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Why and how vitiligo affects you and your skin

Have you ever wondered why Michael Jackson’s skin color has changed through the years? A quick Google search about the King of Pop and you will see the drastic change on his skin. While he was of African-American descent and had predominantly dark skin, he had been seen with white patches on his body, and he reportedly covered himself in make-up and eventually bleached his skin to hide the patches. Michael Jackson is among the one percent of the world’s population that has a skin condition called vitiligo. This week, let us find out why some people have vitiligo, if it is contagious, what the treatments are, and the ways one can protect one’s skin if one has the condition.Vitiligo

Melanin is responsible for providing the skin its color, and melanocytes are the cells that produce it. Without melanocytes, the skin will turn pale or white. Vitiligo is the presence of these pale or white patches of skin on the body, indicating that there are areas on the skin that lack or do not have melanocytes. The patches may vary in size, shape, and location on the body, but the skin is still smooth and not irritated. The patches may increase in number or size gradually, but may also stay the same through the years. Vitiligo is not contagious or infectious. It is considered an autoimmune condition, in which the body’s immune system fights or destroys other healthy cells or tissues. Moreover, a combination of environmental and genetic factors brings about this autoimmune response or the loss of color on the skin.

Vitiligo can affect any race, regardless of gender and age, although half of patients with the condition begin to see symptoms before their 20s. It is also more prominent or visible among dark-skinned individuals. It may also be hereditary, but it doesn’t mean that the offspring of an individual with vitiligo will also have it. It is easy for physicians to diagnose vitiligo for dark-skinned individuals, but some may also use a Wood’s lamp (using ultraviolet light to examine the skin) for those with lighter skin.

Unfortunately, there is no complete cure for vitiligo. The treatments available below may only help manage the condition. Studies and research are ongoing to find a possible treatment.

 

1. Topical corticosteroids may improve the skin’s color, but may be too harsh on the skin and cause stretch marks as well. Topical medicines may work very well on areas of the face, but the hands and feet are not as responsive.

 

2. Phototherapy like PUVA and Narrow band UVB may help patients with vitiligo as it uses various wavelengths of light on the affected skin to help bring back the color. Several sessions, however, are needed and there is no assurance that the pigment will even out.

 

3. Surgery, like epidermal cell transplantation and melanocyte culture transplants while still under development and not yet available to most, involves moving healthy areas of skin from other parts of the body onto the patches where vitiligo is present.

 

4. Lasers, like the Excimer laser and fractional Carbon Dioxide laser, may also help bring the color back, although it may only work in areas where vitiligo patches are smaller and have not changed in size. Recent studies, however, have found that the Excimer Laser, combined with topical Tacrolimus (a treatment for atopic dermatitis) and topical prostaglandins (0.005 percent latanoprost solution or Bimatoprost), have been found to be more effective than the laser alone in treating patients with vitiligo.

 

5. Some who have widespread vitiligo opt to bleach the darker skin areas to achieve even-colored skin instead. Monobenzyl ether of hydroquinone (MBEH) a bleaching chemical that may effectively do so and may be used for treatment-resistant patients with more than 50 percent affected area.

 

6. Alternative therapies like intake of ginkgo biloba, L-phenylalanine, Polypodium leucotomos, khellin, and vitamins and minerals, including vitamins B12, C, and E, folic acid, and zinc may also be used in conjunction to vitiligo treatments.  Further studies are being done to assess the effectiveness of the said supplements.

While the skin remains smooth as described above, the loss of melanocytes mean that the skin is extra sensitive and sun protection is definitely a must.

 

Here are other tips to protect your skin if you have vitiligo.

Cover your skin as much as possible by using umbrellas or hats, and wearing sunglasses, dark-colored clothing, long skirts, jeans, leggings, or cardigans when outside. Sunblock is not enough to protect your skin.

Avoid the sun at peak hours, between 10 a.m. to 3 p.m.

Wear sunscreen with at least SPF 30, and with both UVA and UVB protection.

Since it is preferred that you avoid the sun, you may ask your doctor if you can take vitamin D supplements instead to keep your vitamin D levels in check.

 

If you start to have patches of skin, consult your doctor first before assuming that it is vitiligo. Also, it is better to have the dermatologist’s go signal before trying any topical cream, even cosmetics. While there is no cure for vitiligo, some still go to great lengths to have it treated because of the psychological effect it brings them. Having vitiligo may affect one’s self-esteem and one’s ability to lead a normal life. If this is so, therapy may help one understand oneself better and learn to accept the condition eventually.