What is vitiligo?

Vitiligo is an acquired cutaneous pigmentary disorder characterized by depigmented patches on the skin due to loss of pigment-producing cells of the skin. It can affect up to 0.5%–2% of the world’s population. Both genders are equally affected.

Why does it occur?

Vitiligo is a multifactorial disorder and has a complex pathogenesis. The exact etiology is still not known. It occurs due to the absence of melanocytes in the skin due to their destruction. This destruction can cause depigmented patches on skin. The melanocyte destruction can be due to cytotoxic mechanisms, autoimmune mechanisms, intrinsic melanocyte defects, neural mechanisms, and oxidant-antioxidant mechanisms.

Is it genetic?

The inheritance of vitiligo may be due to genes associated with the synthesis of melanin, regulation of autoantibodies, and response to oxidative stress. Studies have shown that inheritance is complex and also involves both environmental and genetic factors.  

Does it spread by touch?

As it is a disorder which primarily occurs due to melanocyte destruction because of internal mechanisms, it does not spread by touch. Visible lesions can cause more distress and stigmatization and the general population may think it can spread by touch which can have both psychological and social impact on patients.

Can vitiligo be treated?

Early diagnosis and treatment can prevent the destruction of melanocytes. Diagnosis is mainly by clinical evaluation of the lesions. Treatment varies depending on the extent of the disease and stability of the patches. The treatment modalities include topical and systemic medications, phototherapy, laser therapy, and surgical therapies. Recent advances in treatment by the introduction of newer immunomodulators and novel surgical therapies are a ray of hope to patients. 

Take home message

Vitiligo is a treatable disease. It does not spread by touch, nor is it due to any curse. All white patches are not vitiligo. Any new patch on the skin must be brought to the notice of a dermatologist, as a prompt and quick treatment can bring the disease under control. Cultivating healthy lifestyle habits will be the cornerstone of the management. A wide variety of treatment options must be availed. Every patient with vitiligo deserves social and psychological support.

Dr. Suman S

MBBS, DVD (Dermatology), FRGUHS – Paediatric Dermatology

Consultant – Adult and Pediatric Dermatologist