VITILIGO

WHAT IS VITILIGO?
   Vitiligo is a disease in which white patches of skin appear on different parts of the body. This happens because the cells that make pigment (color) in the skin are destroyed. These cells are called melanocytes. The extent and rate of color loss from vitiligo is unpredictable. Vitiligo can be focal and localized to one area, or it may affect several different areas on the body. It can also affect the mucous membranes such as the tissue inside the mouth and nose and the eye, it may also affect hair. Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin because of the contrast of white patches against dark skin. Vitiligo is not painful, life threatening or contagious, as such, it does not have any significant health consequences. However, it can have emotional and  psychological consequences, because it can make you feel bad about yourself. Vitiligo tends to run in families. Treatment for vitiligo does not cure the disease, but it may improve the appearance of the affected skin thereby reducing the severity of the condition. Vitiligo can start at any age, but most often appears before age 20.

CAUSES OF VITILIGO
   The cause of vitiligo is not known, but most experts believe that it is an autoimmune disease. These disease happen when your melanin-forming cells (melanocytes) die or stop producing melanin. Doctors don't know why the cells fail or die but some researchers think that the melanocytes destroy themselves. Or thier immune system mistakenly attacks and destroy the melanocytes in the skin. Other researchers think that a single event such as sunburn or emotional distress can cause vitiligo. The involved patches of skin become lighter or white.

SYMPTOMS OF VITILIGO
1. Skin discoloration- The main sign of vitiligo is white patches on the skin. They are most common in areas of the skin that is exposed to the sun, such as hands, feet, arms, face, and lips. The patches may also be on the elbows, knees, nostrils, navel, genitals and rectum.
2. Loss of or change in color of the retina.
3. Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard.
4. Loss of color inside the mouth and nose (mucous membranes).

TYPES OF VITILIGO
  The parts of the body covered by the discolored patches, depends on the type of vitiligo you have. They are:
1. Generalized Vitiligo - This is when the discolored patches covers many parts of the body.
2. Segmental Vitiligo - The patches are only on one side or part of the body. This type tends to occur at a younger age, progress for a year or two, then stop.
3. Focal or Localized Vitiligo - The patches are on one or only a few areas of the body.

WILL THE WHITE PATCHES SPREAD?
   It's difficult to predict how the disease will progress. For some people,
the white patches do not spread and stop forming without treatment. But in some cases the white patches spreads and eventually involves most of the skin. For some people, vitiligo spreads slowly, over many years, but for other people, it spreads quickly. So there is no way to tell if it will spread.

RISK FACTORS
1. Vitiligo is connected with three other autoimmune diseases (Addison disease, Hyperthyroidism and Pernicious anemia). So people with this diseases are more likely to get vitiligo than people who don't have any autoimmune diseases.
2. Family history (heredity)
3. Trigger event such as sunburn, or exposure to industrial chemicals.
4. Stress or physical illness.
5. Rash, or other skin problem.
6. Sensitivity to the sun.

TREATMENT
   Vitiligo is difficult to treat. Treatment can have unwanted side effects, take a long time, and sometimes don’t work, but treatment may help make the skin look more even. Some treatments are not right for everyone, as the choice of treatment depends on, The number of white patches and how widespread the patches are. Treatment options include:
1. Surgical treatment - Skin may be grafted from normally pigmented areas and placed onto areas where there is pigment loss. The doctor takes skin from one area of a patient’s body and attaches it to another area and tattooing small areas of skin. This is sometimes used for people with small patches of vitiligo.
2. Phototherapy treatment - The skin is carefully exposed to ultraviolet light. A dermatologist applies medicines such as corticosteroid creams or ointments and immunosuppressant creams. Or topical drugs such as methoxsalen (Oxsoralen) that makes your skin sensitive to light.
3. Medical treatments - This treatment includes, Medicines (such as creams) that you put on the skin, drugs and removing the color from other areas so they match the white patches.
Most treatments are aimed at restoring color to the white patches of skin. Other treatments include, use of sunscreens and cosmetics, such as makeup or dye, to mask the white patches.

COMPLICATIONS
1. Hearing loss.
2. Social or psychological distress.
3. Sunburn and skin cancer.
4. Eye problems, such as inflammation of the iris.
5. Side effects due to treatment, such as dry skin and itching.

HOW TO COPE WITH VITILIGO?
1. Counseling and support
2. Learn about the disorder and treatment choices. This can help you make decisions about your treatment.
3. Try and improve appearance by the use of cosmetics to cover white patches. This can make you feel better about yourself.