Vitiligo develops when pigment-producing cells in the skin (melanocytes) are lost or stop functioning, leading to pale or white patches. The most common form is non-segmental vitiligo, which is thought to be autoimmune in origin, meaning the body's immune system mistakenly attacks melanocytes. Segmental vitiligo is less common and is thought to involve different mechanisms, including nerve-related factors. Triggers can include skin damage (Koebner phenomenon), stress, hormonal changes, or other autoimmune conditions, but vitiligo is not contagious. Key points to understand:
- Causes: Loss or dysfunction of melanocytes, most often due to autoimmune processes; segmental vitiligo may involve neurochemical factors. Genetic predisposition can raise risk, but most cases arise without a clear family history.
- Presentation: Well-demarcated white patches on the skin, which can appear anywhere but are common on hands, face, and areas of friction. Hair in affected areas may also lose color (poliosis).
- Progression: Non-segmental vitiligo typically progresses slowly, with new patches developing over years; segmental vitiligo often shows rapid spread initially, then stabilization.
- Diagnosis: Often based on appearance and history; a dermatologist may use tests to rule out other conditions and may examine skin under Wood’s lamp.
- Treatment goals: Halt or slow progression, repigment affected areas, and improve appearance. Treatments include topical steroids or calcineurin inhibitors, light therapy (narrowband UVB), and, in some cases, systemic therapies. Cosmetic options (camouflage, depigmenting agents for extensive vitiligo) may also be used. Response varies by individual and vitiligo type.
If you’re seeking guidance for yourself or someone else, it’s best to consult a dermatologist who can tailor management to the specific type (non-segmental vs segmental), extent, location, and any other health considerations.
