Vitiligo has been the least discussed skin issue. Most of us are unaware of the facts related to this skin condition. It is a condition that causes the skin to lose its natural colour. On average 0.2 to 1% of people are affected by this. It can occur in people of any race. So, in this blog, we will discuss this skin problem in detail. 

Causes of Vitiligo 
Vitiligo occurs as a result of the destruction of melanocytes in the skin. These are the cells present in the skin which are responsible for the colour of the skin as they produce the pigment called melanin. Vitiligo is an autoimmune disease where the body fails to recognise its own melanocytes and hence, destroys them resulting in the formation of white patches on the body. There are certain common factors that are considered to increase one’s risk of developing this disease. These are:

1. Genetics
There are genes that are associated with melanocyte destruction. This makes us more susceptible to the chances of developing vitiligo. 

2. Environmental Factors
Potential environmental triggering factors of this disease can include sunburn, mechanical trauma, or chemical exposure. 

3. Family History
Family history does have an important role to play in this skin disease. Studies have shown that about 20% of vitiligo patients have been known to have a family history of the same problem, which means their relatives were suffering from the same condition. 

4. Koebner’s Phenomenon
As per this, if we face injury on any area or any kind of trauma the skin will be a little lighter than normal skin color forming a vitiligo patch.

5. Existing Autoimmune Disease 
Anyone suffering from vitiligo can also have other autoimmune diseases like alopecia areata or Hashimoto's disease. 

Symptoms of Vitiligo
The white patches of vitiligo do not have any noticeable symptoms like itching, dryness or burning sensation. It only appears as small white flat patches. They generally start appearing as irregular patches. Pre-vitiligo patches appear as pale yellow patches before they turn into white vitiligo patches. It is beneficial if one notices them and treats this problem at an early stage and not let it convert to vitiligo. Mostly they start affecting the areas like face, knees, elbows, back of the hand, etc. These small spots if not treated on time will join together to form large patches affecting the majority of the body area. 

Diagnosis of Vitiligo 
1. Clinical examination
2. Woods lamp
3. Skin biopsy

Types of Vitiligo
There are two main types of vitiligo:

1. Non-segmental Vitiligo
About 90% of vitiligo patients have non-segmental vitiligo which means the white patches can be all over the body scattered on both sides. 
    
2. Segmental Vitiligo
The patch of vitiligo will be on a specific segment or mainly on one particular area of the body and will not affect the rest of the body. Only about 10% of people suffering from vitiligo will witness segmental vitiligo. 

Treatment for Vitiligo
There are multiple options for vitiligo treatment available at the clinic of a dermatologist. A vitiligo expert can help to tackle this skin issue. Some of the common treatment options are:

1. Topical Creams
Generally dermatologist recommends steroid-based creams which should be used under expert guidance. Topical corticosteroid can be used for the patches or Calcineurin inhibitors which are non-steroidal creams but help in improving the condition. They can help with smaller patches of depigmentation.

2. Psoralens
These are available in the form of topical as well as oral formulations which can be consumed or applied on vitiligo patch followed by exposure to sunlight. This will help in triggering pigment production in the patches. These can be done with light therapy under the supervision of a dermatologist for 2 to 3 times a week.

3. Phototherapy
Exposure to UVA or UVB lights is a common treatment to trigger pigment production. The commonly used phototherapy techniques include NBUVB (narrowband UVB) and PUVA (psoralen and UVA). These are available in the form of light chambers at hospitals and clinics. Vitiligo patches are exposed to these lights to improve the condition. It can be done 2 to 3 times a week under the supervision of a dermatologist. UV therapy helps in triggering melanin production in patches over a period of time. However, results can vary from patient to patient. 

4. Vitiligo Surgery
This is also known as skin grafting. In this procedure, a skin graft is carefully taken from a healthy patch of pigmented cells like hip or thigh and transplanted on the affected area to cover it. Slowly affected area catches pigment and covers the white patches by adding colour to it. 

5. Tattoo
If someone has few small patches then permanent tattooing can be done by adding the skin colour pigment to the white patch by a dermatologist. This helps the affected area to merge with the surrounding skin cells. 

6. Depigmentation of Normal Skin
When the affected area is widespread, covering 50% of the body or more, depigmentation can be an option. This means it is advisable to match the colour of the rest of the body area with the white vitiligo patch. In order to achieve this depigmentation, use of topical ointments like ‘monobenzyl ether of hydroquinone’ can be used. These are bleaching agents which help in depigmenting the normal skin to match the vitiligo patch. This tends to make the skin more fragile and hence, it is advised to avoid long sun exposure and melanin production can trigger in the normal skin due to prolonged sun exposure. 

7. Skin Camouflage
Very tiny patches can even be camouflaged with the help of makeup products or coloured cosmetics. 

Childhood Vitiligo
In children, segmental vitiligo can be more prominent and even its prognosis is better than adult vitiligo. Studies even show that girls are more prone to this than boys in childhood. Also, chances of autoimmune diseases are less in childhood than adulthood. 

Diet and Vitiligo
We live in a country where misconceptions about the relation between diet and vitiligo are more prominent. 

• One of the common myths is that sour food can trigger vitiligo or lead to its expansion. But there is no correlation between the two scientifically. 

• The second common myth is that consumption of fish and milk together can also trigger vitiligo which again doesn’t hold any scientific base to this. 
    
• But there are certain food ingredients that can help improve the condition which includes antioxidant-rich ingredients, beta carotene, and lycopene.

Vitiligo is a non-contagious skin disease that is not life-threatening but can shake the confidence of the person suffering from it. It is advised to consult a dermatologist as there are treatment options available to improve this condition and regain the confidence. 

Keep Healthy! Keep Glowing!