Vitiligo

Vitiligo (vit-uh-LY-go) is a condition that causes white patches of skin due to a loss of pigment in the cells and tissues of the body.

Melanocytes (muh-LAN-uh-sites) are special skin cells that make the pigment * that colors the skin, hair, eyes, and body linings. If these cells die or cannot make pigment, the affected skin gets lighter or completely white, causing vitiligo. The hair in affected areas also may turn white, and people with dark skin may notice a loss of color inside their mouths. No one knows for sure what makes melanocytes die or stop working in vitiligo.

Vitiligo affects people of all races and both sexes equally. It affects one or two out of every 100 people. About half of all people who have vitiligo begin to lose pigment before they are 20 years of age.

Vitiligo is common in people with certain immune system * diseases and in children with parents who have the condition. However, most people with vitiligo have no immune system disease, and most children will not get vitiligo, even if a parent has it. In fact, most people with vitiligo are in good general health and do not have a family history of the condition.

Vitiligo is more obvious in people with dark skin. Light-skinned people may notice the contrast between patches of vitiligo and areas of suntanned skin in the summer. The amount of pigment that is lost varies from person to person. The first white patches often occur on the hands, feet, arms, face, or lips. Other common areas for patches to appear are the armpits, the groin (the area where the inner thighs join the trunk), and around the navel (belly button) and genitals * .

There is no way to know if vitiligo will spread to other parts of the body, but it usually does spread over time. For some people, this spread occurs rapidly, but for other people, it takes place over many years. Both sides of the body are usually affected in a similar way. There may be a few patches or there may be many.

To diagnose vitiligo, a doctor may ask what the person's symptoms are, whether the person has an immune system disorder, and whether vitiligo runs in the person's family. The doctor also may suggest various tests to rule out other medical problems that can cause light skin patches.

Vitiligo does not always need treatment. For some people with light skin, simply avoiding a suntan on areas of normal skin is enough to make the patches of vitiligo almost unnoticeable. Other people use makeup, skin dyes, or self-tanning products to cover up the vitiligo. Self-tanning products are creams that give the skin a tan color but not a true tan. The color tends to wear off after a few days. These strategies do not change the condition, but they can make the vitiligo less noticeable. In children, vitiligo usually is just covered up.

In adults, if covering up the vitiligo is not enough, a medical treatment may be tried, although results often cannot be seen for 6 to 18 months. The choice of treatment depends on the person's wishes, how many white patches the person has, and how widespread the patches are. Not every treatment works for every person. There are several choices:

The white patches of vitiligo have no natural protection from the sun and are very easily sunburned. People with vitiligo should be careful to avoid exposure to midday sun, to cover up with clothing and a hat, and to use a sunscreen with a high SPF (sun protection factor) rating.

See also Immune Deficiencies • Skin Conditions: Overview

* pigment (PIG-ment) is a substance that imparts color to another substance.

* immune system (im-YOON) is the system of the body composed of specialized cells and the substances they produce that helps protect the body against disease-causing germs.

* genital (JEH-nih-tul) refers to the external sexual organs.

* ultraviolet light is a wavelength of light beyond visible light. On the spectrum of light, it falls between the violet end of visible light and x-rays.