Sunday, August 7

Vitiligo, what happens when the skin loses its color?


Skin color is related to melanin release by melanocytes. These pigments serve to protect the epidermis and the deep layers of the skin from external aggressions, in particular from the action of the sun’s rays.

The quality of melanin, as well as its quantity, are key to skin color. The progressive disappearance of melanocytes is at the origin of skin discoloration. And this is when we talk about vitiligoa degenerative skin pathology that causes a disorder in skin pigmentation.

what is vitiligo

This skin disease It affects almost 3% of the population.especially in women and, although it can start at any age, in 90% of cases it appears before the age of 40, according to the Spanish Society of Internal Medicine (SEMI).

As highlighted by the Spanish Association of Dermatology and Venerology (AEDV) and the Association of Vitiligo Patients in Spain (ASPAVIT), it is a disease about which there is still significant ignorance by the general population. On the occasion of World Vitiligo Day, June 25it is a good time to try to clear up some of the main doubts about this skin disease.

When the skin loses pigmentation

in vitiligo, the skin loses its pigmentation when the melanin-producing cells, the melanocytes (skin cells), are attacked and gradually disappear (without melanocytes, the skin turns white). They are areas with little or no melanin, the skin’s natural pigment, which forms white spots. Depigmentation can appear at any time in life, at any age, regardless of skin color or gender.

Although there are different theories about the origin of the disease, it is believed that vitiligo is an autoimmune disorder, that is, it is the body’s own immune system that turns against itself. The body destroys its melanocytes because it sees them as foreign bodies.

It is also believed that there are some certain predisposing factors (inherited, esteemed in 30% of cases) and precipitants (environmental) that are involved in vitiligo. In some cases, vitiligo can be caused by physical trauma or emotional stress (the release of neuromediators during psycho-emotional stress could promote the disappearance of melanocytes). The causes of vitiligo can coexist with other diseases such as thyroid damage, anemia, diabetes, alopecia areata or psoriasis.

How vitiligo manifests itself

Vitiligo often begins in the form of white spots They can appear anywhere on the body, although they tend to appear first in areas that receive a lot of sun exposure, such as the face, arms, feet, and hands.

How does vitiligo usually present? In most cases it appears in the form of:

  • depigmented spots white or cream in color, variable in size and shape
  • convex edges with normal skin color
  • In most cases the stain has no reliefalthough it may be slightly elevated
  • Exceptionally, it has been described trichrome vitiligo (three shades)

Although many people do not have any other symptoms, others may also feel other signs such as:

  • hair that turns gray or white prematurely
  • Eyelashes and eyebrows that lose color and they also turn white
  • Color change in the retina Of the eye
  • Loss of color in the nose and mouth
  • Inflammation of ears or eyeswhich can lead to hearing loss and vision problems

As we have seen, vitiligo is a disease with a significant impact on an aesthetic level, therefore, it can have repercussions on a psychological level, but it is neither contagious nor painful. This, together with its unpredictable evolution, can lead to impaired quality of lifenot only in relation to others, but with oneself.

What is the treatment for vitiligo?

Although vitiligo can’t be cured There are medical treatments that target the immune system and try to reverse the destruction of melanocytes. The goal is to stop the loss of melanocytes, help proliferation and prevent recurrences (it is estimated that 40-50% of vitiligo lesions recur in the first year after repigmentation).

The steroid creams and anti-inflammatory creams Non-steroidal steroids are one of the safest and simplest treatments, especially for newly diagnosed or spreading vitiligo.

It can also be treated with phototherapy (light therapy) or even melanocyte transplants (Useful for localized and stable vitiligo and for segmental forms). Treatments aim to block depigmentation, include repigmentation, and prevent recurrence. It should be noted that the more active and stubborn the vitiligo, the faster it needs to be treated.

It is urgent to determine if vitiligo is in the active phase in order to propose a treatment that blocks this scalability. In the case of non-active vitiligo, one of the reference treatments is based on the combination of phototherapy and topical treatment.

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