Vitiligo

Vitiligo symptoms

A disease is manifested by the appearance of white patches that neither itch nor scale. Characteristic of the disease is that the skin adjacent to the clearly defined spots is often more tanned than the rest of the body. The spread of the patches can vary greatly from person to person. While in some cases only single small spots appear, in others whole body parts can be affected by pigment loss. Spotting often begins in sun-exposed areas such as the face or hands, but it can also occur in the genital area or in the axial folds. If the scalp is affected, leading to white discoloration of the scalp hair, eyebrows or eyelashes, this is called poliosis.

The symptoms of vitiligo can start as early as infancy, but in half of all sufferers they begin around the age of 20. In about one third of those affected, there is a hereditary predisposition. A distinction is made between three types of vitiligo:

• Segmental vitiligo usually begins in childhood and develops rapidly. It is characterized by its white, symmetrical patches and is only rarely accompanied by an autoimmune disease. Several skin segments are usually affected by the loss of pigment. Segmental vitiligo accounts for around 5% of all vitiligo diseases.
• Focal vitiligo usually only appears later, but can already become apparent in childhood. It develops gradually and is characterized by asymmetrically distributed white patches on one side, which usually only affect one skin segment. This form accounts for approximately 15% of all vitiligo cases.
• The remaining 80% of affected individuals exhibit generalized vitiligo. This is characterized by a rapid disease progression and is often accompanied by autoimmune diseases, for example thyroid disorders.

Since vitiligo has no symptoms other than the white patches, it is not in itself a health concern. However, the missing pigments provide little protection from UV rays, which leads to an increased risk of sunburns and Skin cancer leads. Therefore, affected skin areas should always be protected with plenty of sunscreen.

Vitiligo causes

The cause of vitiligo is scientifically largely unknown. However, it has been observed that it can often occur in association with hearing impairment or various autoimmune diseases. This suggests a disorder of the immune system, which could suggest destruction of the body's own pigment cells. Another explanation is that the absence of the enzyme catalase may lead to the death of the pigment cells, which would also explain the familial clustering.

It is certain that immunological factors play a role in vitiligo. Therefore, at the beginning of a therapy, a blood test is scheduled to look for possible accompanying autoimmune diseases.

Vitiligo treatment

Light treatments

• Until now the Whole body light therapy with narrowband UVB as the most effective and best-studied therapy.
• At the localized light therapy individual areas of vitiligo are selectively treated with a light wavelength of 308 nm, sparing the remaining healthy skin. In our practice we exclusively offer the excimer lamp. At the beginning, we expose the areas twice a week, then once a week until the therapy is successful. The treatment lasts only a few seconds per area. In addition, local therapy with Tacrolimus ointment (Protopic®) improves the chances of success.

We treat twice a week in the beginning, then once a week. The treatment can be supported by the application of Tacrolimus ointment twice a day. According to the literature and from our own experience, the success rate especially in the face and neck area can be quantified as 80% repigmentation rate.

Vitiligo Frequently asked questions