Vitiligo is considered a skin condition that raises concern and concern, as this disease causes the loss of the natural skin color and the appearance of white spots that may spread in different parts of the body, usually on the face, neck, hands, and in the folds of the skin. Although vitiligo is not a contagious disease, it may lead to psychological and social effects on patients as a result of a change in the appearance of the skin.
The color of the skin, hair, and eyes comes from a pigment called melanin that is produced by melanocytes, which are the cells that make pigment in the skin, located in the epidermis (the outer layer of the skin). People with darker skin tones have more melanin in their skin than people with lighter skin. Vitiligo occurs when the body’s immune system attacks and destroys melanocytes.
Dermatologist and venereologist Dr. Raad Al-Jundi says: “Vitiligo is a skin disease that occurs due to the loss of natural skin color and the appearance of white spots in any part of the body.”
Al-Jundi stressed that vitiligo may affect people regardless of their skin type, but it is more noticeable in people with dark skin. He stated that this disease is not life-threatening and does not spread by infection, but it may cause some stress for those afflicted with it.
The appearance and development of vitiligo
Dr. Al-Jundi pointed out that vitiligo usually begins in the form of small, light spots distributed over the skin, and they may remain the same size for years or their area may increase quickly. He added that the disease can be diagnosed by taking a medical history of the patient and his family, then a clinical examination is carried out using the Wood’s Light device, which emits ultraviolet rays to examine white spots.
The diagnosis is also made by taking a skin biopsy and examining tissues, in addition to performing a blood test to look for other immune diseases that may be linked to vitiligo, such as thyroid problems or diabetes.
Possible causes of vitiligo
Anyone can develop vitiligo, and it can develop at any age. White spots begin to appear in many people with vitiligo before the age of 20, and can begin in early childhood.
Vitiligo is more common in people who have a family history of this disorder or who suffer from certain autoimmune diseases.
Dr. Al-Jundi says: “A disorder in the immune system may lead to the death of melanocytes that produce melanin pigment. There are several factors associated with this disease, such as the presence of autoimmune diseases (such as thyroid disease and alopecia), in addition to family history, where some genetic factors are Responsible for increasing the chances of developing vitiligo. He reported that about 20-30% of vitiligo cases could be inherited.
Types of vitiligo
- Non-segmental vitiligo: It includes the appearance of white spots in any area of the body and is usually associated with autoimmune disorders.
- Segmental vitiligo: White spots appear limited to one side of the body and usually begin at an early age.
- Universal vitiligo: It consists of the appearance of white spots in most parts of the body.
Vitiligo can be lived with as it does not threaten the patient’s life and is a non-contagious disease. Early diagnosis of the disease is very important to determine the appropriate treatment and mitigate the effects of the disease on those affected.
Dermatology and Venereology Consultant Dr. Hoda Khaled Al-Qudah said: “Vitiligo is classified as an autoimmune disease, where immune cells attack the pigment cells responsible for skin color, and this leads to their complete destruction in the affected areas.”
The immune system does not function properly in patients with autoimmune diseases. Instead of attacking foreign cells, such as viruses, the immune system attacks the body’s healthy cells and tissues.
Al-Qudah added that the available treatments mostly depend on medications that suppress the immune system, such as corticosteroids, tacrolimus ointment or pimecrolimus cream, which can be used for a longer period of time than corticosteroids, and work better to restore skin color on the head or neck, and the drug calcipotriene, and there are also new medications belonging to the family. JAK inhibitors: This is a new type of medicine.
Ruxolitinib, known commercially as Opzelura, is the only drug approved by the US Food and Drug Administration (FDA) to restore lost skin color in people with vitiligo.
Al-Qudah explained that there are many other effective treatments, such as laser or light therapy for eczema, and ultraviolet light therapy, which have powerful properties to stimulate melanocytes. She also referred to other treatments such as cell transplantation or skin transplantation, especially for patients who suffer from local or segmental vitiligo that has not responded to topical treatment.
Response to treatment
Al-Qudah added that treatment varies according to the type and location of vitiligo. For example, the areas most responsive to treatment are the face, especially the cheeks and forehead, while the least responsive areas are the fingers and toes. The durability of the response also varies: in the case of segmental vitiligo, the response is often permanent even after treatment stops, while in generalized or peripheral vitiligo, the probability of the disease recurring is high, especially if the disease is in the active stage.
Social and psychological challenges
Al-Qudah pointed out that the biggest challenge facing vitiligo patients is the social aspect, as many patients resort to treatment to try to hide vitiligo, especially in visible areas such as the face, neck, and hands. She added that vitiligo may cause psychological problems such as anxiety, depression, and social isolation, and this necessitates psychological treatment in parallel with physical treatment.
Another challenge facing vitiligo patients is exposure to sunlight. Al-Qudah said that areas of vitiligo lack melanin, a pigment that protects the skin from ultraviolet rays, making patients more susceptible to sunburn and skin cancer.
She recommended that patients avoid exposure to sunlight as much as possible, use sun protection creams prescribed by the doctor, in addition to taking Polypodium leucotomos pills, which provide additional protection. She also stressed the need to take vitamin D to compensate for the deficiency resulting from lack of exposure to sunlight.
Al-Qudah indicated that vitiligo patients should treat their skin with caution, stressing the importance of following these tips:
- Avoid rubbing or scratching the skin excessively.
- Use gentle soap on the skin, free of perfumes or irritants.
- Daily moisturizing of the skin using moisturizers recommended by the doctor.
- Stay away from direct exposure to sunlight.
- Eat a balanced diet that contains all the nutrients necessary to build and renew cells.
The judges also confirmed that there is no conclusive scientific evidence proving that a specific type of food causes vitiligo. On the contrary, eating dairy, meat, fruits and vegetables is necessary to enhance skin health, and foods rich in antioxidants, such as green tea and fruits, help the body Getting rid of toxins that may harm cells.
Al-Qudah concluded that vitiligo is a chronic disease that requires continuous medical care and follow-up, noting that effective treatment and patients’ adherence to medical and psychological guidelines can help significantly improve their condition and reduce its social and psychological effects.