Vitiligo — treatment, classification, diagnosis, disguise
Mechanism of the disease
Vitiligo is the strangest and least studied disease, it is related to immune leucoderma. There
can be dozens of white spots on the skin, and even the hair becomes discolored along with
the skin surface. This disease affects a person of any gender and age. It progresses rather
actively. Med experts noted that the exacerbation is most often observed after staying in the
sun for too long.
Vitiligo is a pathology that can be met quite often, as evidenced by statistics: up to 8% (40
million people) of the entire earth population suffer from this ailment. Half of the patients are
children from 10 years old and young people under 30 years old. Much less often the
disease occurs in people aged 40 and older. Spring and summer are the most productive
seasons for the occurrence of vitiligo.
This disease is very different from other ailments, it is not congenital and can be caused by various reasons. People of any race get sick, but the number of black patients is significantly
The disease develops in the presence of one or several factors:
- Genetic inheritance.
- Brown eyes presence: the people with this color have a significantly higher risk of falling ill than those of blue-eyed and green-eyed people.
- Imbalance of hormones.
- Malfunctions of the thyroid gland.
- The use of low-quality cosmetics with aggressive chemical ingredients.
- Excessive exposure to direct sunlight.
- The use of individual pharmacological drugs, which contain a substance that can cause a change in pigmentation.
- Dysfunction of the digestive tract.
- Autoimmune processes in the body, accompanied by the disorientation of antibodies, which are aimed at the destruction of non-pathological, healthy cells.
- Mechanical violation of the dermis structure: burns, frostbites. An inflammatory process occurs and the cells responsible for the pigment die.
The disease arises suddenly, begins with small white spots, which then expand and merge
into huge patches. They do not have a rash or exfoliation, but sometimes a person can feel a
little irritation. It seems that bleached places are more delicate and vulnerable.
Types of vitiligo
There are 3 general types of vitiligo:
- Localized: discolored patches in selected places.
- Generalized: throughout the torso and limbs.
- Universal: 80% of a body or more is damaged.
The first type is divided into 3 subspecies:
- Focal: 1-2 spots.
- Segmental: the main symptoms are observed only on one side of the body.
- Mucous: on mucous membranes.
The generalized type has subspecies:
- Acrofacial: lesion of the face, hands and/or legs.
- Vulgar: symmetrical arrangement throughout the body.
- Mixed: a combination of the previous ones.
The disease could be classified by the appearance:
- Blue: a stain with a bluish tinge.
- Inflammatory: situated above skin level.
- Trichrome: a white spot in the center, only half of the pigmentation is affected by the transition to healthy skin.
- Four-color: enhanced pigmentation is added to the previous characteristic, bordering the discolored body.
The process of developing the disease can take various forms:
– stable: a pathological change in pigmentation does not change its shape and size over a long time;
– progressive: the process of depigmentation is constantly evolving and affects new areas. It can be swift or slow;
White spots are the main symptoms that distinguish vitiligo from other skin pathologies.
You can see pronounced symptoms of the disease in the photo.
Most often depigmentation affects hands, elbows, legs, and knees.
An important sign of the disease is the inability of the discolored epithelium to perspiration.
White areas of the body react sharply to high and low temperatures, they have impaired the
ability to adapt to temperature differences. If the disease appeared on the hair part of the
head, then the hair on this area will become white.
Sometimes you will notice that the white spots disappear on their own. However, with the
slightest injury, friction or pressure, they occur in damaged areas. At the first stage, the
pigment changes are barely noticeable, they are easy to disguise or hide under clothes
because they are few and very small.
After a certain period of time (for each person this interval is different), they expand. The
patches acquire a white color with a milky tone. Painful feelings are absent, but if the spots
are formed in prominent places, the patient experiences psychological distress due to an
unaesthetic appearance. If a person with this disease sunbathes for too long, he
experiences additional discomfort, because the discolored skin instantly reacts to ultraviolet
and you can easily get a sunburn.
Vitiligo is a non-contagious disease, but for all the harmlessness of this painless pathology, it
is very difficult to treat.
*In the photo of vitiligo that struck huge areas of the body:*
Symptoms are quite understandable and visible. However, there is some difficulty because
of their similarity with lichen and syphilis. It is important to differentiate correctly. To do this,
you should know that lichen, in addition to changes in pigmentation, is peeling the surface of
the affected area. Syphilis is accompanied by the occurrence of pathological processes on
the mucous membrane.
There is an effective method for determination of this illness: use a Wood lamp on a
discolored spot. It will help to see the blue and white color and distinguish the places where
the bleaching process has just begun.
In addition, laboratory tests of biomaterial taken from the affected skin are conducted.
The doctor sets the following tasks when developing a treatment program:
- Eliminate the imbalance of hormones.
- If the patient is depressed due to illness, conduct a special therapy to stabilize the psychological state.
