The most obvious sign that someone has Vitiligo, is the lighter patches that appear on their skin. These patches may vary in size from a few millimetres to several centimetres in width. Sometimes these patches go unnoticed, especially if the skin is naturally light in colour. However, the early signs of Vitiligo are important to note as the earlier we can detect Vitiligo, the faster and more effective the treatment process is.
Vitiligo patches are more obvious in those people with darker skin tones because there is a sharper contrast between the normally pigmented skin and the paler patches. Often, these patches turn pinkish before they become almost completely white, sometimes with a little itchiness or a stinging sensation. Some people may experience light patches in the tissues that line the inside of their mouths (mucous membranes), in the armpits, groin area or belly button. Sometimes Vitiligo affects the hair, eyebrows, or eyelashes.
Early Signs of Vitiligo
Vitiligo patches can occur anywhere on the body, but they are commonly first noticed in places that are more often exposed to the sun. This means that the patches would appear first on the hands, feet, arms, legs, and face. Occasionally, each white patch has an inflamed, reddish border.
Vitiligo can start at any age and typically appears between the ages of 10 and 30. Vitiligo also favours sites of injury (cuts, scrapes, acne, thermal burns, and sunburn). Sites associated with trauma, such as elbows, hands, and knees, represent the Koebner Phenomenon (KP), a common finding in Vitiligo. Confetti-like depigmentation, patches with poorly defined borders, inflammatory borders, and itch, are also associated with disease activity. The retina at the back of the eye can also be affected, but the iris colour does not change.
Although Vitiligo patches have no symptoms other than physical appearance, the psychosocial impact and physical disfigurement of the condition are devastating to many people. Treatments can restore pigment and in many instances, re-pigmentation is possible if the damaged melanocytes are stimulated with the appropriate cream or oral medications. In cases where the Vitiligo is covering a large area of the body, often the cream and supplements are used in combination with ultraviolet (UV) light.
Vitiligo usually appears in one of these patterns:
- Nonsegmental (Generalised) Vitiligo
This is the most common human pigmentation disorder; pigment loss is widespread and occurs evenly across many parts of the body. Typically, the white patches appear on both sides of the body, such as both hands and both knees. Nonsegmental Vitiligo often begins with a rapid loss of pigment, and then stops for a while. Pigment loss then starts up again later. This stop-start pattern can last a lifetime. Patches often expand and become more noticeable – covering larger areas.
Evidence indicates that Nonsegmental Vitiligo is an organ-specific autoimmune disease directed against melanocytes (pigment-producing cells in the skin of humans). About 20% of people with Vitiligo manifest associated occurrences of other autoimmune diseases, predominantly thyroid diseases (Hashimoto’s and Graves’ disease), rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anaemia, lupus, and Addison’s disease.
In the past few years, disease control experts have studied people with Vitiligo, both over short and longer periods of time, to try to uncover patterns or trends of skin depigmentation progression. Areas of study include how genetic factors influence Vitiligo and subsequently interact with the environment in the context of the disease. Vitiligo is recognised as part of a broader, genetically determined, autoimmune and autoinflammatory tendency. Attempts to identify genes involved in Vitiligo susceptibility involve the study of melanocyte defects, innate immune inflammation, and cell-mediated melanocyte destruction.
- Segmental Vitiligo
Segmental Vitiligo does not usually occur in response to autoimmune disorders and is less common than Nonsegmental Vitiligo. It is characterised by its early onset (affecting young people), rapid stabilisation, and one-sided distribution. Recent evidence suggests that Segmental and Nonsegmental Vitiligo could represent variants of the same disease spectrum.
Although the exact pathogenic mechanism behind the melanocyte destruction is still unknown, increasing evidence has been published on the autoimmune/inflammatory theory of Segmental Vitiligo. This type of Vitiligo is characterised by loss of skin colour on only one side of the body. White patches do not cross the body midline, and often have irregular borders. Initially, you might notice spots or patches when your skin has been exposed to the sun. It tends to happen at a younger age, progress for a year or two, and then stop.
Although Segmental Vitiligo spreads rather quickly, more so than other forms of Vitiligo, it stops within six months to a year. The spread could then remain stable for the rest of your life. Sometimes this condition is referred to as Localised Vitiligo as it remains static and does not spread further.
Segmental Vitiligo frequently turns the hair in the affected spot white quite quickly and the white hair can be difficult to treat. Normally the white spot or patch needs to be fully treated before the hair regains its natural colour again. It is thought that the melanocyte stem cells, which could produce more melanocytes, live in the hair follicles, and most likely get destroyed when the hair turns white.
