vitiligo

Quick Overview

• What is vitiligo: Non-contagious, harmless skin disease (“white spot disease”). Mostly affects young people under 20 years. Sometimes accompanied by autoimmune diseases such as atopic dermatitis, Hashimoto’s thyroiditis or type 1 diabetes mellitus.
• symptoms: Isolated or large appearing white (depigmented) skin patches anywhere on the body or only in certain places (face, hands, feet). Sometimes also white coloring of the hair growing on the affected skin. Sometimes itching when new patches emerge.
• Causes: Not completely known. Probably autoimmune disease. Risk factors: genetic predisposition, stress, sunburns, skin irritations.
• Treatment: Medicines (cortisone, calcipotriol etc.), light therapy (phototherapy), PUVA (psoralen plus light therapy), bleaching, transplantation of pigment cells (melanocytes). Shock prevention through stress avoidance and intensive sun protection.
• complications: Significantly increased skin cancer risk in depigmented areas.
• Forecast: Not curable, but easy to treat. Without treatment, vitiligo progresses. Once formed stains usually persist permanently. Only rarely do they return on their own.

Vitiligo: description and causes

Vitiligo (White spot disease) is a safe, non-infectious skin disease. It is based on a skin disorder, Characteristic of the disease are white patches of skin either on the whole body or limited to the face, hands and feet. They usually arise in batches.

In Germany, about one percent of the population suffers from white spot disease. There are no differences between women and men. It is striking that the disease predominantly appears before the age of 20 years. Besides, one is familial accumulation detectable: In 30 percent of patients another family member suffers from vitiligo. In addition, vitiligo sufferers more frequently develop other autoimmune diseases such as autoimmune thyroiditis (Hashimoto’s thyroiditis), atopic dermatitis or diabetes mellitus type 1.

Vitiligo: Different types

Vertiligo mainly affects young people. Depending on when the white spot disease first appears, there are two different types:

• The rarer Type 1 vitiligo begins before puberty. Many sufferers also suffer from atopic dermatitis. In addition, the young patients usually have many birthmarks (Halo nevi) and sometimes gray hair.

• The Type 2 vitiligo begins after puberty. It accounts for about 85 percent of all cases of white spot disease. In contrast to type 1 vitiligo, type 2 is not accompanied by increased birthmarks, atopic dermatitis or gray hair.

White spot disease can also be classified after the spread of white spots:

• In the local vitiligo Occur only occasionally white spots.

• In the generalized vitiligo Several parts of the body are usually affected over a large area. Among the sub-forms of the generalized vitiligo is the Vitiligo vulgaris, the most common form of white spot disease. In this case, large areas of white spots form at various points. Most of the time, the respective body sides are affected in parallel (non-segmental vitiligo). On the other hand, if the white spots are limited to one side, this is called one segmental vitiligo, The Vitiligo acrofacialis is limited to face, hands and feet. In the Vitiligo generalis finally, more than 80 percent of the body skin is pigmentless.

Rarely does the white spot disease spread to mucous membranes and scalp hair.

Vitiligo: causes

How exactly and why the vitiligo arises is not yet finally resolved. Doctors suspect that it is a Autoimmune disease is: The immune system is due to a faulty control against the body’s own structures. In the case of white spot disease, these are the pigment cells (melanocytes) in the skin. The melanocytes produce the pigment melanin and release it to the surrounding skin cells. The more melanin in the skin, the darker it is.

The destruction of the melanocytes in vitiligo patients prevents melanin formation. This results in the typical pigment-free white skin spots.

Vitiligo: risk factors and triggers

The risk of white spot disease seems genetically conditioned to be. This connection suggests familial accumulations. The most important trigger for acute relapses applies stressBoth physical (such as an infection) and mental stress can promote the emergence of more white patches. Also sunburns and local skin irritation, as they occur in the context of psoriasis, can cause a vitiligo.

Vitiligo: treatment

As a vitiligo patient, you can do a lot for yourself. In particular, you should Reduce stressbecause it can trigger new thrusts. Due to the increased skin cancer risk, you should also direct the affected areas of the skin sunlight Protect and use sunscreen with a particularly high sun protection factor.

With strong covering cosmetics Like camo make-up, you can effectively hide the disturbing light spots.

Many sufferers suffer mentally from their illness. It can then help to communicate with other vitiligo patients, for example in one support group, Psychic support is also available psychologists for example as part of a talk therapy.

In addition, you can have your vitiligo medically treated with special medication and phototherapy.

