Vitiligo is a type of skin disease in which light colored areas occur due to loss of pigment in the skin. Because it causes an undesirable appearance, it also negatively affects our patients psychologically. It is an issue that should be emphasized especially in the summer period when the sun shows its effects more. It is important to start the treatment process as soon as the spots are noticed. Since the diseased area does not darken during the summer months, the clarity increases as the surrounding healthy skin becomes darker. This is especially important for us to know how to protect ourselves during this period. Before moving on to the treatment process, let’s first talk about the causes of vitiligo, the symptoms of the disease and how it progresses.
Vitiligo, which can be named in different ways as folklore or tawny disease, is observed in approximately 1 or 2 of every 100 people today, and the risk of this disease increases 7-10 times in people with a family history of vitiligo. Although it can be seen at any age, vitiligo, which starts to show symptoms before the age of 20, occurs because the cells called melanocytes, which are responsible for the production of pigments that give the skin its unique color, are damaged for any reason and adversely affect pigment production.
Depending on the lack of pigment, some white spots of various sizes appear on the surface of the skin. Although the exact cause of the damage to pigment production is unknown, one of the most important factors responsible for the development of the disease is the ‘autoimmune’ mechanism. In other words, the body’s immune system sees its own pigment-producing cells (melanocytes) as a threat and develops a defense against them and destroys its own cells. Apart from this, it is thought that many causes such as anemia, diabetes, psoriasis, goiter, stress, sunburns and feverish diseases may be factors, even if not specified.
If a certain spot suddenly turns white, beware!
In some types of vitiligo, only a certain part of the body is affected, while in some patients the spots can spread throughout the body. Symptoms of the disease usually occur in areas exposed to sunlight. For this reason, in this period as we enter the month of June, white spots, which are the symptoms of the disease, are more likely to be seen in areas such as hands, arms, face, neck and legs that are in more contact with the sun.
Depending on the structure of the skin, the first and most general symptom of vitiligo, which we notice more easily in women than in men, and in dark-skinned people, is the sudden whitening of a certain spot on the skin. In some cases, a small white spot can grow over time and cover a significant part of the skin. However, let’s add that vitiligo is not a contagious disease and does not cause any physiological problems in patients other than appearance.
Early diagnosis and early treatment is very important
Vitiligo can sometimes occur as a result of contact with chemicals, for example, vitiligo on the hand can be triggered by bleach. In the treatment of vitiligo, which includes restoring the skin to its former color, early diagnosis is very important in the success of the treatment. During the physical examination, which must be done by a specialist physician, white spots must be detected first. We use the light called Wood’s light to increase the visibility of the stains and to determine the color differences that are not visible in normal light. It is possible to detect it by clinical examination and examination under Wood’s light, and in some cases, if we deem it necessary, we also use different diagnostic tests such as skin biopsy and pathological examination. If the problem is the immune system, it is possible to have some blood tests done.
Pigment cells are stimulated by light therapy.
Regardless of the cause of the disease, light therapy can be applied if deemed appropriate by the physician. The aim is to stimulate the melanocytes, which are responsible for giving the skin its natural color. Light therapy, also called phototherapy and excimer laser therapy, is an application aimed at preventing the formation of spots and eliminating existing spots by supporting the production of the pigment called melanin, which gives color to the skin from melanocytes. Antioxidant supplements can also be applied to patients with vitiligo to reduce oxidant stress.
It is possible to benefit from some creams in the treatment of the disease. Creams containing tacromilus and pimecrolimus or containing cortisone can be used. It is aimed to remove the spots that occur due to the disease and to prevent the formation of new spots. However, all these creams should be used under the supervision of a physician, as they may cause structural disorders and differentiations in the skin due to long-term use.
How should the treatment be in patients with large spots?
Depigmentation is another treatment method that can be preferred in patients where white spots spread to the whole body and the size of the spots is very large. With this treatment, the pigments on the entire skin surface are destroyed and the whole body is equalized in white color. The pigment loss that occurs in this treatment with a chemical called monobenzylether is permanent and the treatment lasts for approximately 1 year.
Since vitiligo disease accelerates the formation of spots due to the sun and white spots can easily burn in the sun, patients should definitely use sunscreen with a high protection factor. These creams should be chosen among the products of the brands recommended by the physician and should be used continuously, not only in cases such as sunbathing or swimming, but also at all times of the day when outdoors. When sunscreen is not applied, white spots become intensely red in the sun, which can lead to greater discomfort.
Psychological treatment should not be skipped either.
If you also have vitiligo disease, you should know that if you pay attention to the doctor’s recommendations and treatment steps, you can largely eliminate the effects of your disease. In our patients, we observe psychological problems such as unhappiness, decreased self-confidence, depression and stress due to the change in external appearance. For this reason, if you have vitiligo, I recommend you as a physician to receive psychological support in addition to the treatment for the disease.
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