Vitiligo: What is it?
- Vitiligo is a pigmentary disorder characterized by the appearance of asymptomatic white patches, which can manifest at any time in life and may have adverse psychological effects.
- It affects all skin types and ages, with equal frequency in males and females.
- This skin condition affects men and women without distinction to race or age group. It can develop at any age.
- Vitiligo is considered to be an autoimmune disorder, with underlying genetic predisposition in most cases.
- Vitiligo is not caused by inadequate medical care.
- Individual behavior, lack of confidence and state of mind can play a significant role in disease management.
- Vitiligo is not contagious.
- Poor nutrition is not associated with vitiligo, but the right diet, rich in antioxidants may help control its progression.
- Vitiligo is not necessarily a genetic condition, or at least this is not yet fully documented.
- The progression of vitiligo can be prevented in 90% of the cases with the proper treatment.
- The cure is not yet known for each individual case, but more than 75% of vitiligo patients can be treated with medical treatments and the help of phototherapy.
Be optimistic! It is not true that nothing can be done about vitiligo. In fact, the opposite holds true and research is conducted worldwide in order to find the definitive cure for vitiligo.
Recently, in July 2022, ruxolitinib has been authorized as the first treatment that can improve the lesions of nonsegmental vitiligo patients. The FDA has approved Incyte’s ruxolitinib cream for the treatment of vitiligo in adults and children 12 years of age and older.
The root cause of vitiligo is unclear and has been attributed to autoimmune causes, oxidative stress, or neurogenic disturbance.
Vitiligo is a condition that cannot currently be cured permanently, but can be successfully treated with several different treatment approaches. Its progression can be prevented in 90% of the cases with the appropriate treatment, most commonly with a combination of different treatments. More than 75% of vitiligo patients respond satisfactorily to modern treatments (medical treatment, phototherapy, combination or surgical treatment).
Vitiligo is not merely a cosmetic disorder
What is it that makes people lose their confidence, experience extreme guilt about not actually being sick, not feel like going out, avoid eye contact, shudder at the thought of the sun, avoid mirrors and stop swimming?
Whether we like it or not, we live in a society that places a high value on appearance and the impact on the psychological well-being and the quality of life of vitiligo patients does not therefore come as a surprise.
More than 100 million children, women and men in the world who suffer from vitiligo consider that vitiligo is much more than a cosmetic skin disorder.
Moreover, visible disfigurement may cause anxiety and distress as a result of a change in appearance, and it may even cause significant aesthetic issues, often with serious psychosomatic impact on the quality of life, sex and family life of patients.
This is the somatopsychic phase, which can trigger the extension of lesions, and then the psychosomatic phase begins which engages the patient in a vicious circle.
The skin is the mirror of our soul. The skin and the nervous system form simultaneously during fetal life. So, we estimate the impact of the psyche on the onset, progression and treatment of vitiligo with psychological interventions to determine treatment effects.
It has been reported that, in some cases, vitiligo is associated with psychiatric disorders. What’s truly shocking is that vitiligo is associated with an increased suicide risk in certain cases. A study has identified higher prevalence of depression in cases of middle and high socioeconomic status. As expected, patients showing improvement in their condition after treatment, demonstrate improved quality of life.
In an effort to stress the importance of improving the quality of life of vitiligo patients, our research submitted to the international medical journal,
Journal der Deutschen Dermatologischen Gesellschaft, in collaboration with the Psychiatric Clinic of the University of Thessaly, has proven that the improvement of the quality of life is proportional to the improvement of the patient’s body image (Manuscript ID JDDG-2015-OA-006 entitled “Investigation of factors associated with health-related quality of life and psychological distress in vitiligo”).
Types of vitiligo
- Generalized: This is the most common type of vitiligo that causes macules to appear in different parts of the body.
- Segmental: This type affects only one side of the body or one particular area, such as the hands or the face.
- Mucosal: Mucosal vitiligo affects the mucous membranes of the mouth and/or genitals.
- Focal: Focal vitiligo is a rare type where macules develop in a small area and do not spread in a distinct pattern within one to two years.
- Trichome: This type manifests as a bullseye with a white or colorless center, then an area of lighter pigmentation and an area of natural skin tone.
- Universal: This is a rare type of vitiligo in which depigmentation covers more than 80% of the skin.
