What is vitiligo?

Vitiligo is a relatively common skin disorder, in which white spots or patches appear on the skin. These spots are caused by destruction or weakening of the pigment cells in those areas, resulting in the pigment being destroyed or no longer produced. Many doctors and researchers believe that vitiligo is an autoimmune-related disorder. Although researchers are not exactly sure what causes the autoimmune response, more is being learned every year. In vitiligo, only the color of the skin is affected. The texture and other skin qualities remain normal.

What does vitiligo look like?

Vitiligo appears as uneven white patches on the skin, that may vary from lighter tan to complete absence of pigment. Many people develop vitiligo bilaterally, in other words, if it appears on one elbow, it often appears on the other elbow. Researchers do not completely understand why this is. Others develop what is known as segmental vitiligo, where the patches develop in only one area or on only one side of the body.

What is an autoimmune disorder?

An autoimmune disorder is any of a number of conditions in which a person's immune system reacts against the body's own organs or tissues, and the person's immune system produces antibodies to them. An autoimmune disorder is NOT an "immune deficiency". In the case of vitiligo, we believe that the immune system probably sees the person's own pigment cells as foreign bodies, and attacks them, destroying them or weakening them. Other examples of autoimmune disorders include thyroid disorders, alopecia areata, lupus, and pernicious anemia.

What is a Melanocyte (Pigment Cell)?

A Melanocyte is a specialized cell located in the skin, which produces melanin (pigment). Surprisingly, all humans have roughly the same number of pigment cells in their skin. Those with darker toned skin, have pigment cells that are able to store more melanin within them. In the diagram below, the cell with the tendrils, marked "I" is the melanocyte. The brown color within the cell is the melanin. The cell uses the tendrils to distribute the melanin evenly throughout the skin.

What is Melanin?

Melanin is a dark brown pigment of skin and hair in animals, particularly vertebrates, derived from the amino acid tyrosine. It is synthesized by special cells called Melanocytes, which also store the melanin.

What are the symptoms of vitiligo?

People who develop vitiligo usually first notice white patches or spots (depigmentation) on their skin. The skin remains of normal texture, though some people experience itching in areas where depigmentation is occurring. The white patches are more obvious in sun-exposed areas, including the hands, feet, arms, legs face, and lips. Other common areas for white patches to appear are the armpits and groin and around the mouth, eyes, nostrils, navel, and genitals. Vitiligo generally appears in one of three patterns. In one pattern (focal pattern), the depigmentation is limited to one or only a few areas. Some people develop depigmented patches on only one side of their bodies (segmental vitiligo). For most people who have vitiligo, depigmentation occurs on different parts of the body, in a bilateral pattern (generalized vitiligo). In addition to white patches on the skin, some people with vitiligo may experience white hair growing in on the scalp, eyelashes, eyebrows, and beard.

I have vitiligo patches on my underarms, my feet and my genitals. Is this common?

For reasons we don't really understand yet, there are certain parts of the body, which are commonly affected in those who have vitiligo. The face, underarms, hands, wrists, fingers, feet, elbows, knees and genitals are among these areas. There are many theories about why such sensitive areas of the body seem to be commonly affected - the presence of many nerve endings, the bony nature, sweat glands, etc.

How does vitiligo develop?

The course and severity of pigment loss differ with each person. In many cases, vitiligo begins in a small area. Over time, other spots may appear, while existing spots may grow larger. Some people notice that their vitiligo may stay the same for years or even decades, and then suddenly new areas of depigmentation may occur. Occasionally, vitiligo patches will repigment spontaneously, all by themselves, with no treatment whatsoever. Many people with vitiligo do notice this happening at some point in their lives.

Is depigmentation ever accompanied by itching?

Some, though not all patients, do experience itching of the skin prior to or while depigmentation is occurring. No research or studies have suggested a reason for this.

Will the vitiligo patches spread over time? Will they get larger?

In many, but certainly not all cases, vitiligo does progress slowly over time, but there is really no way to tell whether your vitiligo will progress or not. It is a slow progressing condition however, and many patients report that they may go many years without new patches developing, and then may discover new patches appearing years later. Some people even report spots that spontaneously repigment, with no treatment at all. Use of new technologies however, may be able to arrest new spots in their development.

What is segmental vitiligo?

Some people develop vitiligo only in one or a few limited areas of their body. This is called segmental vitiligo. People with vitiligo can have a combination of segmental and generalized vitiligo.

What is generalized vitiligo?

Most people find that their vitiligo develops in a generalized way, most often with bilateral characteristics, meaning that if a vitiligo patch appears on one elbow, it often appears on the other elbow about the same time.

Is vitiligo at all contagious?

Vitiligo is NOT contagious. If it were, many more people in the world, including doctors who treat vitiligo and family members of those with vitiligo, would have the condition. There are many theories about what causes vitiligo, but many experts believe, and data supports the theory, that one must be genetically susceptible, in order to develop vitiligo.

Where does the word "vitiligo" come from?

It is believed that the word "vitiligo" comes from Latin. The first part of the word, "viti" is from the Latin word "vitium" meaning a mark or blemish. The suffix, "ligo" is a common Latin ending meaning to bind or cause.

How do you pronounce the word "vitiligo"?

Many people pronounce this word incorrectly the first time they see it. But to hear it correctly, say the words "Little I Go." Then replace the first "L" with a "V" - giving you "Vittle I Go." Run the words together and you have the correct pronunciation.