- In addition to medical prescriptions, develop an individualized therapeutic diet in order not to provoke a malfunction of the gastrointestinal tract.
Creams and ointments containing topical glucocorticosteroid are prescribed at the first stage of the disease when depigmentation hasn’t reached the mark of 20% of the skin surface.
The doctor takes into account the size of the pathology, laboratory data and develops an individual plan of pharmacological agents usage. There are 3 common types of medicines
which could be recommended in this case:
– methylprednisolone aceponate and analogs;
– alclometasone dipropionate and analogs;
– betamethasone dipropionate and analogs.
Special attention is given to the drug named “Antiseptic Dorogov’s Stimulator fraction 2”, or simply ASD-2F. It significantly improves the immune system, stabilizes the production of
melanin, inhibits the progression of the disease, does not allow complications.
If after a course of treatment with a duration of 4 months to six months, the result is not obtained, the doctor recommends the next stage with the use of more effective drugs. These
include topical calcineurin inhibitors:
An important component of the treatment course is vitamin therapy. The patient receives all the necessary macro- and microelements in the right amount.
Modern medicine provides new methods of treatment:
- Bleaching with the use of injections of mefloquine, hydroquinone and with the monobenzyl ether externally. This method requires substantial costs and is relatively
dangerous because of negative side effects.
- Treatment with an excimer laser, when the patient absorbs a wave of radiation. The laser will help only if the disease is up to 5 years. This method is not recommended
for everyone. It is appointed only on the condition that the patient has no
- Melagenina plus is applicable for localized forms. Its effect is assessed as average, so the doctor does not always achieve the goal of beating vitiligo completely.
- Melanocyte transplantation is a complex surgical operation in which healthy human pigment cells are implanted in discolored areas.
- Phototherapy: selective, PUVA, UVB with a wavelength of 311 nm. As for PUVA therapy, not every organism responds normally to it. There is a risk of negative
consequences in the form of nausea, dizziness with a headache and even the development of malignant tumors. UVB therapy is classified as the safest and most effective. The only negative point is a long healing process. You should go for 30 to
100 procedures, 2-3 times a week.
Surgical methods are appropriate when therapeutic can’t cope with the disease. According
to statistics, it is 20% of all cases. As mentioned above, the operation takes place by
transplanting healthy cells to pathological foci. The implanted cells responsible for the
production of new, healthy ones. This method is effective, but consumes a lot of time, up to
six months and more.
This method is recommended when the disease affects the hands, face, neck, decollete.
The operation is also recommended if the spread of depigmentation has stopped over the
past 2 years.
Surgical methods include epidermal transplantation. The point of the operation is the
excision of colorless areas and the transplant of a healthy flap of the epidermis.
After surgical interventions such negative consequences may occur:
- The appearance of scars.
- Uneven pigmentation.
- The grafted flaps are rejected.
How to disguise vitiligo?
There are lots of ways to disguise the symptoms of this disease. These methods are
temporary, they help to hide the traces of the disease in order to look more aesthetic at least
for a while. One of these methods is called dermabrasion. With the help of special layer
treatment, you can achieve the desired effect. Types of polish can be different: mechanical,
chemical, and thermal.
Tanning can also smooth out the difference between healthy and affected skin. But
cosmetologists recommend carrying out such a procedure in the beauty salon. The
specialists will correctly select the shade and be able to put a masking agent on the
bleached areas more professionally.
Walnut rind, crushed in a blender is a natural and safe tool for dyeing white spots. Moreover,
this natural remedy is not imprinted on clothing.
The use of concealer is an affordable and simple way. It is important to take into account the
roughness of the skin, align and then matt it.
Permanent tattooing is coloring stains for a long period. Before making a decision to use this
method, it is necessary to consult a dermatologist. Discolored areas are covered with very
thin and delicate skin, which is easy to injure or cause allergic reactions.
Fresh news about vitiligo treatment
As a result of the experiments, scientists have determined that the main cause of the
disease is the stress-inducible protein HSP70i. It contains 641 amino acids. Studies were
conducted on mice. Medical researchers from the Loyola University New Orleans managed
to create a modified protein that can stop the process of skin depigmentation. When HSP70i
was introduced in experimental animals with symptoms of the disease, soon their coat
became monotonous, dark in color. Later, in 2013, experiments were carried out with human
skin cells. However, for unknown reasons, the study does not progress further.
It is advisable to talk about specific preventive measures only if the etiology of the disease is
precisely known. Here you can only take into account the nuances that somehow slow down
the depigmentation process. Such measures include staying at the seaside, swimming in
seawater and sunbathing in a limited model (about 10 minutes a day). But do it daily during
the sunny seasons.
The main point at which the disease stops progressing is a normal metabolism. Therefore, it
is extremely important to control the work of the digestive tract, avoiding failures. It is
appropriate to remember good nutrition, not overloaded with carbohydrates, fats, and sugar.