A hand affected by vitiligo placed against a white wall.
Vitiligo is a skin condition that causes skin to lose color.

Vitiligo Treatment

A condition called vitiligo affects about 1% of the global population. This skin condition may not impact your overall health, but some folks who have it may wonder if they have options for treating if. If so, there are a few options for vitiligo treatment you can try.

What is Vitiligo?

Vitiligo is a condition that causes your skin to lose its color. Affected skin will have patchy areas where the skin pigment lightens. If vitiligo affects an area on the body with hair, such as the head or arms, the hair in these areas may also turn white. Vitiligo is considered an autoimmune disorder since it appears that the immune system targets and destroys melanocytes—the pigment cells in the skin.

The onset of this condition is usually mid-20s, but can start at any age, and typically progresses over time. In many cases, it usually starts on the hands, forearms, feet, and face. While this is considered an autoimmune condition, vitiligo does not affect a person’s general health or physical abilities. The light patches are not painful but may be more sensitive if exposed to sunlight.

Some Types of Vitiligo

There are several types of vitiligo, a few of the more common ones are:

  • Generalized (non-segmental): This type of vitiligo causes depigmented patches of skin all over the body. Loss of pigment typically occurs on the face, neck, scalp, and around body openings (areas such as the mouth). Generalized vitiligo is the most common type.
  • Segmental: Smaller patches of skin that lose pigment occur in a limited area on one side of the body or a singular area, such as the hands. This type is less common and only affects about 10% of those with vitiligo.
  • Mucosal: This type of vitiligo affects the mucous membrane in areas such as the mouth or genitals.

What Causes It?

There is no definitive cause of vitiligo and what specifically triggers the immune system to attack melanocytes. The condition likely originates from a combination of environment and genetics, but specific factors have yet to be identified.

Research shows that variations in over 30 genes are associated with an increased risk of developing vitiligo. Two genes being looked at by researchers are NLRP1 and PTPN22, both of which carry instructions for making proteins involved in the immune system.

Some possible causes for vitiligo:

  • An irregular immune system reaction by chemicals or ultraviolet radiation, which causes the immune system to react abnormally to melanocytes.
  • Other autoimmune disorders may affect the immune system and cause the body to develop antibodies that destroy melanocytes.
  • Genetics may play a part, as about 30% of vitiligo cases run in families.
  • A defect in the melanocytes themselves may cause them to self-destruct.
  • Emotional or physical stress may trigger vitiligo.
  • A substance that is toxic to melanocytes may be released at nerve endings in the skin.

What Are the Symptoms?

The optimistic stance on vitiligo is that there are not any symptoms that affect a person’s general health. The symptoms of vitiligo are mostly visual, and include:

  • Patches of skin that lighten or lose color. Your eyes and/or the mucous membranes in your mouth or nose may also be affected.
  • Patches of hair may change color. Areas of vitiligo where there is hair growth may make the hair turn prematurely grey or white.
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Treatment Options

There is no universal treatment for vitiligo and treatment ranges from no treatment, to cosmetic treatment, to surgery. Since vitiligo does not affect general health, treatment is only used to alter how the skin appears, which is why some people skip treatment altogether.

1. Non-medical Treatment

These options are purely cosmetic and offer a safe way to make vitiligo less visible. Cosmetic covering includes makeup, self-tanners, and skin dyes. A pro for this option is that it does not come with the side effects of medication and a con is that it is not permanent and needs to be reapplied.

2. Topical Medication

There are a few topical creams that can be applied to add color to the skin, most often a corticosteroid. After about six months, some patients regain some skin color from using these medicinal creams. With any medication, be sure to consult with your doctor about potential side effects and how to use the cream properly.

3. Light Treatment

Doctors use light to help restore the skin’s lost color. Depending on how widespread the vitiligo is, light treatment may be done having the patient sit in a light box, or the patient receives excimer laser treatments. The result of these treatments may be temporary, and the patient needs to undergo several treatments to see results.

4. PUVA Light Therapy

This treatment uses a combination of UVA light and a medicine called psoralen. PUVA therapy requires the patient to have treatment a couple times a week for approximately a year in order to restore pigment to the body and is effective in treating widespread vitiligo.

5. Surgery

There are a few different surgical options available if other treatments are not effective. The general surgical procedure for treating vitiligo involves removing areas of your pigmented skin and placing them in areas of vitiligo. Surgery is not a guaranteed solution, and there may be other side effects that need to be considered before moving forward with this option.

6. Depigmentation

Instead of restoring pigment as other treatments do, depigmentation does the opposite and eliminates any remaining pigment of the skin to leave the patient with completely lightened skin. While few people choose this treatment, it is an option for someone looking to effectively even out their skin tone. People who opt for depigmentation have to use a cream multiple times each day for up to four years in order to even out their skin tone.

An Overview

If you have vitiligo, you get to choose which treatment, if any, are the right fit. Treatments work differently for each individual, so consult with your doctor and determine what works best for you.