A closer look at Vitiligo, the autoimmune skin disease.

14 02 skin colour discolouration vitiligo

For some, having skin pigment just die off, changes our skin colour to white. It’s called Vitiligo, and aside from the obvious celebrity connection (Michael Jackson), there hasn’t been much discussion. I thought it was time to shed some light on this lightness of being.

Symptoms of Vitiligo

Vitiligo is an autoimmune disease, which affects between 0.5 per cent to three per cent of the general population. Celebrities with vitiligo include The Cosby Show’s Tempestt Bledsoe, actress Hollie Mary Combs as well as journalist Lee Thomas. More common in women and most likely to occur during childhood, (I’ve had it since I was 13) vitiligo often presents itself first as a harmless rash that then subsides, leaving the affected area white. Antibodies attack the body’s own melanocytes, the melanin pigment-producing cells, essentially killing them off, along with the colour they produce. Not contagious, vitiligo is viewed to some extent as hereditary as genes do play a part in 30 per cent of cases. And of course on darker skin, the contrast not only can be visually jarring, but also psychologically and emotionally traumatizing. There isn’t a known cure however, many treatments are available to cover up the areas, reinvigorate the pigment to produce colour again or depigment the skin to create a unified colour.

Treatments of Vitiligo

“For most individuals with vitiligo, the starting point would be topical therapy with steroid creams,” notes Dr. Vince Bertucci, MD, FRCPC, vice president of the Canadian Dermatology AssociationDr. Bertucci also went on to explain that for those who have active vitiligo (when the affected areas seem to continue to change shape and size), there is a potential repigment scenario.

Another viable option is a series of medically supervised treatments of narrow band ultraviolet B (NB-UVB) light. Then there is also skin grafting, where skin cells of a healthy, unaffected area are lifted and grafted into the affected area to see if the healthy pigment can thrive in its new location.

Micropigmentation can also be used to tattoo the border areas where pigment is affected, such as around the lips.

Excimer Laser is a laser which is used (using similar Narrow band wavelength) to target smaller areas of Vitiligo.

As there isn’t a recognized cure, the condition does create a mini-cottage industry of concoctions ranging from topical creams to homeopathy to naturopathic regiments (I’ve done all three). Of course various global dermatological associations and research groups often release their own findings, which includes unusual treatments. One study from Havana Cuba examined rates of freckling in affected areas by topically applying “humanal placenta” (yes, it’s exactly what you are thinking)
to the affected area twice a
day. And, yes, I tried that, too.

Cosmetic Options to Treat Vitiligo 

Throughout my teens and early 20s, I was able to disguise my condition with conservative clothing. However, when spots started to appear around my hands, feet, eyes and neck I knew that it was time to explore cosmetic solutions. Camouflage foundation is a great way to cover it up. Today’s marketplace has plenty of options, including Keromask London, Makeup Forever and, my personal favorite, Dermablend, which was one of the very few tried-and-true lines available on the market when I needed it. The reality is that not all Vitiligo cases end up with perfectly reinvigorated pigment. Some people will continue to see their white patches slowly take over their entire bodies. When the whiteness may cross a certain threshold of maintainability, it may just be better to just unify the white.

Depigmentation

The depigmentation option is usually offered to those who are 50 per cent white—mine was at 70 per cent—when clearly other treatments haven’t worked. (Although, I did have high hopes for the “humanal placenta” just to use as cocktail chatter). Prescription-only skin-whitening cream Monobenzyl ether of hydroquinone, commonly called monobenzone or mono, is used to kill the remaining pigment cells. Depending on the patient’s specific case, it can take up to two years—with me depigmentation took one year.

When the skin lacks pigment either in patches or completely, sun protection is crucial. Use at least SPF 60+, advises Dr. Sonya Abdulla, MD, M.Sc, FRCPC, a dermatologist from The Cleveland Clinic Canada. The high SPF rating is imperative to protect the depigmented areas as they are “far more susceptible to ultraviolet light exposure and sunburn,” but it also “compensates for our imperfect ability to apply sunscreen,” and our tendancy to apply it “too sparingly,” says Dr. Abdulla.

Not only can Vitiligo be a physically challenging condition, but, emotionally and psychologically tasking for the patient and his or her families.  However, with the enormous options of support, networking and social media connectivity that is available today, combined with the continued efforts of increasing awareness, there are ways to handle the disease in a supportive environment so that it doesn’t consume one’s entire identity. Rather, it just becomes a unique part of you.