- Focal Vitiligo
Depigmentation is restricted to one or two areas on the body. It is an uncommon form of Vitiligo, with inconsistent depigmentation patterns. Focal Vitiligo is characterised by depigmented patches located in a small area without Nonsegmental or Segmental Vitiligo distribution patterns. Focal Vitiligo is classified as an undetermined type, with a more conclusive diagnosis made when the white patches do not show typical patterns after one or two years.
- Mucosal Vitiligo
Vitiligo can affect the mucous membranes and is known as Mucosal Vitiligo. This characteristically affects the moist linings of the mouth, nose, genital, and rectal areas.
- Acrofacial Vitiligo
This type of Vitiligo can affect the lips, fingers, and toes, which is also called Lip Tip Vitiligo.
- Trichome Vitiligo
Trichome Vitiligo presents as patches with three shades of colour – a white or colourless centre, then an area of lighter pigmentation, and then an area of normal-coloured skin on the outside. Very rarely, there are four shades of pigment (white, pale brown, dark brown and normal skin).
- Universal Vitiligo
This is a rare type of Vitiligo, where more than 80% of the skin of the body lacks pigment. It is characterised by the wide distribution of white patches throughout the body with minimal areas of normal pigmentation remaining. Universal Vitiligo ultimately leads to complete depigmentation of the skin, mucosa, and hair. This kind of Vitiligo represents the high end of the Vitiligo spectrum and is represented by a high prevalence of comorbidities (the presence of one or more diseases or medical conditions). People with this type of Vitiligo frequently opt for depigmentation therapy to achieve a more uniform (and lighter) skin tone.
Early Signs of Vitiligo – The Condition:
Most people with Vitiligo are otherwise healthy and have normal skin sensation and texture. Vitiligo may be more common in people that have certain autoimmune diseases. These may include vitamin B-12 deficiency anaemia known as pernicious anaemia, Addison’s disease, or thyroid disorders such as hypothyroidism and hyperthyroidism.
If you have an autoimmune disease, and white patches start to appear on your skin, chances are it is Vitiligo. Vitiligo also has the potential to affect all races and both sexes equally.
Vitiligo differs from person to person and progresses differently for everyone. This makes the disease development challenging to predict. Vitiligo may cause significant psychological problems, and people with Vitiligo have reported associated feelings of depression, embarrassment, anxiety, and shame. The unpredictable and often unstable disease course and measures needed to cover up their disease with clothing and/or cosmetic products may create a lasting psychological burden. Many people live in constant fear that their Vitiligo will progress unchecked. In some cultures, Vitiligo is a highly stigmatised disorder, while others believe it to be contagious.
There are other conditions that resemble Vitiligo.
The skin conditions that mimic Vitiligo include:
- Chemical leukoderma – is skin cell damage, resulting from exposure to industrial chemicals, presents in linear or splotchy white areas.
- Tinea versicolor – is a yeast infection that can create dark spots on light skin and white spots on dark skin.
- Albinism – is a genetic condition that results in little or no production of melanin, resulting in very pale or white skin, hair, and eyes.
- Pityriasis alba – is a low-grade type of eczema or dermatitis mainly seen in children, first presenting as pink, scaly patches which fade and then become lighter.
No two cases of vitiligo are the same, and whether the patches will spread depends on the type of vitiligo you have.
Remember, Vitiligo can be Treated:
Vitiligo can be treated, and it is important to keep perceptions in line with reality! Commitment and adherence to the available treatment options are important when managing Vitiligo. Medications and light-based therapies exist to help restore skin colour or even out skin tone. During this phase you can try a tinted foundation to cover up the lighter patches.
Make sure you eat healthy foods and drink lots of water. It is important to supplement with certain vitamins like B12, folic acid, vitamin d3, and zinc. Living with Vitiligo can be challenging! After you have been diagnosed, deal with your emotions and find a solution. Get support from a reputable Vitiligo treatment specialist and embark on a specific treatment plan – one that is sustainable for you.
Help your body by tweaking your diet to include nutrient-dense food options. Engage in an exercise or sports programme to boost your health, and then kick back and enjoy those endorphins! Get a minimum of eight hours of good sleep per day. Continually manage your expectations and adjust them as and when necessary.
At Vitiligo Treatment we offer a large range of products to help treat most Vitiligo conditions. This is one of the factors that has contributed to our success in Treating Vitiligo.
We do have a combination of products formulated to treat Low, Medium, and High Vitiligo body coverage. Contact one of our consultants or read more on our website for information pertaining to your own Vitiligo condition.
As always, please don’t hesitate to contact us if you require any further information pertaining to this article – Early Signs of Vitiligo – or require any additional detailed information on our products.
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