Diagnosis and Treatments of Vitiligo | Dermatology


What is vitiligo?

Vitiligo is a disease that causes a loss of colour in the skin in the form of spots. The discoloured areas usually increase with time. The condition can influence the skin on any aspect of the body. It can also affect the hair and the inside of the mouth.

Usually, hair and skin colour is determined by melanin. Vitiligo occurs when the cells that produce melanin die or stop working. Vitiligo affects people of all skin types, but it may be more pronounced in people of darker skin tone. The condition is not life-threatening or contagious. It can be stressful or make you feel bad about yourself.

Vitiligo treatment may return the colour of the affected skin. But it does not prevent continued loss of skin colour or its recurrence.

Vitiligo types

There are five types of Vitiligo. Which type you have depends on where you have it.

  • Generalized is the most common type. This happens when discoloured spots appear all over your body.
  • Segmental is when the vitiligo is confined to one area of your body, such as your face or hands.
  • Focal occurs when the colour remains in one spot and does not spread.
  • Trichrome occurs when there is an area of intense colour, followed by a lighter-coloured area, followed by a normal-coloured complexion.
  • Universal is a rare species. If you have this, at least 80% of your skin will have discolouration.

Vitiligo symptoms

Usually, you will lose pigment quickly in several areas of your skin. After the white spots appear, they may remain the same for some time, but later on, they may get bigger. You may have cycles of loss and persistence of the pigment.

Vitiligo usually affects:

  • Body folds (like armpits)
  • Areas exposed to the sun
  • Aroundmoles
  • Places that have been injured in the past
  • Mucous membranes (tissues that line your nose and mouth)
  • Around body openings

It can also affect the eyelids and hair. It is rare for the pigment to return once the white spots appear.

Vitiligo causes

Although the causes of vitiligo are not fully understood, there are a number of different theories:

  • Autoimmune disorder: An affected person’s immune system may develop antibodies that destroy melanocytes.
  • Genetic factors: Some of the factors that increase the chance of developing vitiligo can be inherited. About 30% of cases of vitiligo are hereditary.
  • Neurogenic factors: A melanocytic substance may be released at nerve endings in the skin.
  • Self-destruction: An abnormality causes melanocytes to self-destruct.

Vitiligo may also be caused by certain events, such as physical or emotional stress. Since none of the explanations appears to fully explain the condition, it is possible that a combination of these factors is responsible for vitiligo.

Vitiligo diagnosis

Your doctor can usually diagnose vitiligo by looking at your skin during a physical examination. You may also undergo other tests, including blood tests and:

  • Skin biopsy, in which a sample of your skin is sent to a laboratory for further examination
  • Wood’s lamp test, in which a doctor looks at your skin under UV light


The good news is that Vitiligo often has few physical side effects on the body. More serious complications may affect the ears and eyes, but they are not common. The primary physical effect is that loss of pigment increases the risk of sunburn. You can protect your skin by applying sunblock with SPF 30 and wearing sunscreen clothing.

Psychological effects

Research shows that Vitiligo can cause major psychological effects. Scientific reviews from a reliable source indicate that more than 50 per cent of people with Vitiligo report negative effects on their relationships. Some people have reported thinking about their condition throughout the day, especially because of its unpredictability.

They also reported:

  • Avoiding physical activities
  • Feeling like their condition is a disfigurement
  • Depression
  • Emotional burden
  • Withdrawing from events
  • Anxiety

If you have vitiligo and feel any of these negative effects, talk to your doctor or someone who cares about you. It is also important to know as much as possible about the disorder. This can help ease the tension you may have about your condition or treatment options.

Vitiligo treatment

The American Academy of Dermatology (AAD) describes vitiligo as “more than a cosmetic problem”. It is a health issue that needs medical attention. A number of treatments can help reduce the appearance of the condition.

Using sunscreen

The AAD recommends using sunscreen, as light patches of skin are particularly sensitive to sunlight and can burn easily. A dermatologist can advise on the appropriate type.

Phototherapy with UVB light

Exposure to ultraviolet B (UVB) light bulbs is a popular treatment option. The home treatment requires a small lamp and allows for daily use, which is more effective. If the treatment is done in a clinic, this will require two to three visits per week and the treatment period will be longer.

If there are white spots on large areas of the body, UV phototherapy can be used. This includes treating the whole body. This is done in the hospital. UVB phototherapy joined with different medicines can positively affect Vitiligo. However, the result is completely unexpected, and there is still no treatment that completely pigments the skin.

