Vitiligo & Its Treatments
Vitiligo is a skin condition affecting up to 6 million Americans, causing pigment loss in the skin and hair, which creates irregular white patches of skin. The condition typically develops early in life, but can occur at any age. The process of pigment loss can stop on its own, but it may continue until most or all the body is affected.
The cause of vitiligo is unknown. Current research has demonstrated that people with vitiligo may have a genetic predisposition.
Many consider vitiligo to be an "autoimmune condition". This means that your own immune system is destroying the cells in your skin that make pigment (melanocytes). Despite ongoing research, there is no clear cause of vitiligo.
Vitiligo is not contagious. While vitiligo may be more noticeable in individuals with darker skin tones, it affects all races and ethnicities. There is no cure for vitiligo, but there are treatment options available. Our doctors will work together with you create the best treatment plan for you.
Facts about vitiligo
- Vitiligo is a disease that is often misunderstood by many people. To help clear the confusion, some common facts about vitiligo are listed below:
- Vitiligo is an autoimmune disorder and not a “cosmetic” problem.
- Vitiligo affects the immune system and shows up as a change in skin color presenting as white patches on the skin.
- There is no known cure.
- Many of the currently available treatments are not covered by insurance.
- 70 million people across the world have vitiligo.
- There are no boundaries of race, ethnicity or gender.
- Vitiligo is difficult to hide. This disease is misunderstood and the isolation people with vitiligo feel can be crippling. This can lead to difficulties in both the personal and professional lives of affected individuals.
- Anyone—children and adults representing all ethnicities— can get vitiligo at any time.
- 20-35% of patients are children.
- Nearly 1% of the population is affected.
- Vitiligo is NOT contagious.
- Various treatments, including surgery, topical creams and light therapy, can help some patients.
- There is very little research funding for vitiligo to better understand the disease and develop new treatments.
- More treatments and research are needed.
For more information, please visit the Vitiligo Working Group Website.
Treatments are more effective if started when the condition begins, rather than when the disease has been present for a longer period of time. For all forms of treatment for re-pigmentation, response varies by the location on the body. Typically, the tips of fingers and toes are the most difficult areas to treat.
Will medications help my vitiligo?
Topical steroids may be used for limited areas, but may be ineffective for some people and not practical when the patient has widespread vitiligo. Topical steroids may also be used in combination with other treatments.
Protopic (tacrolimus), and Elidel (pimecrolimus) are creams and ointments that may help the pigment cells make color. Ask your physician to discuss these drugs with you as a possible treatment.
Does light therapy work?
Ultraviolet light therapy is the treatment of choice for patients with widespread vitiligo. The majority of patients (80%) that undergo ultraviolet light treatments will get a response, but individual degree of response varies.
What kind of result should I expect from light therapy?
The typical response is seen as islands of freckles in the affected skin that will grow in size. Occasionally, the edges of the white area will tan and fill inwards. About half of patients respond with ultraviolet light will keep the new color. There are several types as described below:
- PUVA: Psoralen + Ultraviolet A or PUVA (pronounced pooh-vuh) is a frequently used light treatment. PUVA involves taking an oral or topical medication (psoralen) followed by being placed in a light booth and exposed to ultraviolet A light.
- Narrowband Ultraviolet B: Narrowband UVB involves exposing the skin to UVB light two to three times a week. It usually takes 20-30 treatments for a response to become apparent. Unlike PUVA with which the medication (psoralen) is taken orally or applied to the skin, UVB treatment is strictly a light therapy.
- Excimer Laser: The excimer laser is a form of ultraviolet B laser phototherapy that can be used if your vitiligo is localized to less than 10% of your body.
Is surgery an option?
Surgical treatment involves transferring intact skin or individual cells from an unaffected area of your body to the area of vitiligo. There are different types of surgical treatments, including:
- Suction blister grafts
- Split thickness grafts
- Punch grafts
- Cultured melanocyte transplantation
- Non-cultured melanocyte keratinocyte transplantation
Please visit the Henry Ford Department of Dermatology for more information on the melanocyte keratinocyte transplant procedure (MKTP).
What about bleaching creams for depigmentation?
Special prescription bleaching creams are an option for those who have extensive loss of pigment and/or who do not respond to treatment. These creams will bleach any remaining pigment the patient has. This will result in the permanent loss of any pigment in the skin. Your physician should be consulted before attempting this treatment option.
Are there alternative treatments?
Ginkgo biloba is an herbal medication that may have an effect on generalized vitiligo. For other natural remedies (vitamins, herbal supplements, homeopathic treatments, etc.) or dietary changes, there is no strong scientific evidence showing a significant effect on vitiligo. You should discuss these treatments with your physician before taking any vitamins or supplements.
It is very common for those with Vitiligo to experience impact on their quality of life. Interacting with others that also have Vitiligo can be useful to offer a sense of validation, community and acceptance. The Henry Ford Department of Dermatology is proud to sponsor V Strong, the Southeast Michigan Vitiligo Support Group. This group is open to those with Vitiligo, their family and friends. Please visit the support group Facebook page for further information on support group meeting dates and times.