests an organic compound known as psoralen approximately 2 hours before being exposed to artificial UVA light. This treatment is done 2-3 times per week, but never 2 days in a row. The doctor will adjust the dosage of light each time until a slight pinkness in the skin can be seen. After treatment patients are advised to avoid direct sunlight for up to 24 hours. Side effects usually include sunburn and upset stomach from psoralen pills.

PUVA-SOL

PUVA- SOL is generally for patients who cannot go to a PUVA facility, and uses natural sunlight instead of artificial. The doctor gives the patient careful instructions and closely monitors the patient through regular checkups.

Topical Treatments

Topical treatments are perhaps the most convenient type of medication available to vitiligo patients.

Psoralen therapy

Topical psoralen therapy is used for patients with less developed depigmentation (meaning less than 20 percent of the body has been affected). It is also used for children 2 years and older with only localized patches. The nurse or doctor rubs on a thin coat of topical psoralen 30 minutes prior to UVA light exposure. The worst side effects can be severe sunburn and/or blistering, and the surrounding pigmented areas becoming hyperpigmented.

Laser treatment

There are several laser treatments available to patients, which have a much lower risk of sunburn side effects, and allow the patients the option of not having to take additional medication. These include

Narrow Band UVB treatment
Excimer Laser Treatment

These treatments have gained increasing popularity among vitiligo patients because it has the least amount of side effect. On the other hand, laser treatments can also be extremely costly and time consuming.

Surgical Procedure

Several Surgical procedures are available to patients, but are the priciest of all treatments, and most are still in experimental stages.
The ultimate surgical treatment for vitiligo is complete depigmentation. This is generally recommended for patients whose spots cove 50 percent or more of their body. This process is irreversible, and patients are often unusually sensitive to sunlight for the rest of their lives.

 Non-Prescription Options

While prescription drugs are the most effective treatment, there are non-prescription options available that you can even use in addition to medication, unless otherwise directed by your doctor. These include

. Cosmetics such as concealers that match pigmented skin.
. Sunless tanning products to cover up spots.

Remember you should try to stay away from hair dyes and bleaches, because they contain phenols, which can worsen symptoms. When in doubt, always check with your physician for vitiligo-safe products.

Why bother Treating?

It’s understandable for those with vitiligo to see treatment as pointless and useless. Why should you spend time and energy for results that aren’t guaranteed?

The fact is you should pursue treatment for a couple reasons. First, the process of treating and having the upper hand on the disease acts as a coping mechanism for most. Second, the larger the area vitiligo has spread, the more difficult it is to regain pigmentation.

Research

Nowadays, there is much more vigorous research on vitiligo than ever before. Effective research involves a thorough understanding of the structure of the skin, as well as the immune system and its disorders.

Types of Current Research

Many research methods from the effects of UV radiation on melanocytes to genetic manipulation are happening in countless universities and research centers across the globe.

Will There Ever be a Cure?

Despite extensive research, vitiligo still remains difficult to find a cure because every individual responds differently to treatment. Each person has an immune system that behaves much differently from the next individual, and everyone’s genome is very diverse and complex. Although a single cure is unlikely, a better understanding of the human body will lead to improved treatments.

People and Emotional Issues

The change in appearance can certainly have a major psychological and social impact, especially if it develops in visible areas like hands, arms, legs, and feet. It can be especially challenging for adolescents, since appearance is immensely important.

Who is effected

There are approximately 50 to 100 million people in this world today who have vitiligo. Some populations have a higher incidence of it for genetic and societal reasons, but it basically affects all races, ethnicities, and sexes equally.

How many People?

About 1 to 2 percent of the global population has vitiligo, which is about 100 million people, so it’s not quite as uncommon one may think.

How Long?

Vitiligo has been around as long as man has existed. There are references of vitiligo found in ancient Greek and Chinese writing, so this disease is nothing new.

Who’s Who?

There are also many famous people who have vitiligo, the most famous of which is Michael Jackson, who notoriously had all the pigmentation removed from the skin-the only cure that exists today.

Sufferers and Concerns

There are many people who suffer from vitiligo. The best thing you can do for yourself is to find a good doctor who is good listener and will take the condition seriously. Open communication between patient and doctor is very important, especially when the worst side effects are your emotions.

 



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