Vitiligo is a pigmentation disorder that can impact a patient’s emotional health.
What is Vitiligo?
Vitiligo is a disorder where pigmentation of the skin is affected, leading to white patches of skin. Melanocytes, cells in charge of skin pigmentation, are destroyed in this condition. There are a few schools of thought about the causes of vitiligo. It is possible that it could be inherited, in that three genes leave the affected people “susceptible to depigmentation”. Another theory suggests that “melanocytes destroy themselves”. However, the most common cause of vitiligo is believed to be an autoimmune disease. Vitiligo is generally developed before the ages of 20-40. People with autoimmune diseases, hyperthyroidism, adrenocortical insufficiency, pernicious anemia, and alopecia areata could develop vitiligo. Vitiligo can also appear in people with no autoimmune disorder, and it may run in families. The white patches of skin in this disorder are generally found on areas of the body that have been exposed to sun, such as the face, hands, feet, and arms. They can also appear in the groin, armpits, naval, and genitals. The three patterns of vitiligo are generalized (symmetrically on the body), segmental (one side of the body), and focal (only a few areas). Vitiligo can also lead to premature graying of facial and scalp hair. The disease is usually progressive in the generalized form.1
Patients may use cosmetics to cover up the skin patches. Medical treatments include topical steroid therapy (to repigment the skin), depigmentation (to make the rest of the skin match), and psoralen and ultraviolet A therapy (PUVA) therapy (topical or oral). PUVA is the most effective therapy, but it is takes a long time and has potentially severe side effects. In PUVA, the psoralen is applied to the skin or taken orally, and then the patient is exposed to sunlight or UVA lamp light. Other sun exposure needs to be avoided during the therapy. There are also surgical options, such as skin grafts, tattooing, and melanocyte transplants.2
Coping with Vitiligo
Mental health professionals should be consulted to deal with the emotional issues that arise from the changes in the patient’s appearance. The patient may experience depression from their own feelings about their skin, and they may also be treated differently by other people they encounter. A vitiligo support group could also be beneficial.3 Singer Michael Jackson was one famous person with vitiligo. Actor Jon Hamm developed a “stress-induced vitiligo”.4 Managing stress is important with vitiligo, as stress can worsen the disorder.5 In addition to mental health therapy, patients can also engage in alternative means of stress reduction, including massage, chiropractic, acupuncture, yoga, meditation, and dietary and exercise changes.