Vitiligo, the skin disease that, despite being common, is very little known

Despite being a relatively common skin disease, vitiligo is one of the least known and most poorly understood disorders among both the general public and the medical profession.

It is a common disorder that affects between 0.5% and 1.0% of the world’s population, according to the United States National Institutes of Health (NIH). However, many cases may go unreported and some researchers estimate that the condition may occur in 1.5% of the population.

The disease causes the skin – and sometimes the hair – lose their pigmentation and turn white. It may be more noticeable in dark-skinned people, but the frequency with which it occurs is similar in all ethnic groups.

vitiligo It is not an infection and cannot be spread..

However, it is a disorder that causes enormous concern and distress for those who suffer from it.

It can also raise issues of cultural identity when a dark-skinned individual faces the possibility of a future with white skin.

Contrary to popular belief, any person, man or woman, Regardless of your skin color, you can develop vitiligo.

The disease, which is chronic, causes the appearance of white or pale patches on the skin in which melanin is lost.

The melanin It is a substance responsible for skin pigmentation, which is produced by specialized cells called melanocytes.

In addition to giving color to the skin, melanocytes protect it from the sun’s rays.

But when melanocytes are damaged or destroyed, the pigment is lost and vitiligo develops.

The disease can occur in any area of ​​the skinbut it usually appears on parts that are exposed to the sun, such as the face, neck, and hands.

It may be more noticeable in people with dark or tanned skin and varies from person to person.

Can classified into two typesdepending on how and in which regions of the body depigmentation occurs.

SegmentalAlso called unilateral vitiligo, it commonly appears at an early age, with patches of discoloration in just one area of ​​the body.

It can occur on one leg, one side of the face, or in several areas on just one side of the body.

Approximately half of those who suffer from this type of vitiligo may experience hair loss in the regions where there is discoloration.

Non-segmental: is the most common form of the condition. It is also known as generalized or bilateral vitiligo. With this type the patches appear symmetrically on both sides of the body.

This classification also has subtypes:

• Acrofacial: affecting the face, head, hands and feet.
• Mucosal: affects the oral and genital mucosa.
• Universal: It is the most severe condition, but also the rarest. It extends over 80% to 90% of the skin.

According to the organization The Vitiligo Society, 70 million people have the condition and between 20% and 35% of patients are children.

Vitiligo usually begins to appear at age 20, although it can develop at any age.

And it affects men and women of any ethnic origin.

It is an autoimmune disorder and not simply a “cosmetic” problem.

Until now, it has not been possible to know what the cause of vitiligo is, but it is not an infection and cannot be spread from one person to another.

Since it is unknown what causes it, it is impossible to predict, once a first spot of vitiligo appears, how much of the skin will be affected.

and the white spots are often permanent.

Vitiligo does not cause physical symptoms, in addition to the fact that the spot can burn in the sun if it is not protected.

But it can cause a enormous psychological distress for the affected person, especially if white patches appear on the face, neck, hands or genitals.

“Vitiligo is a highly visible disease that can affect a lot psychologically and emotionally,” Nina Goad, from the British Association of Dermatologists, told the BBC.

According to the expert, although vitiligo may be more noticeable in dark skin, the degree of psychological distress it causes is not necessarily linked to skin color or how widespread the disease is.

However, he adds, when the disorder spreads throughout much of the body, dark-skinned people from certain ethnic groups may feel particularly stigmatized due to a fear of losing their cultural identity.

It is impossible to predict how the disease will develop. Some people do not notice changes in skin spots for years, but in other cases the disorder can spread quickly.

Also Sometimes white spots can regain their pigmentparticularly in children, although it is not usually the case that the disease cures itself without treatment.

In general, specialists usually prescribe a combination of treatments, such as phototherapy (ultraviolet light therapy) with drugs, usually corticosteroids applied to the skin.

But corticosteroids are only effective in less than 25% of patients and ultraviolet light can cause irregular repigmentation of the skin and, in the long term, may increase the risk of skin cancer.

The United States and the European Union have approved a drug to treat non-segmental vitiligo under the trade name Opzelurawhose active substance is ruxolitinib.

The medication comes in the form of an ointment and is applied directly to the affected areas.

Approximately half of the patients who used it twice a day reported significant improvement and approximately a sixth achieved complete recovery of pigmentation in three months.

However, the formula has several contraindications. It can affect the immune system and cause acne and irritations where it is applied. Besides, each tube of Opzelura costs US$2,000.

On the other hand, a study published in the Journal of Dermatology (Journal of Dermatology) revealed that piperinethe compound responsible for the spicy flavor of black pepper, stimulates skin pigmentation by increasing the production of melanocytes.

However, anything that causes an increase in melanocytes also leads to greater melanoma riskthe most lethal form of skin cancer.

Therefore, it has not yet been proven whether piperine can be used in humans to treat vitiligo without this dangerous side effect.

The US-based Global Vitiligo Foundation points out that there is very little funding allocated to research to better understand the disease and develop new treatments.

*This is an update of an article originally published on April 11, 2011.

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