Beyond Skin Deep – Coping With Vitiligo

June is Vitiligo Awareness Month.  Vitiligo is an autoimmune skin condition that can take an emotional toll on those with the disease.

Clinically, vitiligo presents as patches of skin that lose their pigment and turn bright white.  It can negatively affect self esteem and can be hard to disguise, especially if it spreads over large areas of the body.

If you’ve been diagnosed with vitiligo, you’ll have areas of skin that turn white with defined margins.  Vitiligo typically starts on the feet, hands, or face with small, barely visible patches. Pigment loss is progressive and can affect other parts of the body. This includes your hair, eyelids, and inside your mouth, nose, and ears.

What causes vitiligo?

Vitiligo is an autoimmune disorder.  The body’s own immune cells attack the pigment producing cells, melanocytes, causing them to die and no longer produce pigment.  It is unclear as to why some people develop vitiligo, but there is believed to be a genetic component.  Symptoms usually present before a person turns 21 years old.

Vitiligo can be associated with:

• Other autoimmune disorders such as thyroid disease (Hashimoto’s thyroiditis), Celiac disease, or alopecia areata
• Family history of vitiligo

While vitiligo sometimes accompanies an underlying autoimmune disorder, it does not affect your overall health. That said, it does affect your appearance and can induce depression or negatively impact your self-esteem. You may experience a variety of emotions, including:

• Embarrassment
• Feeling self-conscious or insecure
• Emotional and psychological issues
• Anxiety, stress, and depression
• Shame, sadness, or anger
• Wanting to isolate and mood swings
• Worry about how others will react and treat you

In particular, young people who often struggle to fit in and already feel self-conscious can experience social isolation and emotional problems due to vitiligo.  This can lead to a  wide range of emotions and impact one’s ability to go about normal daily activities and feel comfortable in social situations.

Coping with vitiligo

Vitiligo can be hard to live with, but these tips can help you cope, take charge of your health, and maintain a positive attitude:

• Find a dermatologist that you trust, who shows compassion, is willing to listen and take extra time with you, and has experience treating vitiligo
• Learn as much as you can about the skin disease and associated autoimmune disorders
• Take charge of your health and participate in making decisions about your care
• Seek support from your doctor, other vitiligo patients, family, or a therapist
• Manage stress and monitor your diet and lifestyle to address underlying autoimmune conditions
• Wear sunscreen and protect your skin from the sun and artificial sources of UV light
• Ask questions and follow treatment recommendations
• Work with an aesthetician to find concealing products that make you feel more comfortable in your skin
• Avoid tattoos or anything that can damage to your skin, which can cause a new patch of vitiligo to appear
• Consider trying natural supplements including Ginkgo biloba, alpha-lipoic acid, folic acid, vitamin C and vitamin B-12 in addition to the treatments recommended by your dermatologist
• Seek support from a mental health professional who works with people with depression and anxiety, particularly related to chronic illness
• Talk to others who have vitiligo or other chronic skin conditions or autoimmune diseases.
• Ask your doctor about local support groups or seek out online groups

Treatment options for vitiligo

The goal of treatment in vitiligo is to decrease immune system activation within the skin.  This can lead to regeneration of pigment cells.  The stem cells that turn into melanocytes live in hair follicles so repigmentation typically presents around hair follicles.  That said, areas without many hair follicles – lips, hands, knees – are harder to treat.

Treatment options for vitiligo include:

• Prescription corticosteroid creams
• Non-steroidal anti-inflammatory creams
• Oral medications to induce repigmentation
• nbUVB light therapy
• Xtrac Laser Therapy
• Self-tanning or cosmetic products
• Homeopathic remedies (vitamins and minerals, herbs, etc.)
• Depigmentation (removing remaining pigment from the skin)
• Skin grafting, blister grafting, and micropigmentation (only effective for certain types of vitiligo)

Although research is ongoing, vitiligo has no cure.  If you have vitiligo, you will have it for the rest of your life. Changes in pigmentation may be reversed or reduced through medical treatments, but some of these treatments can have serious side effects. The goal is learning to manage your symptoms and outbreaks – and your mindset – so you can live a fulfilling and active life!

APDerm offers a variety of medical, cosmetic, and surgical dermatology services. Our caring and experienced board-certified dermatologists will work with you to develop the best treatment plan. Contact APDerm to learn more about vitiligo or schedule an appointment today!

We are here to help you with all your dermatology needs.

Sources:

https://www.the-rheumatologist.org/article/autoimmune-diseases-common-in-patients-with-vitiligo/

https://www.apderm.com/condition/vitiligo/

https://www.mayoclinic.org/diseases-conditions/vitiligo/diagnosis-treatment/drc-20355916

https://www.aocd.org/page/Vitiligo?