Vitiligo

Vitiligo is like melasma in that it is a pigmentary disorder of the skin that commonly occurs in women who suffer from hormone fluctuations or imbalances. However, it differs from melasma in that it appears as white symmetrical patches varying in size and location. Even the hair in these areas may start to turn white. Celebrities that are reputed to have suffered from vitiligo are Michael Jackson and former professional baseball player Sammy Sosa.

The disorder is considered progressive in that some or all of the melanocytes (melanin-producing cells) in the affected area are destroyed. The areas in which vitiligo most commonly develop are the face, neck and scalp, body folds, and sites of injury.

What Causes Vitiligo?

The cause and cure of this condition are unknown, but many draw a connection between the disorder and autoimmune diseases like hyper/hypothyroidism, Addison’s disease, or neural mechanisms in which the melanocytes are attacked, to name a few. Many individuals with vitiligo report pigment loss shortly after a severe sunburn or emotional trauma.

• Vitiligo affects between 0.5-1% of the population
• About half of those who develop vitiligo experience some pigment loss before age 20
• About one third of all vitiligo patients say that other family members also have this condition
• Vitiligo may appear at any age, though most frequently between 10-30 years

Treatment Options For Vitiligo

Initial treatment often incorporates topical application of steroidal ointments that help in preventing further loss of the pigment. In case of significant pigment loss, repigmentation may be attempted through PUVA therapy. During PUVA therapy, photoactive substances called psoralens are applied topically or administered orally; exposure of the narrowband UVB in a controlled environment assists in bringing back the pigmentation.

Phototherapy may also be administered, a therapy similar to PUVA therapy minus the use of psoralens. During phototherapy, the patient is exposed to narrow-band ultraviolet B (UV-B) light, either alone or in combination with hydrocortisone-type compounds.

A less common approach to vitiligo treatment is depigmentation through the application of drugs like hydroquinone or monobenzone. During the depigmentaton process, melanin is removed from the skin in attempt to achieve even skin color.

If you have questions or concerns about vitiligo or its treatment, we encourage you to set up a consultation with Dr. Mickalak. Our office in Issaquah is conveniently for residents of the greater Seattle metro area. Please dial 425-391-2500 to make and appointment.