Phototherapy with UVA light

UVA therapy is usually done in healthcare settings. First, the patient takes a drug that increases the sensitivity of the skin to UV rays. At that point, in a progression of medicines, the influenced skin is presented to high dosages of UVA light. Progress will be evident after 6 to 12 months of sessions twice a week.

Skin camouflage

In cases of mild vitiligo, the patient can camouflage some white spots with coloured cosmetic creams and makeup. They should choose the ones that best suit the features of their skin. If applied correctly, creams and makeup can last from 12 to 18 hours on the face and up to 96 hours for the rest of the body. Most topical applications are water-resistant.


When the affected area has spread and covers 50% or more of the body, depigmentation can be an option. This reduces the colour of the skin on the unaffected parts to match the whiter areas. Pigmentation is removed by using strong topical lotions or ointments, such as monobenzone, mequinol, or hydroquinone.

The treatment is permanent, but it may make the skin more fragile. Long exposure to the sun should be avoided. Depigmentation removal can take 12-14 months, depending on factors such as the depth of the original skin tone.

Topical corticosteroids

Corticosteroid ointments are creams that contain steroids. Some studies have concluded that applying topical corticosteroids to white spots can stop their spread. Others reported a complete restoration of their original skin tone. Corticosteroids should never be used on the face.

If after a month there is some improvement, the treatment should be stopped temporarily for two weeks before starting again. If there is no improvement after a month or if side effects appear, treatment should be stopped.

Calcipotriene (Dovonex)

Calcipotriene is a form of vitamin D that is used as a topical ointment. It can be used with corticosteroids or light therapy. Side effects include rashes, dry skin, and itching.

Drugs affecting the immune system

Ointments containing tacrolimus or pimecrolimus, which are medicines known as calcineurin inhibitors, can help get rid of small spots of pigmentation. However, the FDA warns of a link between these drugs and skin cancer and lymphoma.


Psoralen can be used in combination with UVA or UVB phototherapy, as it makes the skin more vulnerable to UV rays. When the skin heals, the normal colour sometimes returns. The treatment may need to be repeated two or three times a week for 6 to 12 months.

Psoralen increases the risk of sunburn, skin damage, and therefore skin cancer also in the long term. Not recommended for children under 10 years old.

Skin grafts

In a skin transplant, the surgeon carefully removes healthy patches from the pigmented skin and uses them to cover the affected areas. This procedure is not very common, because it takes time and can lead to scarring in the area the skin came from and the area the skin belongs to. Is positioned.

Pimple grafting involves producing a blister on normal skin using suction. Then the top of the bubble is removed and applied to an area where the pigment has been lost. There is less risk of scarring.


Surgery is used to implant the dye into the skin. It works best around the lips, especially in people with darker skin tones.

Disadvantages can include difficulty matching the colour of the skin and the fact that the tattoo fades but does not darken. Sometimes, skin damage from a tattoo can lead to another spot of Vitiligo.

Risk factors

It is not known exactly what causes Vitiligo. The condition does not appear to be inherited. A great many people with vitiligo don’t have a family background of the confusion. But a family history of vitiligo or other autoimmune diseases may increase your risk, even though it does not cause vitiligo. Another risk factor may be the presence of genes linked to vitiligo, including NLRP1 and PTPN22

Most researchers believe that vitiligo is an autoimmune disorder because your body attacks your cells. But it’s also unclear how your body attacks the melanocytes. What is known is that about 20 per cent of trusted sources for people with vitiligo also have another autoimmune disorder. Depending on the population, these disorders can include the following, from most common to least common:

  • Scleroderma, a disorder of the connective tissue of the body
  • Lupus
  • Pernicious anemia, an inability to absorb vitamin B-12
  • Type 1 diabetes
  • Thyroiditis, caused by an improperly functioning thyroid
  • Psoriasis
  • Alopecia areata, or baldness
  • Addison’s disease
  • Rheumatoid arthritis

Some experts have also reported the appearance of vitiligo after accidents:

  • Severe sunburns or cuts
  • High levels of stress
  • Exposure to toxins and chemicals

How can I prevent it?

Since no one knows for sure what causes Vitiligo, no one can tell you how to prevent it. In general, it is smart for everyone to practice sun-safe habits and take good care of their skin.

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