Vitiligo: drug therapy

Since vitiligo is believed to be an autoimmune disease, medications are used to treat the immune system. These so-called immunosuppressants are intended to prevent or at least to weaken the attack of the immune system on the pigment cells. Are used approximately Glucocorticoids (Cortisone) and calcipotriol, Both active ingredients can be applied to the skin as a cream. In certain cases, the doctor may also use the immunosuppressant tacrolimus (as an ointment) prescribe.

Vitiligo: phototherapy and PUVA

Alternatively or in addition, you can undergo phototherapy. This results in good results in the Vitiligo therapy: The white skin spots are targeted with UV-B light irradiated at a certain wavelength. This should stimulate the growth of pigment cells.

Even better is a combination of phototherapy and the active ingredient psoralen (PUVA = psoralen plus UV-A light): The patient first receives psoralen (as a tablet, cream or bath additive), which makes the skin more sensitive to light. Then the skin areas affected by the vitiligo are irradiated with UV-A light.

Other methods of vitiligo treatment

With a very strong, generalized vitiligo that can bleaching the skin is the last treatment option: the unaffected areas of the skin are chemically bleached to match their color tone to that of the white spots. But beware: the result is not always consistent. Moreover, it is permanent and can not be undone.

Also one Transplantation of melanocytes is a possibility of vitiligo treatment. In the process, the doctor detunes the patient with healthy pigment cells, replicates them in the test tube and transplants them into the affected areas of the skin. Discuss with your doctor if this treatment is possible.

From a naturopathic point of view, experts recommend Gingko extract for the treatment of white spot disease. According to studies, it promotes the repigmentation of the skin in some patients.

Vitiligo: symptoms

Typical of the white spot disease is the Whitish (depigmentation) of the skin: In more or less numerous places stains arise, which are only weakly or not at all pigmented (just white). They are a few millimeters to centimeters in size, round or oval. Their edges are irregular, but sharply distinguish themselves from the surrounding skin. The white spots can also merge into each other and so-called herd form.

The white patches of skin can in principle occur on all parts of the body, from face above Finger and wrist joints, elbow, forearms and Kneel right up to the genitals, Also the mucous can be affected, as well eyes and inner ear.

In some patients also lose the hairgrowing on the pigment spots, their color. The emergence of a new spot is seen in some patients itching accompanied.

Vitiligo: examinations and diagnosis

If you think you have white spots, it’s best to seek one Dermatologist on. This first questions you in detail about yours medical history (Anamnese). Possible questions include:

• When did you notice the skin changes for the first time?
• Where are the spots located and how big are they?
• Are other family members sick?
• Do you have any other diseases (diabetes mellitus, atopic dermatitis etc.)?
• Do you regularly take medication?
• Did you contract a severe sunburn before the onset of the disease or did you suffer from other skin diseases or irritations?

Vitiligo: physical examination

After the anamnesis interview, the doctor will examine you: he examines the skin all over. Ideally, he photographs the affected skin areas in order to understand the course of the disease later.

In addition, the doctor considers the white patches of skin using a special UV lamp, the so-called Wood’s light (Wavelength: 364 nm). In this light, the vitiligo spots light up white-yellow.

To ensure the diagnosis, healthy areas of the skin can be mechanically irritated with a wooden stick. If it is indeed the white spot disease, new spots of pigment develop at the irritated area. This effect is under the name “Koebner phenomenon” known.

Vitiligo: further investigations

In case of suspected vitiligo is usually still the blood tested for specific antibodies (such as total IgE, anti-nuclear antibodies = ANA). Thyroid levels are also determined because white spot disease is often associated with thyroiditis (Hashimoto’s thyroiditis). The diabetes also looks closer to the doctor – diabetes is another possible concomitant disease in vitiligo.

If the laboratory values ​​show abnormalities, further investigations will follow for clarification.

differential diagnosis

The various examinations are not just for vitiligo diagnosis. They also help to rule out other conditions that can cause similar skin changes. These so-called differential diagnoses of white spot disease include other pigment disorders and skin diseases such as certain forms of birthmarks (nevus depigmentosus, nevus anemicus), piebaldism, hypomelanosis guttata and pityriasis versicolor alba.

Vitiligo: disease course and prognosis

White spot disease is a chronic disease that progresses untreated. Once formed stains usually persist permanently. Only rarely do they self-educate themselves. Further relapses can be prevented by consistent treatment of the vitiligo, A cure is currently not possible.

Additional information

Self-help:

• German Vitiligo Bund e.V.
• German Vitiligo Club e.V.