Dr

About Your Diagnosis
Vitiligo is a disorder that causes loss of skin pigment. It is a relatively common problem, affecting 1% of the population. Half of all cases begin before 20 years of age. The cause is not known. In one fourth of cases, there is a family history of vitiligo. Some cases are related to sunburns, trauma, or physical illness. Vitiligo is not contagious. Vitiligo can cause serious cosmetic changes in the skin. It is not life threatening but is sometimes associated with other illnesses such as thyroid diseases, which if present should be treated. Vitiligo is not curable, but some skin pigment may return on the face and neck.

Living With Your Diagnosis
Vitiligo can occur anywhere on the body, but most commonly occurs on the face, hands, and feet. This disorder slowly worsens over time, but remissions
(temporary improvements) are common. Vitiligo does not cause any other problems, but it can be associated with disorders such as thyroid disease and diabetes. Vitiligo starts as small, white spots on the skin with no pigment that grow to larger spots and the spots sometimes come together to form larger areas without pigmentation. It occurs on both sides of the body. Common areas of involvement are the nostrils, mouth, eyes, nipples, belly button, and anus. Vitiligo can also affect the hair.

Treatment
Treatment is not always necessary for patients who have mild involvement.
Treatment involves a combination of cosmetics, prescription creams, and specialized light therapy. Patients with limited areas of involvement can do well with cosmetic stains and makeup. Fairskinned individuals may benefit from avoidance of tanning. This can be achieved by using sunscreens with an SPF of 15 or greater and avoiding direct sunlight. For limited areas of involvement, a steroid cream applied once per day can be helpful. Best results may take 3 or 4 months. Steroid creams should not be applied to eyelids, armpits, or groin areas. Specialized light therapy, or PUVA therapy, consists of application of a solution of medication called psoralens, followed by ultraviolet light therapy. Psoralens can also be taken in pill form. This treatment is most helpful for vitiligo of the face, neck, trunk, upper arms, and upper legs. This is a slow process; results begin after 25–50 treatments depending on the areas of involvement. The major side effect is severe sunburning and blistering.

The DOs
• Mild cases may not require treatment, but if your disorder worsens, seek the advice of your doctor.
• If you will be in the sun, use a sunscreen with an SPF of 15 or higher, and wear a hat, a long-sleeve shirt, and pants.

The DON’Ts
• Avoid direct sunlight especially between 11 AM and 3 PM during summer months.
• Avoid sunburns or tanning. The skin that is not affected by vitiligo will darken with sun tanning, and the affected areas will become more obvious.

When to Call Your Doctor
• If severe reddening or blistering occurs during treatment.
• If any new symptoms occur.

VITILIGO