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Vitiligo Information

Vitiligo or leukoderma is a skin disease that causes loss of pigment, resulting in irregular white patches of skin. The precise etiology of the disease is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic and environmental factors. The population incidence in the United States is between 1% and 2%. The incidence in other countries such as India is thought to be higher.

Half of vitiligo patients develop signs of the disorder before the age of 20, with patches of de-pigmented skin appearing on extremities. The patches may grow or remain constant in size. Occasional small areas may repigment as they are recolonised by melanocytes. The location of vitiligo affected skin changes over time, with some patches re-pigmenting and others becoming affected.

In some cases, mild trauma to an area of skin seems to cause new patches - for example around the ankles (caused by friction with shoes or sneakers). Vitiligo may also be caused by stress that affects the immune system, leading the body to react and start eliminating skin pigment.

Vitiligo on the scalp may affect the color of the hair (though not always), leaving white patches or streaks. It will similarly affect whiskers and body hair.

There are a number of ways to alter the appearance of vitiligo without addressing its underlying cause. In mild cases, vitiligo patches can be hidden with makeup or other cosmetic solutions. If the affected person is pale-skinned, the patches can be made less visible by avoiding sunlight and the tanning of unaffected skin. However, exposure to sunlight is preferable in the long run, because it helps the melanocytes regenerate to allow the pigmentation to come back to its original color.

Repigmentation therapies to remove the white patches include corticosteroids, calcineurin inhibitors, ultraviolet light and surgery, but they are not very effective. Current treatments include exposure to Narrow Band UV-B light, which seems to blur the edges of patches, and lightly freckling the affected areas. Immunomodulator creams are believed to cause repigmentation in some cases, but there is no scientific study yet to back this claim. Other more dramatic treatments include chemically treating the patient to remove all pigment from the skin to present a uniform skin tone. This is used by applying Monobenzone.

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