My 14-year-old son has been diagnosed with vitiligo. I can’t seem to find any information on the Internet about it. It is only slightly noticeable right now, but does it get worse or better with time? He was given some type of topical solution to wear as a treatment.
Vitiligo is a fairly common skin condition, occurring to some extent in about one percent of the population. It often begins in adolescence or young adulthood, and there is some inherited basis for it, although the exact form of inheritance is not clear.
The condition occurs because of a loss of melanocytes, the cells in the skin that contain color pigment. For many years, the cause of this condition was unknown, but recent research has demonstrated the presence of antibodies against the pigment cells circulating in the blood. It is now considered to be one of the autoimmune diseases, which are caused by the production of antibodies against our own body’s cells or tissues.
Several other autoantibodies are frequently found circulating in people with vitiligo, and as might be expected, other autoimmune diseases are more common in people with vitiligo than in the general population. These include Graves’ disease or hyperthyroidism; Addison’s disease, caused by autoimmune destruction of the adrenal glands; and pernicious anemia, caused by autoimmune destruction of the cells in the stomach that produce intrinsic factor, thereby leading to anemia because of the inability to absorb vitamin B12.
Vitiligo can be very embarrassing to people who suffer from it, but it does not lead to disability or death, and affected people will usually live to a ripe old age. The white spots tend to be sharply outlined, clear white, and symmetrically placed on the body. Skin around the mouth, nose, and other orifices is commonly affected, as is skin in skin folds and the outside of the arms. The white areas expand unpredictably, but usually reach a certain size and then enter a quiescent state. Occasionally, the entire skin surface can become depigmented.
Treatments have recently been developed to fight the autoimmune response that destroys the pigment cells and to stimulate the growth of new pigment cells. Strong cortisone creams may be effective in reducing the autoimmunity, but must be used with care, especially on the face, because they may cause skin atrophy. A combination of a psoralen, which sensitizes the skin to light, followed by a light treatment has been effective in stimulating new pigment cells. The treatments have to be done several times a week for a year or so and may have to be continued indefinitely.
Except when light treatments are being given deliberately, a person with vitiligo should always use a sunscreen on the affected skin. A dermatologist should be consulted and should monitor both kinds of treatment, due to the possibility of damaging the skin.