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Vitiligo Facts: Skin Pigment Loss and Possible Treatments

Linda Crampton is a writer and former teacher with a first-class honors degree in biology. She writes about the scientific basis of disease.

What Is Vitiligo?

Vitiligo is a skin disorder in which cells called melanocytes are destroyed. The cells make melanin, the brown pigment that colors our skin. Without melanocytes, pigment can't be made. People with vitiligo often have irregularly-shaped patches of depigmented skin. The patches frequently enlarge over time and produce a mottled appearance.

I've had vitiligo patches on my hands and forearms for several years. Since I have pale skin, the white areas are most noticeable in summer when the rest of my skin tans. At other times of the year, the pigment loss is not a big problem. For people with darker skin or for people who have lost pigment in a more visible place, such as the face, the disorder may be much more problematic. The darker the skin, the more obvious the contrast between light patches and pigmented areas.

The cause of the melanocyte destruction in vitiligo isn't known for certain, but most researchers think that it arises due to an autoimmune problem. Our immune system normally destroys bacteria and viruses. In an autoimmune disease, the system mistakenly attacks the body's own cells.

Pigment loss on my right arm and hand

Pigment loss on my right arm and hand

Types of Vitiligo

The classification of vitiligo varies. Today most dermatologists recognize two types—non-segmental and segmental. The non-segmental version is said to be the most common type. According to the American Academy of Dermatology, the following features are the main characteristics of the condition.

  • Depigmented patches appear on both sides of the body. They may have different shapes, however.
  • The loss of pigment often begins on the hands, wrists, or feet or around the eyes or mouth.
  • Depigmented patches often grow in size once they form.
  • Loss of pigment may proceed for a while, then pause, and then start again. This start-and-stop cycle may occur repeatedly.

Segmental vitiligo develops in one part of the body and usually starts at an early age. Pigment loss often stops at a certain point and doesn't restart. The condition is frequently accompanied by a loss of hair color.

I have non-segmental vitiligo. The depigmentation is slowly spreading over my hands and forearms and has also appeared on my legs. In some people, the pigment loss is located in other or additional areas and the condition progresses more rapidly.

Melanocytes are cells that make melanin. Some of the cells are destroyed in vitiligo.

Melanocytes are cells that make melanin. Some of the cells are destroyed in vitiligo.

Possible Symptoms of the Disorder

Depigmentation tends to first develop as small spots on areas exposed to sunlight, especially the face, lips, arms, and hands. It may be particularly noticeable around openings in the skin, such as the lips and the eyes. The spots may enlarge over time. New spots sometimes develop in areas that aren't normally exposed to the sun. The depigmented patches may be paler than the surrounding skin or may be completely white. The patches are flat and feel normal to the touch. They also have normal sensation.

Some people with vitiligo develop grey hair, eyelashes, eyebrows, and facial hair at a relatively young age (before 35). There may be pigment loss inside the mouth. Pigment is sometimes lost from the retina, the light-sensitive layer at the back of each eyeball, although this seems to be a very rare process.