Vitiligo- A skin condition which affects not just the skin but also the psyche.

Vitiligo- A skin condition which affects not just the skin but also the psyche.

Known commonly as the white patch disease or leukoderma or vitiligo, this is a condition of the skin. The skin in small or big patches start to turn white. The condition may be slowly progressive or may rapidly progress. It affects 0.5-2% of the world’s population.

What causes Vitiligo?

Let me give example of our defence forces. Their job is to protect us from external forces like our enemies. Now imagine our own defence forces turn rogue and start to work against us by killing us. This phenomenon in medical science is known as ‘Autoimmunity’, in which our antibodies turn against our own body cells. These antibodies as we all know function normally to protect us from external bacteria, viruses and parasites. Why do these antibodies turn against our own cells is poorly understood. In vitiligo, antibodies work against the melanin producing cells called as melanocytes. So when melanocytes get destroyed, melanin is not produced and hence no color, which leads to white patches. Melanin is the pigment in our skin responsible for our skin color. Indians have more melanin than Caucasians and Blacks have the maximum melanin pigment. Melanin also increases in production on sunlight exposure, which we commonly refer to as tan.

Can it be treated or cured?

So far, medical science is inadequate to treat autoimmunity but in severe cases in which progression occurs rapidly, we try to control it by giving oral steroids. However, oral steroids can also only control the progress of the disease and may not be able to cure it. Good news is that we can treat vitiligo patches. We have multiple treatment options to get back the color. It takes time to see the results but there is definite hope and one has to be regular with the treatment. Phototherapy plays a significant role in getting back color. I personally have been able to get visibly good results in many patients with the help of phototherapy, but as many as 30-50 sessions of phototherapy sessions may be required. Phototherapy is a form of light therapy; can be in the form of narrow band UVB or UVA light. Along with that, certain creams and ointments will also be prescribed which the patient has to use regularly. There are different types of surgical options, in which normal colored skin is implanted at the site of white patches. The results will depend on the skill of the surgeon and how well your skin takes up the graft. Usually surgery should be opted after phototherapy also has failed.

Social impact:

Stress contributes majorly in vitiligo in my opinion. Getting worried and depressed about it does not help but only aggravates the condition. The social stigma attached to this condition is severe. Some people may suffer depression or lack of self-worth even if they have small patches. Young people find difficulty in finding suitable partners for marriage. Even the most accomplished ones suffer emotionally and parents play a significant role here. Most often it’s the parents who are responsible in making their child feel inferior. In India, sadly so much emphasis is given to skin color. If one is dark then also it’s a problem and if one suffers from vitiligo then it’s the biggest problem! It’s saddening that we all give priority to external beauty and blindly ignore all other positive attributes of a person like their intelligence and pleasant personality. It is not contagious and so there is no reason for people suffering from vitiligo to isolate themselves from others. If you know someone who suffers from vitiligo, be kind and sensitive towards them. Color of the skin does not determine the true value of a person. Let us not judge people based on their skin color as external beauty is only skin deep.

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