Fair, dark, or any shade in between — most of us have skin that is generally the same color all over our bodies. But this isn't the case for people who have a condition called vitiligo.
Vitiligo is a loss of skin pigment that causes white spots or patches to appear on the skin. No one knows exactly why this happens, but it affects people of all races, many of them kids and teens.
Because vitiligo affects a person's appearance, it can be upsetting. But it isn't medically dangerous. It's not a form of skin cancer. It's not an infection like MRSA. And it's definitely not contagious, so you can't catch it from someone else. In fact, most of the people who have vitiligo are every bit as healthy as everyone else.
To explain vitiligo, it helps to know a bit about how skin gets its color in the first place. Skin color is determined by cells called melanocytes. They produce a pigment called melanin, which gives skin its color and helps protect it from the sun.
Skin color is determined not by how many melanocytes someone has (we're all born with a similar amount), but rather by how active the cells are. Dark-skinned people have cells that naturally produce a lot of melanin, while light-skinned people produce much less.
Sometimes, the skin suddenly stops producing melanin. At first, this might cause a small spot, called a macule, that's lighter in color than the skin around it. In time these white patches may spread and grow to cover a larger portion of the body. Sometimes these white patches spread quickly at first and then remain stable for years. Other times the spread is slower, occurring over a longer period of time.
Although vitiligo affects people of all races equally, the spots tend to be more noticeable on darker skin.
There are three types of vitiligo, depending on how many patches someone has and where they are on the body:
Vitiligo can happen anywhere on the body, but it's more likely to develop in some areas:
Because pigment cells give color to hair as well as skin, some teens with vitiligo may notice graying of the hair or a loss of color on the lips.
Experts don't know exactly what causes vitiligo, but they do have theories. Some think it's an autoimmune disorder and that the immune system is mistakenly attacking healthy melanocytes. Others think it's genetic.
Scientists do know that the risk of developing vitiligo increases in people with a family history of thyroid disease, diabetes, and certain conditions like alopecia (an autoimmune disease that causes hair loss).
A dermatologist can usually tell if someone has vitiligo just by looking for the telltale white patches. On people with fair skin, a special tool called a Woods lamp might be used. This lamp uses ultraviolet light in a dark room to illuminate areas of damaged skin that would otherwise be hard to see with the naked eye.
Your doctor will ask about your medical history, and probably also ask you about:
The doctor also may do a blood test to check for thyroid problems and diabetes, since they can increase the risk of vitiligo.
Very occasionally a doctor may perform a biopsy — removing a small piece of the affected area to check whether there are pigment cells in the skin. (The word biopsy might make you think of cancer, but in this case doctors aren't looking for cancer. People with vitiligo are at no greater risk of developing skin cancer than anyone else.) If the biopsy shows there are no pigment cells, the doctor can confirm a case of vitiligo.
There is no "cure" for vitiligo. Sometimes patches go away on their own. But when that doesn't happen, doctors can prescribe treatments that might help even out skin tone. Some of these treatments are things you can try at home; others are done by a doctor.
People and conditions are very different, so what works for one person may not work for another. And no vitiligo treatment is likely to be 100% effective at making the spots disappear altogether.
Some of the more common medical treatments for vitiligo include:
Researchers are looking into a new procedure called a melanocyte transplant. It works by removing a sample of normally pigmented skin and using it to grow new melanocytes in the lab. These can then be transplanted back into the depigmented skin to return some of the missing color.
Vitiligo isn't dangerous to your physical health. But it can still feel like a big deal if you're concerned about your appearance.
It's normal to feel like you want to cover up vitiligo, and you need to do what makes you most comfortable. But if you're starting to turn down every pool party or beach invitation, it's a signal to take back your life. If people ask about your skin, go ahead and explain — if you want to. It can help to know you're not alone. Even pop star Michael Jackson is said to have struggled with vitiligo.
In the end, if people still don't seem to get it, that's their problem, not yours. If you're feeling upset, get support from people you trust, whether that's a family member, friend, teacher, counselor, or support group. There are plenty of people who love you just the way you are.
Reviewed by: Patrice Hyde, MD
Date reviewed: July 2012
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